Starting in 2026, the expiration of enhancements – along with policies in the One Big Beautiful Bill Act (OBBBA, P.L. 119-21) and the 2025 Marketplace Integrity and Affordability Final Rule (2025 Final Rule) – will significantly alter major aspects of the Affordable Care Act’s premium tax credits (PTCs). These changes will affect who is eligible for PTCs, who receives them,... Read More
Impact Health - Weekly, July 7, 2025
On the 4th of July, President Trump signed the One Big Bill Act (H.R. 1) into law (Impact Summary). The law features the following significant health policy changes: Medicaid: Work requirements no later than December 31, 2026, new restrictions on provider taxes and state directed payments, and more frequent eligibility determinations ACA Marketplace: New verification requirements and restrictions on premium tax credit eligibility, and... Read More
Impact Health - Weekly, June 30, 2025
This morning at 9:00 am, the Senate kicked-off its vote-a-rama for the One Big Beautiful Bill Act (updated text and CBO score as of June 28), where the Senators have filed close to 300 amendments to the bill, most of which are offered by Democrat Senators. Senate Finance Committee Ranking Member Wyden (D-OR) will offer a Motion to Commit to strike... Read More
Impact Health - Weekly, June 23, 2025
Senate Republicans are aiming to pass the budget reconciliation bill by the end of the week, with floor action set to begin on Wednesday. It is expected that the Senate Finance Committee members will meet with the Senate Parliamentarian to review its portion of the bill (Impact Summary). Senate Democrats are looking to challenge approximately 60 provisions of the Committee’s... Read More
Impact Health - Weekly, June 16, 2025
Senate Republicans are working to meet President Trump’s July 4 deadline to deliver a budget reconciliation bill for his signature. The Senate Finance Committee is expected to release its legislative text today, including revisions to House-passed Medicaid provisions and other policy changes. However, some sections are anticipated to contain placeholders that will be updated at a later time. Prospects for... Read More
Impact Health - Weekly, June 9, 2025
As Senate Republicans enter the second week of closed-door negotiations over the One Big Beautiful Bill (H.R. 1), the debate has sharpened with new Congressional Budget Office (CBO) projections highlighting the bill’s health care implications, and with pressure building from both moderates and budget hawks within the GOP. The latest CBO estimate finds that if the House-passed reconciliation bill were enacted, 10.9... Read More
Impact Health - Weekly, June 2, 2025
The Senate is back in session this evening and will attempt to put its mark on the House-approved One Big Beautiful Bill (H.R. 1). Most of the Senate’s deliberations will take place behind closed doors, and Senate Majority Leader John Thune (R-SD) will have to manage the competing priorities of the Medicaid moderates, Sens. Josh Hawley (R-MO), Lisa Murkowski (R-AK),... Read More
Impact Health - Weekly, May 27, 2025
The House and Senate are in recess, and Senate leadership plans on holding preliminary discussions this week to consider any changes to the House-passed version of the budget reconciliation package, the One Big Beautiful Bill Act (H.R. 1), as well as begin vetting the package against the Byrd Rule. This follows President Trump indicating that he expects the Senate to... Read More
Impact Health - Weekly, May 19, 2025
Last night, the House Budget Committee reconvened its vote and advanced the budget reconciliation package, by a vote of 17-16, with the Republican holdouts, Reps. Chip Roy (R-TX), Josh Brecheen (R-OK), Ralph Norman (R-SC) and Andrew Clyde (R-GA.), voting ‘present’ to allow the bill to proceed. Prior to the vote, it is reported that discussions were had regarding moving up the implementation of work requirements from 2029 to... Read More
Impact Health - Weekly, May 12, 2025
Last night, the House Energy and Commerce (E&C) Committee released its draft text (section-by-section) for its portion of the budget reconciliation package, which will be marked up tomorrow. Impact Health is preparing a full summary of the Health Subtitle, which includes the following: Establishing Medicaid work requirements for able-bodied adults without dependents; Sunsetting the 5 percent Federal Medical Assistance Percentage... Read More
Impact Health - Weekly, May 5, 2025
At the end of last week, it was reported that the House Energy and Commerce (E&C), Ways and Means (W&M), and Agriculture Committees are delaying the markups for their respective portions of the budget reconciliation package amid internal disagreements amongst House Republicans and shifting priorities from the White House. The markups are now expected to be convened the week of... Read More
Impact Health - 100 Days of Disruption: Health Policy Under Trump 2.0
Yesterday marked the end of the first 100 days of the second Trump Administration. President Trump has sought to remake America at breakneck speed over the first 100 days of his second term, issuing more than 140 executive orders (EOs) since returning to office, dismantling government agencies, and testing the limits of his power. Elevating government critics like Elon Musk and science skeptics... Read More
Impact Health - Weekly, April 28, 2025
Congress is back in session and begins its work on drafting the budget reconciliation package. Speaker Mike Johnson (R-LA) is aiming for the House to pass its side of the bill by Memorial Day, with Johnson eyeing the week of May 19th for a floor vote, however this is still an ambitious timeline. Tomorrow, the House Education and Workforce Committee,... Read More
Impact Health - Weekly, April 21, 2025
Congress is in recess for one more week before it resumes on April 28th and begins in earnest its reconciliation work. The House Energy and Commerce Committee is expected to mark up its portion of the package, including any Medicaid provisions, on May 7th. House Republican leadership is also tentatively planning a vote on President Trump’s recission package, which includes... Read More
Impact Health - Weekly, April 14, 2025
The House and Senate are in recess and will return on April 28. On Thursday, the House passed the Senate-amended budget resolution that sets up a minimum of $4 billion in savings for Senate Committees and $1.5 trillion in cuts for the House Committees by a vote of 216-214. Following its passage, Senate Majority Leader John Thune (R-SD) stated that... Read More
Impact Health - Weekly, April 7, 2025
Over the weekend, the Senate adopted an amended budget resolution by a vote of 51-48. The resolution directs Senate Committees to find a minimum of $4 billion in savings, while the House is instructed to cut at least $1.5 trillion. It also features using the current policy baseline to make President Trump’s 2017 tax cuts permanent and increasing the debt... Read More
Impact Health - Weekly, March 31, 2025
Over the weekend, Senate Majority Leader John Thune (R-SD) indicated plans to begin moving the chamber’s budget reconciliation resolution as soon as Wednesday, with a vote-a-rama expected to start on Thursday. The resolution is likely to represent a compromise between the House and Senate versions, and includes a minimum of $3 billion in spending cuts for the Senate Committees and... Read More
Impact Health - Weekly, March 24, 2025
Congress returns this week with Speaker Mike Johnson (R-LA) setting the expeditious goal of finalizing the Republicans’ budget resolution before recessing again in three weeks. However, large differences remain between the House and Senate versions. The House resolution includes a minimum of $1.5 trillion in spending cuts and $4.5 trillion in tax cuts, while the Senate version includes $325 billion... Read More
Impact Health - Weekly, March 17, 2025
Over the weekend, President Trump signed the Full-Year Continuing Appropriations Act of 2025 (H.R. 1968), which provides government funding through September 30, 2025, and includes a package of health care extenders. The House and Senate are in recess this week, but when Congress resumes on March 24, it will return its attention to advancing the budget reconciliation package and confirming... Read More
Impact Health - Weekly, March 10, 2025
The House recesses on Wednesday and Speaker Mike Johnson (R-LA) will attempt to pass a stop-gap funding measure along party lines on Tuesday to avoid a government shutdown and fund the government for the remainder of the fiscal year. If passed by the House, the pressure will then be on the Senate, which will require support from several Democrats to... Read More
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