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Emerging State Data Paint a Bleak Picture of 2026 Marketplace Enrollment
Congress’s failure to extend premium tax credit enhancements led to unprecedented net premium increases in Affordable Care Act (ACA) marketplaces in 2026. As a result, fewer people signed up for coverage during the 2026 open enrollment period, and many others “bought down” to less expensive plans that carry higher out-of-pocket costs. However, to more fully…
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Cash is No Substitute for Coverage: Why Health Insurance Matters
As Congress ends the federal government shutdown, the underlying debate about extending enhanced premium tax credits (ePTCs) that help enrollees purchase coverage in the Affordable Care Act (ACA) marketplaces is not only unresolved, but is lurching into unexpected territory. President Donald Trump has suggested that instead of extending ePTCs into 2026 and beyond to support…
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What to Expect for Open Enrollment, 2026 Edition
The Affordable Care Act (ACA) Marketplaces have had their ups and downs over the last decade, but it’s hard to find a year when consumers have faced more uncertainty going into an open enrollment period. “Window shopping” for 2026 Marketplace health plans has already begun in several states and open enrollment begins in most states on November…
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Preventive Services at Risk: Federal Instability and State Responses
In late June, the Supreme Court upheld the Affordable Care Act’s (ACA) preventive services provision, preserving—for now—zero cost sharing access to screenings, vaccines, and other preventive care for more than 150 million people. The decision in Kennedy v. Braidwood Management Inc. foreclosed a constitutional challenge to coverage of preventive care while underscoring new risks to consumers’ access to…
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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…