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This brief highlights some of the key federal agencies and offices that play a role in making Medicare work and, to the extent possible, describes the recent staffing and organizational changes made by the Trump administration that could affect the operations of Medicare in the future.
On May 30, 2025, the administration released additional details of its Fiscal Year 2026 budget request, including more specific information on funding for global health activities at the State Department, U.S. Agency for International Development (USAID), Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH).
Every summer, health insurers submit rate filings to state regulators detailing expectations and justifying premium rate changes for ACA-regulated health plans for the coming year. With the enhanced premium tax credits set to expire at the end of 2025, consumers can expect increases in how much they pay for coverage.
This tracker provides a listing of global health-related legislation introduced in the current Congress.
The Trump administration is proposing a reorganization and staffing cuts at HHS that create uncertainty about the potential effects on older adults, who receive services authorized under the Older Americans Act. This brief provides an overview of programs and services provided under the Older Americans Act, the role played by the Administration for Community Living in administering these programs, and trends in program funding and service utilization by older adults.
The House budget reconciliation bill contains various expansions to Health Savings Accounts (HSAs). This policy watch explains what HSAs are, how they have been used, what the key changes to HSAs would be, and how much they would cost the federal government.
This analysis examines the potential impacts of a provision in the House reconciliation bill that proposes reducing the federal matching rate for the Affordable Care Act (ACA) Medicaid expansion population from 90% to 80% for states that either provide health coverage or financial assistance to purchase health coverage to individuals who are not “a qualified alien.”
If enacted into law in its current form, and Congress takes no further action, [the House reconciliation bill's] increase in the deficit would trigger mandatory cuts, also known as sequestration, under the Statutory Pay-As-You-Go Act of 2010.
In his latest column, President and CEO Drew Altman shows how proposals contained in the House reconciliation bill could result in a one-third reduction in ACA Marketplace enrollment. “While all eyes are on the big Medicaid cuts being proposed in the House,” he writes, “significant changes are also being proposed that together would dramatically reduce enrollment in the ACA Marketplaces.”
This analysis illustrates how provisions included in the House budget reconciliation bill could expose Marketplace enrollees with unpredictable incomes to higher penalties when filing taxes if they underestimate their incomes. About one in four potential Marketplace shoppers had incomes that varied at least 20 percent from the beginning to the end of the year.
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