ACA enrollment breaks records again in 2025
Healthcare Dive
JANUARY 21, 2025
million people signed up for Affordable Care Act plans during the open enrollment period for 2025, with huge increases in major Republican-led states.
Elevance expands ACA plans in Florida, Texas, Maryland
Healthcare Dive
SEPTEMBER 9, 2024
The insurer’s Wellpoint subsidiary is expanding its ACA footprint for the 2025 coverage year, likely in a bid to capture enrollees who recently lost Medicaid coverage.
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Millions of Americans Remain Uninsured or Underinsured Despite ACA Gains
HIT Consultant
NOVEMBER 22, 2024
What You Should Know: – A new report from the Commonwealth Fund reveals that despite significant progress in expanding health insurance coverage under the Affordable Care Act (ACA), millions of Americans still lack adequate and affordable healthcare.
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Premiums for ACA plans to grow 7% next year: KFF
Healthcare Dive
AUGUST 7, 2024
Insurers cited workforce shortages, hospital consolidation and growing demand for pricey GLP-1 drugs as reasons driving the premium increases for 2025.
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Patient Centered Care Through Value Based Care, Social Determinants of Health, and Behavioral Health – 2025 Health IT Predictions
Healthcare IT Today
JANUARY 14, 2025
As we wrap up another year and get ready for 2025 to begin, it is once again time for everyone’s favorite annual tradition of Health IT Predictions! Check out the community’s predictions down below and be sure to follow along as we share more 2025 Health IT Predictions !
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Biden’s proposed budget for 2025 boosts cybersecurity funds, extends ACA subsidies
Healthcare Dive
MARCH 13, 2024
The budget request includes proposals for “Medicaid-like” coverage in non-expansion states and future penalties for hospitals that don’t implement cybersecurity standards.
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The Shift from Traditional Employer-Sponsored Coverage to ICHRA: The Health Plan Perspective
HIT Consultant
NOVEMBER 3, 2024
This increase could bump employer-sponsored plan costs past $16,000 per employee in 2025. ICHRA Gaining Traction as Employer-Sponsored Alternative Under the ACA, applicable large employers (ALEs) are mandated to provide health insurance that meets specific coverage and affordability standards, or face penalties.
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UnitedHealthcare grows ACA exchange footprint to 30 states for 2025
Fierce Healthcare
NOVEMBER 4, 2024
UnitedHealthcare is growing its reach on the Affordable Care Act's (ACA's) exchanges and will offer plans in 30 states for 2025. UnitedHealthcare is growing its reach on the Affordable Care Act's exchanges and will offer plans in 30 states for 2025.
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Report: Not-for-Profit Hospitals See Margin Improvements in 2025
HIT Consultant
APRIL 3, 2025
These shifts are partly due to Medicaid policy changes and Affordable Care Act (ACA) expansion. Conversely, median self-pay reimbursement as a percentage of gross patient revenue has declined from pre-pandemic levels, dropping to 2.0% in 2023 from 2.8% in 2019, excluding childrens hospitals, and to 1.8% for hospitals with early 2024 FYE.
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Oscar Health unveils ACA expansion plans for 2025
Fierce Healthcare
OCTOBER 18, 2024
Oscar Health is expanding its reach in the individual market, and plans to offer coverage in 504 markets in 18 states for the 2025 plan year. Oscar Health is expanding its reach in the individual market, and plans to offer coverage in 504 markets in 18 states for the 2025 plan year.
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CMS proposes stricter network adequacy standards for plans in state-run ACA exchanges
Healthcare Dive
NOVEMBER 16, 2023
Beginning in 2025, plans sold in state-based exchanges would be required to meet time and distance standards for provider access under a new rule proposed Wednesday.
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Dental Coverage under the ACA: Marketplace Rule Would Give States the Opportunity to Expand Coverage
Center for Health Insurance Reform
FEBRUARY 12, 2024
The Affordable Care Act (ACA) requires coverage of pediatric dental services in many commercial plans, but the law has had less of an impact on adult dental coverage. Dental care is an important element of comprehensive health care.
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Centene sets itself up for ‘equilibrium’ in 2025
Healthcare Dive
FEBRUARY 4, 2025
The insurer also reported notable ACA growth for this year, though membership could tick back down through the second quarter due to program integrity efforts.
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Elevance Health adds ACA plans in Florida, Maryland, Texas
Fierce Healthcare
SEPTEMBER 5, 2024
Elevance Health subsidiary Wellpoint is debuting plans in three states for the 2025 coverage year. Elevance Health subsidiary WellPoint announced the company is debuting individual marketplace plans in Florida, Maryland and Texas.
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CMS finalizes network adequacy standards, expands dental benefits for ACA exchange
Fierce Healthcare
APRIL 2, 2024
States now can add routine adult dental services as an essential health benefit, the Centers for Medicare & Medicaid Services announced in its 2025 Notice of Benefit and Payment Parameters fina | In its annual Notice of Benefit and Payment Parameters final rule, CMS prioritized dental and prescription drug benefits, network adequacy standardization (..)
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Here’s Something to Celebrate: The Affordable Care Act Just Turned 15!
Center for Health Insurance Reform
MARCH 24, 2025
On March 23, 2025, we celebrated the 15th anniversary of the Affordable Care Act (ACA). In this post, CHIR experts reflect on how the law's reforms affected people's access to affordable, high quality health insurance, and what the next 15 years might bring.
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TEFCA’s Moment and Policy Changes on the Horizon: A Conversation with Eric Musser at NCQA
Healthcare IT Today
DECEMBER 4, 2024
With subsidies under the Affordable Care Act set to expire in 2025, he highlighted potential shifts in the insurance market based on the direction from the new incoming administration. If we can get them standardized that should help make the experience for all stakeholders more efficient and more valuable.”
The Health Insurance Premium for a Family Averages $25,572 in 2024 – KFF’s Annual Update on Employer-Sponsored Benefits
Health Populi
OCTOBER 14, 2024
the costs of health care and perceived ROI to employers (and employees bearing out-of-pocket financial skin in the game), the state of labor markets and availability of needed workers, and regulatory pressures that might shift prospects for industry in general or particular sectors in and beyond 2025.
CMS’s 60-Day Rule Impacts False Claims Act Liability
Hall Render
JANUARY 10, 2025
On January 1, 2025, the Centers for Medicare and Medicaid Services’ (“CMS”) new 60-Day Rule became effective. 180-Day Suspension Period The ACAs initial enactment of the 60-Day Rule required reporting and returning of overpayments within 60 days of discovery.
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Section 1557 Compliance for Healthcare Providers by July 5, 2025
American Medical Compliance
MARCH 13, 2025
Compliance of Section 1557 of the Affordable Care Act (ACA) reinforces this by prohibiting discrimination and holding healthcare providers accountable for fostering an inclusive environment. With July 5, 2025, fast approaching, healthcare organizations must act now to ensure compliance. Click here.
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Oregon Senator Proposes Criminal Charges and Fines for Rogue Obamacare Agents
Kaiser Health News
JULY 24, 2024
Often, consumers who are targeted don’t know they’ve been enrolled or that their coverage has been switched to a new plan until they lose access to preferred doctors, learn they have different deductibles, or find they owe taxes for ACA insurance premium subsidies.
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Stakeholder Perspectives on CMS’s 2025 Notice of Benefit and Payment Parameters: State Insurance Departments and Marketplaces
Center for Health Insurance Reform
MARCH 1, 2024
In November, the Biden administration released the proposed Notice of Benefits and Payment Parameters for plan year 2025, an annual rule setting standards for the Affordable Care Act (ACA) Marketplaces and health insurers.
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Proposed 2025 Payment Rule: Marketplace Standards And Insurance Reforms
Center for Health Insurance Reform
DECEMBER 18, 2023
Last month, the Biden administration proposed changes to Affordable Care Act (ACA) Marketplace policies and procedures. In a post for Health Affairs Forefront, Sabrina Corlette and Jason Levitis take a look at the proposals related to market reforms, Marketplace standards, and premium tax credits.
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CMS Promotes Health Equity through Marketplace Standards and More in New Proposed Rule
Healthcare Law Blog
DECEMBER 11, 2023
Reducing the risk adjustment user fee for 2025 from $0.21 1] These modifications are intended to further the Biden Administration’s goals of advancing health equity by addressing disparities in access to quality care while minimizing administrative burdens and ensuring program integrity. per member per month to reduce insurer costs.
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Final Rule Implementing Section 1557 of the Affordable Care Act Is Effective
Hall Render
JULY 8, 2024
Although Section 1557 took effect immediately upon the signing of the Affordable Care Act (“ACA”), a final rule was not promulgated until 2016 (the “2016 Rule”). Nondiscrimination in health insurance coverage and other health-related coverage (§ 92.207(b)(6)) By the first day of the first plan year beginning on or after January 1, 2025.
La atención de salud, en el centro del debate entre DeSantis y Newsom
Kaiser Health News
NOVEMBER 27, 2023
Esa política de gran alcance entra en vigencia en enero y va mucho más allá de la expansión opcional de Medicaid que la Ley de Cuidado de Salud a Bajo Precio (ACA) ofreció a los estados. Florida no cuenta con un mercado estatal, ni ofrece subsidios patrocinados por el estado.
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Biden Administration Issues Final Rule to End the “Family Glitch”
Compliance Now
OCTOBER 13, 2022
The Biden Administration issued a final regulation and a new IRS notice on October 11, 2022, which eliminate the Affordable Care Act’s (ACA) “family glitch” beginning on January 1, 2023. The preamble to the final rule also explicitly states that the policy change will not impact ACA reporting for either ALEs or health insurance issuers.
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Biden Administration Issues Final Rule to End the “Family Glitch”
Compliance Now
OCTOBER 13, 2022
The Biden Administration issued a final regulation and a new IRS notice on October 11, 2022, which eliminate the Affordable Care Act’s (ACA) “family glitch” beginning on January 1, 2023. The preamble to the final rule also explicitly states that the policy change will not impact ACA reporting for either ALEs or health insurance issuers.
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The Impact of Section 1557 Final Rule on Healthcare
AIHC
AUGUST 13, 2024
Written by Corliss Collins , BSHIM, RHIT, CRCR, CSM, CCA, CBCS, CPDC and Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS The 2024 Final Rule for Section 1557 of the Affordable Care Act (ACA) was issued by the Department of Health and Human Services (HHS) on April 26, 2024.
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Healthcare Reforms Under the IRA: Expanding Access to Care
Healthcare Law Blog
AUGUST 25, 2022
Additional updates of note include: ACA Premium Tax Credit Eligibility. Essentially, the moratorium on the requirement that, to be eligible for a premium tax credit, household income must be at or below 400% of the federal poverty level, is extended through 2025. Other Updates. Catastrophic Phase Cost-Sharing. Out-of-Pocket Costs.
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How the Growth of GLP-1s in the U.S. Pharmacy Channel Illustrates Many Challenges and Opportunities for Consumer-Directed and Retail Health
Jane Sarashon
FEBRUARY 19, 2025
To keep sharp on the topics, I attended Rx Market Insights: Performance Trends and Outlook for 2025, a data-rich session presented on February 18 by IQVIA and sponsored by Ascend Laboratories. The research was fielded between December 30, 2024 and January 7, 2025]. A poll conducted among 2,000 U.S.
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Americans’ Views on the Quality of Healthcare Fell to a Record Low — with Costs Ranking as the Most Urgent Problem for Health in the U.S.
Jane Sarashon
DECEMBER 9, 2024
Similar divergence by party is shown here in partisans’ approval or disapproval of the Affordable Care Act (the ACA, or “Obamacare”). This teases the question for 2025 and beyond: what “concepts” might President Trump #47 have in store to potentially repeal and replace the ACA?
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Biden Wants States to Ensure Obamacare Plans Cover Enough Doctors and Hospitals
Kaiser Health News
DECEMBER 6, 2023
It’s likely one of the last major ACA policy efforts of President Joe Biden’s first term — and, if he loses reelection, could represent his final touches on the landmark health program created when he was vice president. In part because of those subsidies, enrollment has increased steadily and hit records under his watch.
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Most People in the U.S. Trust the CDC and NIH for Health Information, and Most Want President Trump to Strengthen Health Institutions
Jane Sarashon
DECEMBER 12, 2024
There are uncertainties with which we, who work in the health/care ecosystem, wrestle as we enter 2025 and the inauguration of President Trump, #47, slated for January 20, 2025. As we continue to plan for designing, delivering, and assuring health care for all in 2025, we would do well by our fellow health citizens to keep MLK Jr.’s
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Lo nuevo y lo que debes tener en cuenta en el próximo período de inscripción abierta de ACA
Kaiser Health News
OCTOBER 8, 2024
En la mayoría de los estados, la temporada de inscripción abierta de la Ley de Cuidado de Salud a Bajo Precio (ACA) para los planes de salud comienza el 1 de noviembre y dura hasta el 15 de enero. Estamos en esa época del año otra vez. Aunque intenten parecer oficiales, no lo son.
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Health Provider News
Hall Render
JUNE 28, 2024
NATIONAL 50% of physicians are thinking of leaving the field due to shortage AHA backs bid to repeal nursing home staffing rule AHA wins lawsuit against HHS over third-party web tracking AHA responds to study blaming hospital prices for societal issues AHA slams study tying unemployment to hospital price increases Behind the battle against corporate (..)
Start Shopping: Enrollment Begins Nov. 1 for Most Obamacare Insurance Plans
Kaiser Health News
OCTOBER 31, 2023
1 for the ACA’s federal and state exchanges. Health policy experts and brokers recommend all ACA policyholders at least look at next year’s options, because prices — and the doctors and hospitals in plans’ networks — may have changed. It Could Be Another Record Year ACA plans are now well entrenched — an estimated 16.3
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Health Provider News
Hall Render
JANUARY 17, 2025
OrthoIndy to merge with Evansville, Fort Wayne practices St. healthcare fraud scheme New Orleans launches tool to help doctors find reproductive care drug amid tight state restrictions MAINE Owner of Woonsocket hospital expands into Maine St.
Comienza la inscripción para los seguros de salud del Obamacare
Kaiser Health News
OCTOBER 31, 2023
Para millones de personas que compran su propio seguro de salud a través del mercado establecido por la Ley de Cuidado de Salud a Bajo Precio (ACA, popularmente conocida como Obamacare), el final del año trae un ajuste de cuentas: es el momento de comparar beneficios y precios, cambiar a un nuevo plan o inscribirse por primera vez.
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Everything Old Is New Again? The Latest Round of Health Policy Proposals Reprises Existing Ideas
Kaiser Health News
JULY 24, 2023
The latest round of rules and legislation comes as the ACA — passed in 2010 — is now cemented in the system. Concerned that people would choose this option instead of more comprehensive and more expensive insurance offered through the ACA, President Barack Obama’s administration set rules limiting the policy terms to three months.
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Health Provider News
Hall Render
JANUARY 10, 2025
A new state-sponsored group will help. UCHealth to use war medical tactic to help save lives in Northern Colorado New Northern Colorado program delivers whole blood to patients in the field CONNECTICUT $1.9
Health Provider News
Hall Render
MAY 24, 2024
Chicago children’s hospital completes cyberattack recovery CommonSpirit posts $365M quarterly loss, -3.9%
Some Bipartisan Concurrence on Health Care Issues in the U.S. – But Trust in Health Care Isn’t Bipartisan – KFF’s January 2025 Polls
Jane Sarashon
JANUARY 28, 2025
The Kaiser Family Foundation has hit the 2025 health policy ground running in publishing the January 2025 Health Tracking Poll last week and a poll on health care trust and mis-information yesterday. As of the second week of January 2025, the top priorities for health care among U.S.
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