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The ACA enhanced premium tax credits expanded financial assistance to more Marketplace enrollees, an expansion that was especially helpful to older middle-income enrollees, who would see the largest increases in out-of-pocket premiums if the enhanced credits expire.
Medicaid represents $1 out of every $5 spent on health care in the U.S. and is the major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.
Take this ten-question quiz to see how much you know about how the ACA affects health insurance coverage and costs as well as who is eligible for financial assistance
After failed Senate votes late last year and no subsequent bipartisan agreement, the enhanced premium tax credits expired as of January 1. Some states, particularly those operating State-Based Marketplaces (SBMs), have been preparing for this possibility for months and are moving to blunt the impact on consumers by implementing their own state-funded subsidies and implementing other programs aimed at stabilizing the cost of unsubsidized premiums.
Editor's Note: The press release was updated on March 27, 2023, to reflect corrections in the underlying analysis, resulting in a modest increase in the total estimated value of tax exemption, from $27.6 to $28.1 billion. The tax-exempt status of the nation’s nonprofit hospitals collectively was worth about $28 billion in 2020, a new KFF analysis of hospital financial data estimates. The total reflects the estimated federal, state and local taxes that nonprofit hospitals do…
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.
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.
House Republicans are considering deficit reductions of $5.5 trillion, which includes $2.3 trillion cuts in Medicaid… Cuts of this magnitude would put states at financial risk, forcing them to raise new revenues or reduce Medicaid spending
The ACA's enhanced premium tax credits expired at the end of 2025. This calculator estimates how much out-of-pocket premium payments would increase for families without the enhanced credits. The projected premium increases are estimated based on family income, zip code, size, ages, and 2026 ACA Marketplace premiums.
The budget resolution is unusual because it establishes different tracks for reconciliation in each chamber: House committees are instructed to increase deficits by $2.3 trillion, with major cuts to Medicaid; and Senate committees are instructed to increase deficits by what amounts to $5.8 trillion, without clear implications for Medicaid cuts.
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