Search Results for: stop-loss

After H.R.1, Millions More Could Lose Marketplace Coverage

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…higher-income families reduce their health insurance premiums, will expire at the end of 2025 unless Congress takes action. Should ePTCs expire, millions of Marketplace enrollees will face higher premiums and 4.2 million people will become uninsured—compounding the coverage losses attributable to H.R.1.  Enhanced Premium Tax Credits Improve Insurance Affordability The vast majority of Marketplace enrollees—93 percent of enrollees in early…

The Dismantling of Obamacare Starts August 25 – Unless Litigation Can Stop It

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…lifeline, and 100,000 additional enrollees could be cut off from premium tax credits for failing to meet a new tax filing deadline. Protecting consumers from the looming loss of coverage and higher out-of-pocket costs will require congressional action—and soon.  *For a full summary of the Marketplace Integrity rule, see our article here. **Neither lawsuit challenges the rule’s changes to the…

New Federal Rules Affecting Coverage of Treatment for Gender Dysphoria: Considerations for States

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Early in his second term, President Trump issued an Executive Order instructing the Secretary of Health & Human Services (HHS) to “take all appropriate actions” to stop the provision of treatment for gender dysphoria to children. A separate Executive Order barred the use of federal funds to promote “gender ideology.” Shortly following these executive orders, HHS proposed, and then finalized, a regulation prohibiting health insurers from…

H.R. 1, Recently Enacted Federal Budget Law Spells Trouble for Patients with Insulin-Requiring Diabetes

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…enrollees following the COVID-19 pandemic. An additional 4.2 million are projected to lose coverage if Congress decides not to extend enhanced premium tax credits. Congress could still extend the enhanced subsidies, but time is running out.  The anticipated loss of coverage will make care less accessible and affordable for people across the country, particularly those with chronic conditions for whom…

Early 2026 Rate Filings Show Marketplace Policy Changes Contribute to Eye-Popping Rate Increases

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…Island’s regulator noted the “requested rate increases are the highest in over a decade,” while Maryland’s said they “are the highest since the implementation of Maryland’s reinsurance program in 2019.” Insurers point to loss of ePTC and uncertainty around federal policy changes A handful of states also publish the detailed supporting documentation filed by insurers relatively early compared to other…

Second Verse, Same as the First: Senate Reconciliation Language Failes to Fix Paperwork Burdens, Other Barriers to Marketplace Coverage

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…language would still leave Marketplace enrollees vulnerable to unexpected premium bills and at risk of losing their health insurance coverage.  Recapping the House Bill: Coverage Losses Driven by Enrollment Barriers The House-passed bill will reverse the coverage and access gains made possible by the Affordable Care Act health insurance Marketplaces by relying on several key strategies. First, it will increase…

The Reconciliation Bill Eliminates Long-Standing State Flexibility to Operate Marketplaces and Regulate Private Health Insurance

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…per member user fees to generate the revenue to fund their operations. The reconciliation bill would reduce Marketplace enrollment by millions of people, thus reducing SBM revenue. To be financially sustainable, SBMs will need to increase their user fees. This will result in an increase in premiums, which could, in turn, lead to further enrollment losses. The Bill May Alter…

Federal Efforts Ostensibly Aimed at Marketplace “Fraud” Ignore Obvious Strategies to Counter Broker Misconduct

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…on the other hand, some of whom have fallen victim to broker misconduct, will be impacted by the rule. CMS anticipates that the proposal will cause 2 million people to lose Marketplace coverage (and that is without accounting for coverage losses that can be reasonably expected from changes that will make it harder for eligible individuals to enroll and renew)….

Death by Slow Strangulation: New Tactics in Longstanding Efforts to Repeal the Affordable Care Act 

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…rule) and a 90 percent reduction in funding for ACA Navigators, individuals who help consumers learn about and enroll in Marketplace coverage. Also, Congress has yet to extend the enhanced premium tax credits, due to expire at the end of 2025. The Congressional Budget Office (CBO) has preliminarily estimated the coverage losses between 2025 and 2034 as follows: 7.7 million…

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