Early 2026 Rate Filings Show Marketplace Policy Changes Contribute to Eye-Popping Rate Increases This year, insurers are setting their rates for 2026 while Congress and the administration weigh several policies that are projected to cause premiums to spike and the number of people with Marketplac...

What voters *thought* they were voting for in November:
- cost relief
What voters are getting:
- eye-popping premium hikes due to Trump's budget bill
chirblog.org/early-2026-r... @staceypogue.bsky.social

Reconciliation Bill and End of Enhanced Subsidies Would Cut Health Care Provider Revenue and Spike Uncompensated Care The House of Representatives passed, and the Senate is now negotiating, a budget reconciliation bill that would impose federal funding cuts on Medicaid and the ACA Marketplaces.

Holy cow - provider losses if the tax reconciliation bill passes would approach $1 trillion. Yes, that's trillion with a "t"! www.urban.org/research/pub...

Don't miss this event - it's a great opportunity to hear from innovative state leaders on ways to improve health care affordability!

The Sleeper Provision in the Reconciliation Bill That Could Hobble the ACA Marketplaces An obscure provision in the U.S. House reconciliation bill could have major consequences for the Affordable Care Act Marketplaces. In a guest post for CHIRblog, the Urban Institute's Jason Levitis and...

Does the House GOP reconciliation bill take health insurance away from newborn babies? Why yes, yes it does. If you read nothing else today, read this post from CHIRblog guest authors @jasonlevitis.bsky.social and @clinkeyoung.bsky.social chirblog.org/the-sleeper-...

Death by Slow Strangulation: New Tactics in Longstanding Efforts to Repeal the Affordable Care Act The U.S. House of Representatives is poised to take up legislation that, if enacted, would be tantamount to a repeal of the Affordable Care Act (ACA) for millions of Americans who will lose their heal...

The House reconciliation bill = Affordable Care Act repeal, just under a different name. In addition to devastating Medicaid cuts, millions of moderate-income people will lose insurance/face higher costs & red tape. Our take: chirblog.org/death-by-slo...

Kennedy Swims in Washington Creek That Flows With Sewage and Bacteria

Maybe his brain worm needed company? www.nytimes.com/2025/05/12/u...

You can’t cut hundreds of billions from #Medicaid without harming people. New CBO analysis confirms proposals House Republican have floated would leave millions uninsured, each slashing billions from Medicaid w/ $170b-$472B in cuts coming from lower enrollment . www.cbo.gov/system/files...

Chairman Guthrie Introduces Budget Reconciliation Text to be Marked Up The Committee on Energy and Commerce is the oldest standing legislative committee in the U.S. House of Representatives and is vested with the broadest jurisdiction of any congressional authorizing com...

Congress' twisted idea of a Mother's Day gift: a reconciliation package, that, when added to its failure to extend Marketplace tax credits, throws 13.7 MILLION people off of their insurance coverage. energycommerce.house.gov/posts/chairm...

A New Rule to Limit ACA Enrollment Periods May Deter Sign-Ups and Worsen Risk Pools

In our latest post for @commonwealthfund.org, Rachel Swindle & I delve into a proposed ACA rule that limits enrollment opportunities and increases paperwork. The result? Up to 2 million people to lose coverage in 2026. www.commonwealthfund.org/blog/2025/ne...

Job announcement! The Georgetown Center on Health Insurance Reforms is seeking a Research Fellow to support projects focused on health care access and affordability. Great team, great work, great benefits - win win win! Check out our job announcement: chir.georgetown.edu/index/jobs/

If the Supreme Court rules to end the ACA's preventive services benefit in Braidwood case, states can help preserve access for their residents. @tarastraw.bsky.social & my roadmap: www.shvs.org/protecting-a...

Fact Sheet on CMS Marketplace Rule -- Final 4-11-25.pdf | Powered by Box

Trump administration proposal would be "death by a thousand cuts" for the Affordable Care Act - up to 2M people would lose coverage, millions more would face higher costs. @jasonlevitis.bsky.social @clinkeyoung.bsky.social and I sum it up: georgetown.app.box.com/file/1831720...

Trump Administration Highlights: Cuts of 10,000 Jobs at Health Agency Reflect Kennedy’s and Trump’s Priorities

CMS recently reinstated the Marketplace brokers suspended last year for enrolling people in plans w/o consent. They deserve "due process," officials said. Apparently, these days you get due process if you're a fraudster, but not if you're a federal public servant www.nytimes.com/live/2025/03...

Here’s Something to Celebrate: The Affordable Care Act Just Turned 15! On March 23, 2025, we celebrated the 15th anniversary of the Affordable Care Act (ACA). In this post, CHIR experts reflect on how the law's reforms affected people's access to affordable, high quality...

Here's something to celebrate! The ACA just turned 15: chirblog.org/heres-someth...

Trump administration proposes ACA program integrity rule that would decimate enrollment The rule is like “making people crawl through broken glass” for health insurance, one expert said.

The Trump Administration’s proposed sweeping rule changes will raise premiums, increase costs, and make enrollment harder. Its own estimates show 2M people losing coverage. @sabrinacorlette.bsky.social says it’s like making people “crawl through broken glass.” www.healthcaredive.com/news/trump-a...

So let's call it what it is...yet another attempt by President Trump and his team to sabotage the ACA. As their own proposal acknowledges, the result will be a lot more people losing health insurance.

There is nothing in the rule that would address the vulnerabilities associated with using EDE vendors, nor is there anything that strengthens CMS' ability to go after bad brokers or the scammy lead generators that are causing the fraud in the federal marketplace.

A 90% Cut to the ACA Navigator Program Cutting funding for the trusted and impartial source of important information Navigators provide could have big impacts just as many consumers may need to re-evaluate their coverage options.

And by the way, they want to increase the bureaucracy and complexity of the process for people at the same time they've slashed funding for consumer assisters (Navigators) by 90%. www.kff.org/quick-take/a...

This new Marketplace rule first mis-diagnoses the problem, then proposes solutions that will (1) increase paperwork burdens on low- and moderate income people and (2) hike premiums for low- and moderate income enrollees.

Notably, none of the SBMs use EDE vendors (except for Georgia, which just launched their SBM this year). So they haven't had the fraud experienced by the federally run states.

Policymakers Can Protect Against Fraud in the ACA Marketplaces Without Hiking Premiums Policymakers can strengthen oversight of entities involved in selling coverage to address fraud and ensure integrity in the ACA marketplaces.

Is this a problem? YES. And CMS has taken steps to fix it, with signs of improvement. The main culprit is unscrupulous brokers taking advantage of vulnerabilities with HealthCare.gov and the web-brokers (called "EDE vendors) the feds use to drive enrollment. www.commonwealthfund.org/blog/2025/po...

But what they don't acknowledge is that the state-based Marketplaces (SBMs) adopted the SAME (and often more generous) enrollment and affordability policies as the Biden admin, and they've had NO MEANINGFUL FRAUD. The fraud has been in the states where the feds run the marketplace (FFM).

Their basic thesis is that the Biden administration made it too easy and affordable for people to sign for health insurance, which has led to millions of fraudulent enrollments and higher costs for taxpayers.

Here's a thread (is it called a thread on Bluesky?) about the Trump admin's new ACA or "Marketplace Integrity" proposal... www.cms.gov/newsroom/fac...

Trump Health Care Proposal Billed as Consumer Protection but Adds Enrollment Hoops - KFF Health News The proposal also would reverse a Biden administration policy that allowed “Dreamers” — immigrants in the country illegally who were brought here as children — from qualifying for subsidized ACA cover...

Once again, the Trump administration is trying to take down the Affordable Care Act, under the guise of preventing "fraud." What's galling about that is instead of taking on real fraud, their new rule would punish low- and middle income consumers. kffhealthnews.org/news/article...

The Trump administration's war on the ACA continues, with a new proposed rule that - in their OWN words - would "increase administrative burden" and "deter some eligible low-income" from enrolling. The proposal = more paperwork + higher premiums. www.cms.gov/newsroom/fac...

Policymakers Can Protect Against Fraud in the ACA Marketplaces Without Hiking Premiums Policymakers can strengthen oversight of entities involved in selling coverage to address fraud and ensure integrity in the ACA marketplaces.

What to do about broker fraud in the ACA Marketplaces? My colleagues @staceypogue.bsky.social and Justin Giovannelli have answers, for @commonwealthfund.org. www.commonwealthfund.org/blog/2025/po...

State Spotlight: New Massachusetts Law Enhances Oversight of Private Equity in Health Care Massachusetts has recently enacted a law to increase transparency and oversight of private equity in healthcare following the collapse of Steward Health Care, which exposed risks from private equity p...

The latest state in Gtown CHIR's State Spotlight series is...Massachusetts! In the wake of Steward Health Care's collapse, the state has adopted a number of reforms to beef up oversight of private equity and protect consumers. chirblog.org/state-spotli...

Coverage Matters: Enduring and Recent Evidence As the federal budget reconciliation process heats up, Congressional committees will soon be drafting legislation that spells out the program cuts Congress will need to offset the cost of extending ex...

As Congress debates massive cuts to Medicaid and ACA, some on the right are suggesting that having health insurance is bad for people. Gtown CHIR's Karen Davenport takes this self-serving argument head on: chirblog.org/coverage-mat...

Events - Center on Health Insurance Reforms Health care is big business and is getting bigger. In recent years, health care mergers and acquisitions have ramped up, more corporate entities have entered the market, and maximizing profit has rise...

The final webinar of GtownCHIR's Corporate Transformation of Health Care series focused on SOLUTIONS. Thank you Jane Beyer, Evan Klein, Charles Miller & Meg Garratt-Reed for sharing your insights. If you missed any episodes, don't worry! Watch the recordings here:
chir.georgetown.edu/events/