Policy Uncertainty is Creating Challenges for ACA Marketplace Insurers
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.
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CMS Marketplace Rule’s Sunset Provisions Could Help Congress Find Budget Reconciliation Savings
Quick TakeA CMS rule, once finalized, is generally intended to exist permanently or until it is repealed....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.
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Medicaid Changes in House and Senate Reconciliation Bills Would Increase Costs for 1.3 Million Low-Income Medicare Beneficiaries
Issue BriefOn May 22, the House passed a reconciliation bill, the One Big Beautiful Bill Act, which would partially pay to extend expiring tax cuts by cutting Medicaid. The Congressional Budget Office (CBO) estimates that the bill would reduce federal Medicaid spending by $793 billion over ten years and 10.3 million fewer people would be enrolled in Medicaid in 2034, including 1.3 million people with Medicare, otherwise known as “dual-eligible individuals”.
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How the Reconciliation Bill Limits States’ Authority Over ACA Insurance Markets
Quick TakeTaken together, the reconciliation bill's provisions impose additional administrative burdens on state-based marketplaces and could limit state flexibility in choosing marketplace policies and procedures.
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5 Key Facts About Medicaid and Pregnancy
Issue BriefThis brief examines Medicaid’s pregnancy and postpartum coverage and its support for strengthening and improving maternal health outcomes.
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Utilization of Health Care Services by Medicaid Expansion Status
Issue BriefSome critics of Medicaid expansion have argued that expansion diverts resources away from other groups of Medicaid enrollees, including people with disabilities and children, and that expansion enrollees are “able-bodied” implying they have minimal health care needs. However, data show that expansion states spend more per enrollee overall and on each eligibility group than non-expansion states and that nearly half of expansion enrollees have a chronic condition. This data note analyzes 2021 Medicaid claims data to compare utilization of health care services among Medicaid expansion enrollees with other Medicaid enrollees in expansion states and to compare utilization of health care services among adult Medicaid enrollees living in expansion and non-expansion states.
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Implementing Work Requirements on a National Scale: What We Know from State Waiver Experience
Policy WatchOn May 18, the House Budget Committee advanced a budget reconciliation bill that includes significant changes to the Medicaid program. As anticipated, Medicaid work requirement provisions are included and preliminary estimates released by the Congressional Budget Office (CBO) show that this provision would reduce federal spending by $280 billion over ten years, nearly half of all estimated Medicaid savings in the bill. The provisions raise many operational and implementation questions, particularly considering the experience of Arkansas and Georgia with implementing work requirements through waivers.
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Medicaid Eligibility for Katie Beckett Children with Significant Disabilities and Special Income Rule
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Medicaid Eligibility through Buy-In Programs for Working People with Disabilities
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Medicaid Eligibility for SSI Enrollees and Optional Seniors & People with Disabilities Up To 100% FPL
State Health Facts IndicatorMedicaid eligibility, seniors, people with disabilities