Marketplaces

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 documents average deductibles for Affordable Care Act Marketplace plans available on Healthcare.gov in 2025 for all metal tiers, including silver plans after cost-sharing reductions are applied, as well as trend data since 2014.

Legislation passed by the Energy and Commerce Committee could increase the number of people without health insurance by 8.6 million, due largely to changes to Medicaid and the ACA. Combining the provisions with the effect of the expected expiration of the ACA’s enhanced premium tax credits, CBO expects 13.7 million more people will be uninsured in 2034.

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.

This policy watch discusses key provisions in the draft 2025 budget reconciliation legislation that are aimed at limiting health coverage for immigrant families.

This analysis details the number of people who would become uninsured from policy changes in the ACA Marketplace and Medicaid. The Congressional Budget Office estimates that, taken together, these changes will result in at least 13.7 million more uninsured people in the year 2034 than would otherwise be the case.

In his latest column, president and CEO Drew Altman discusses why debate about extending the ACA enhanced tax credits set to expire this year has been slow to develop, and why it could matter to Republicans politically if the tax credits are not extended.