ACA enhanced premium tax credit subsidies on the negotiating table
Democrats are reportedly eyeing a deal to push the expiration of enhanced tax credits for Marketplace coverage.
Congress has until Sept. 30 to avert a government shutdown, which would require bipartisan support to approve stop-gap funding for federal agencies. With 2026 midterm elections top of mind for many members, Congressional Democrats are wary of working with the party that made $1 trillion in cuts to Medicaid and Marketplaces that will result in 10 million more uninsured people in the nation. Still, Democrats may try to head off the expiration of enhanced health insurance subsidies in exchange for working across the aisle, Politico reports.
Too Poor for Affordable Health Insurance: CBO Breaks Down H.R.1 Marketplace Coverage Loss Impacts and Fraud Claims
The Congressional Budget Office (CBO) released the numbers underpinning its projection that 2.1 million individuals will go uninsured due to H.R.1’s Affordable Care Act (ACA) Marketplace provisions. About half of that coverage loss is the result of eliminating premium tax credit (PTC) eligibility for some categories of lawfully present noncitizens, and the other half is from making it more difficult for individuals to sign up for and maintain Marketplace coverage.
These losses are on top of CBO’s estimate that 4.2 million people will go uninsured if Congress does not act to extend Marketplace enhanced premium tax credits (ePTC) and that another 1.9 million will lose coverage through the implementation of CMS’ Marketplace Integrity and Affordability final rule. Together, that could raise the number of newly uninsured people by as many as 8 million.
In the report, CBO analyzes potential incidences of enrollment fraud and estimates that 2.3 million people earning less than 100% of the FPL ($15,060 for the 2025 PTC calculation) inappropriately projected their income to be above 100% of the FPL.
However, CBO gives short shrift to the fact that income projection is a feature of the ACA’s advance PTC and that income clairvoyance is an impossibility, particularly for individuals with low and unpredictable income.
Keep reading at The 80 Million.
ICYMI: Eroding the American Dream: The Roll-back of Health Coverage and Care for Lawfully Residing Immigrants
H.R.1 includes major policy and funding changes that scale back access to health coverage for many lawfully residing noncitizens beginning next year. These changes are estimated to leave 1.3 million more immigrants uninsured, undermining their access to healthcare. At the same time, the Trump administration has announced similar restrictions on noncitizen immigrants’ access to other federally-funded health and human service programs. These policy actions are aimed at noncitizen immigrants who “play by the rules” — they are in the country under a legal status — impeding their ability to work and putting their financial security and shot at the “American dream” at risk.
Immigrants in the United States have always faced barriers to health coverage, and as a result, they are less likely to be insured compared to U.S. citizens. Despite high rates of employment, noncitizen immigrants are more likely to work in low-wage jobs that don’t offer employer-sponsored health insurance. Medicaid has also long been a crucial coverage program for immigrant families, with many lawfully residing noncitizens eligible for Medicaid and the Children’s Health Insurance Program (CHIP) for decades. The Affordable Care Act (ACA) significantly improved access to affordable healthcare for immigrants by extending Marketplace subsidies to lawfully present noncitizens, helping to further lower the uninsurance rate and improving access to care.
Keep reading at The 80 Million.
California’s health care services department launched a new clinician-to-clinician reproductive health hotline that’s accessible to all providers, including Medi-Cal physicians. The hotline’s goal is to minimize the need for referrals to specialists, avoid unnecessary treatments and enhance health care outcomes.
Colorado Gov. Jared Polis signed a series of bills during the 2025 special legislative session to address H.R.1’s cuts, including a bill that ensures Medicaid enrollees can continue receiving health care services from providers like Planned Parenthood.
Maryland Gov. Wes Moore launched Rural Advancement for Maryland Peers (RAMP), a $1.6 million grant program to help more rural Marylanders in access support to address substance use.
States like Delaware, Missouri and South Dakota are considering how to apply for the Rural Health Transformation Program.
Wisconsin Gov. Tony Evers released new estimates showing H.R.1 will increase costs to Wisconsin taxpayers by over $284 million over a two-year biennial budget cycle, while forcing over 270,000 Wisconsinites to lose their health insurance and tens of thousands of Wisconsinites to lose access to basic food necessities.
He Built Michigan’s Medicaid Work Requirement System. Now He’s Warning Other States. – Michigan Public/KFF Health News
Medicaid expansion boosted these Appalachian counties. Will cuts deliver an outsized hit? – USA Today
Medicaid cuts threaten rural hospitals — and access to maternity care – The Washington Post
Ripple effects of Medicaid cuts roll out to assisted living providers at the state level – McKnights Senior Living
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