health coverage helps lower, middle-income families purchase coverage with tax credits and cost-sharing subsidies to help reduce how much they pay out-of-pocket for health care.
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Medicaid, CHIP, and Affordable Care Act Marketplace Cuts and Other Health Provisions in the Budget Reconciliation Law, Explained
Editor’s Note: this brief was updated on August 13, 2025 to reflect additional Congressional Budget Office coverage estimates of the reconciliation law issued on August 11, 2025 In partnership with On July 4, 2025, President Trump signed the Congressional Republican budget reconciliation bill into law (H.R. 1 or P.L. 119-21 which was previously entitled the…
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Budget Reconciliation Law Takes Aim at Medicaid and the Affordable Care Act
Just before our nation’s birthday, the House passed the Senate version of the budget reconciliation bill and it headed to the President’s desk. Congressional leaders cheered and clapped as President Trump gleefully signed the law. But what’s to cheer about a law that promises to take health insurance through Medicaid and CHIP away from 11.8…
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Imposing a Per Capita Cap on the Medicaid Expansion Would Lead to an Effective Cut in the Expansion Matching Rate for States
On March 5, according to Axios, House Energy and Commerce Committee Chair Brett Guthrie (R-KY) is now considering a proposal to impose a per capita cap on the Medicaid expansion as part of budget reconciliation. Chairman Guthrie, as well as other House Republican leaders, may believe that such a cap could be viewed as more…
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Medicaid Managed Care: The Big Five in Q4 2024
The “Big Five” earnings results for Q4 of 2024 are now in. The “Big Five” are the publicly-held companies that together control half of the Medicaid managed care market: Centene, CVSHealth/Aetna, Elevance Health, Molina Healthcare, and UnitedHealth Group. (There are five nonprofit Medicaid managed care organizations (MCOs) with significant regional or single-state market footprints, but…
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What’s New for the 2025 Plan Year Open Enrollment
As the Affordable Care Act Marketplaces enter their 12th year, enrollment is at an unprecedented high, insurer competition is robust, and four out of five Marketplace enrollees can find a plan for $10 per month or less. This has also been a year of relative stability, without dramatic policy reforms or market disruptions. However, there are several…