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The House of Representatives recently passed a budget reconciliation bill that would appropriate funding for cost-sharing reductions that insurers are required to provide to low-income enrollees in the Affordable Care Act marketplace. This policy watch explains what these cost-sharing reductions are, how they relate to federal spending, and what effect appropriating funding might have on premiums and the uninsured rate.
Until Congress passes the reconciliation bill, Marketplace insurers will face uncertainty regarding the regulatory landscape and may find it difficult to set premiums for 2026.
A CMS rule, once finalized, is generally intended to exist permanently or until it is repealed.... This temporary implementation may preserve the potential for the reconciliation bill to generate official savings through changes to ACA marketplaces in later years (2027–2034) if enacted.
This brief looks at changes to Marketplace plans recently finalized by the Centers for Medicare and Medicaid Services (CMS) that may incentivize insurers to make their plans less generous. With less generous plans, consumers could face higher out-of-pocket costs, though those who don't qualify for premium tax credits could see lower premiums.
Prior KFF analysis allocated CBO’s federal Medicaid spending reductions and enrollment losses across the states, and this policy watch builds on that analysis to examine the potential impacts in expansion states compared with non-expansion states.
This analysis details the number of people who would become uninsured from policy changes in the ACA Marketplaces and Medicaid. The Congressional Budget Office estimates that, taken together, these changes will result in 16 million more uninsured people in the year 2034 than would otherwise be the case.
In a new column, Dr. Drew Altman, KFF’s President and CEO, discusses the limits of polling on policy, and what we have learned over more than 30 years of polling about how giving people more information and arraying tradeoffs can change opinion, including on the health policy changes and funding cuts in the current reconciliation bill.
KFF's Health Tracking Poll looks at public awareness and support for ACA Marketplace subsidies and finds that most adults are unaware the subsidies are set to expire soon. Three in four say Congress should extend the subsidies and support persists despite hearing counter arguments.
With the Affordable Care Act’s (ACA) enhanced premium tax credits set to expire at the end of 2025, a large majority (77%) of the public favor Congress extending the credits while about one in five (22%) say they should let them expire, the latest KFF Health Tracking Poll finds.
This policy watch discusses key provisions in the draft 2025 budget reconciliation legislation that are aimed at limiting health coverage for immigrant families.
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