Category: Implementing the Affordable Care Act
June-July Research Roundup: Anticipated Effects of H.R. 1 on health insurance coverage, affordability, and uncompensated care

President Trump recently signed into law some of the most dramatic changes to our healthcare system since the Affordable Care Act (ACA) was enacted in 2010. CHIR’s Leila Sullivan provides a roundup of recent research projecting what the new law means for coverage, affordability, and uncompensated care.
Explainer: The Medicaid and Marketplace Provisions of the Budget Reconciliation Bill
A Setback, Not a Defeat: Our Work to Ensure Access to Affordable, High Quality Health Care Continues

President Trump’s signature on H.R. 1, the budget reconciliation bill, will lead to upwards of 17 million people losing their health insurance and millions more with higher barriers to accessing care. At CHIR, we’ll be working to minimize the law’s harms, document its effects, and partner with those seeking to reverse its worst abuses.
The Reconciliation Bill Eliminates Long-Standing State Flexibility to Operate Marketplaces and Regulate Private Health Insurance

The budget reconciliation bill passed by the U.S. House of Representatives would eliminate much of the flexibility granted to states over the operations of State-Based Marketplaces (SBMs), impose burdensome new requirements, and reduce their revenue base. In a new CHIRblog post, ACA experts Jason Levitis, Christen Linke-Young, Sabrina Corlette, Ellen Montz, and Claire O’Brien dive into the bill’s costly new mandates for states.
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 Brookings’ Visiting Fellow Christen Linke-Young dig into how this provision could radically change people’s ability to access and maintain affordable health insurance.
Recent Federal Marketplace Proposal Imposes New Requirements for States and Consumers

On March 10, 2025, the Trump administration released draft rules with policy changes for the Affordable Care Act Marketplaces and insurance rules. In their latest Expert Perspective for the State Health & Value Strategies program, Sabrina Corlette and Jason Levitis review the implications of the proposal for State-Based Marketplaces and state insurance regulators.
Policymakers Can Protect Against Fraud in the ACA Marketplaces Without Hiking Premiums

Last year, reports emerged of unscrupulous health insurance brokers enrolling people in marketplace coverage or switching enrollees to different plans without permission. In their latest piece for the Commonwealth Fund, CHIR’s Justin Giovannelli and Stacey Pogue explore how policymakers can crack down on broker misconduct.
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 existing tax cuts. CHIR’s Karen Davenport discusses the growing body of research around the important role health insurance plays in the health and financial status of American families.
Protecting Access to Preventive Services: A State Roadmap

A case before the Supreme Court and a new Secretary of the U.S. Department of Health & Human Services could substantially weaken the ACA’s guarantee of no-cost preventive services in private insurance. Experts Sabrina Corlette and Tara Straw provide a roadmap for state policymakers to protect their residents, in a recent article for State Health and Value Strategies.