Fiery Senate Hearing Casts Doubt On Subsidy Extension
Democrats and Republicans battled at a Senate Finance Committee hearing today on the future of the enhanced Exchange subsidies set to expire at the end of the year. The tone and tenor of the GOP suggested that a clean extension was very much in doubt, at least without major sweeping conservative changes to healthcare, if it happened at all.
Republicans largely indicated they wanted to see the subsidy enhancements expire and instead work on conservative reforms, including expansion of Health Savings Accounts to allow individuals to purchase healthcare of their choice. This comports with President Trump’s views that subsidies should be sent to Americans directly. Sen Bill Cassidy, R-LA and Chair of the HELP Committee, has proposed pairing beefed up HSAs with low-level, high-deductible Bronze Exchange plans. HSAs currently cannot be used to pay for premiums.
Democrats argue the HSA payments would be nowhere close to buy affordable and comprehensive insurance. They also indicated that time does not allow a major overhaul – millions are nearing a doubling of their premiums.
Where Republicans have some solid points is that the fallout from the expiration of the temporary enhancements do point to larger issues with the Affordable Care Act in terms of affordability. Republicans say markets have become overly regulated and very inflationary.
GOP moderates favor a short-term, one-year extension of the enhanced subsidies with some small changes to appeal to conservatives. They say broader reforms can be tackled later.
Additional articles: https://www.modernhealthcare.com/politics-regulation/mh-republicans-hsa-aca-subsidies-insurance/ and https://www.modernhealthcare.com/politics-regulation/mh-senate-finance-committee-hsa-aca-subsidies/ and https://thehill.com/policy/healthcare/5611836-trump-republicans-aca-subsidies-health-care-plan/ and https://www.healthcaredive.com/news/aca-subsidy-unlikely-republican-opposition-senate-finance/805942/
#exchanges #healthcare #coverage
Major Medicaid Plans Struggling
A good article in Modern Healthcare about the financial troubles of health plans in Medicaid, which will only get worse with the impacts of the One Big Beautiful Bill Act (OBBBA). Showing how tenuous Medicaid is getting with the major determination losses once the COVID pandemic ended, the biggest Medicaid plan in the nation, Centene, announced that it lost a $5 billion Medicaid contract in Florida and decided not to appeal.
Centene, UnitedHealthcare, and Elevance Health all have complained that rates are not adequate enough for rising risk in the program. Through the first three quarters of 2025, Medicaid insurers have reported the highest medical loss ratios in at least five years. There are signs of recovery by these big plans, but Medicaid managed care’s future looks precarious.
(Article may require a subscription.)
#healthplans #medicaid #managedcare
https://www.modernhealthcare.com/insurance/mh-unitedhealth-group-centene-elevance-medicaid
— Marc S. Ryan
