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  • Implications of Congress Eliminating Major Biden Era Regulations for Medicaid

    Policy Watch

    The Biden administration finalized several major Medicaid regulations with the intent of improving access to Medicaid services. Collectively, the rules span hundreds of pages of text, are extremely complex, and were set to be implemented over several years, with measurable increases in federal Medicaid spending. Overturning the rules would reduce regulation of managed care companies, nursing facilities, and other providers; increase barriers to enrolling in and renewing Medicaid coverage, and roll back enrollee protections, payment…

  • The Effect of Delaying the Selection of Small Molecule Drugs for Medicare Drug Price Negotiation

    Policy Watch

    In a new Trump administration executive order, the Secretary of HHS is directed to work with Congress to implement a change in law to delay negotiation of so-called “small molecule” drugs under the Inflation Reduction Act's Medicare Drug Price Negotiation Program for an additional 4 years. This brief analyzes how many of the drugs previously selected for negotiation would not have been eligible if this policy had been in place at the time.

  • Enrollment Growth in the ACA Marketplaces

    Policy Watch

    This analysis of enrollment in Affordable Care Act (ACA) Marketplace health plans finds a record 24.3 million people enrolled in 2025, more than double the total in 2020, with most of the growth occurring in states won by President Trump in the 2024 election. In six states, enrollment more than tripled from 2020 to 2025: Texas, Mississippi, West Virginia, Louisiana, Georgia, and Tennessee.

  • Will the Trump Administration Fast Track the Privatization of Medicare?

    Policy Watch

    The privatization of Medicare has been taking place without much public debate – a trend that has implications for the 68 million people covered by Medicare, health care providers, Medicare spending, and taxpayers. It's not yet clear whether the administration will promote policies to accelerate the privatization of Medicare or focus more on achieving efficiencies and savings within Medicare Advantage, or pursue policies that aim to achieve both. How this plays out will have implications…

  • Who Might Lose Eligibility for Affordable Care Act Marketplace Subsidies if Enhanced Tax Credits Are Not Extended?

    Policy Watch

    This analysis looks at the individual market enrollees who make at least four times the federal poverty level who would no longer be eligible for any tax credits if the current ACA Marketplace enhanced subsidies expire at the end of this year. Compared to other people with similar incomes, these enrollees are more likely to be early retirees, self-employed and living in rural areas.

  • The Outlook for PEPFAR in 2025 and Beyond

    Policy Watch

    PEPFAR, the U.S. global HIV/AIDS program, is - for the first time in its two-decade history - facing significant challenges that could impede its ability to fulfill its mission. This policy brief provides an overview of recent events and ongoing challenges facing the program.