Congress Comes Back To Exchange Saga
Congress is slated to reopen next week and will return to the Exchange subsidy controversy. Some lawmakers say that arriving at a potential compromise on extending enhanced subsidies is about 50-50 right now. A vote will be held in the House on a Democratic bill to extend the subsidies with no changes for three years. At least four Republicans are expected to support the measure, which would mean the bill likely passes. The same extension was voted down in the Senate (it did not reach 60 votes), but the bill could be used for a compromise measure, which then would go back to the House. GOP leaders in each house, though, are expected to put roadblocks up to final passage.
With the reduction in subsidies and major increases in premiums, between 2.2 million and 7.3 million people may decide against renewing their insurance because of the price hikes. In 2025, over 24 million had Exchange coverage. Young people, blacks, Hispanics, and those between 250% and 400% of federal poverty are expected to see the biggest increases in their uninsured ranks.
But so far published data have not shown a massive reduction in enrollees. State officials though are seeing terminations and enrollees choosing less-generous benefits.
Because it fully made up for federal subsidy losses, New Mexico’s health insurance marketplace has reached record enrollment. More than 80,400 people have enrolled for medical or dental coverage through BeWell, the state’s ACA marketplace, as of Dec. 30. That is more than the 79,000 people that enrolled for 2025 coverage. Other states have partially replaced expiring subsidies.
Health insurance marketplace Access Health CT has extended open enrollment to Jan. 31 (by two weeks) for coverage that starts in February.
Additional articles: https://www.beckerspayer.com/payer/aca/connecticut-health-insurance-marketplace-extends-open-enrollment/ and https://www.beckerspayer.com/payer/aca/new-mexico-sees-record-aca-enrollment-after-state-replaces-expired-subsidies/
#exchanges #healthcare #coverage
https://thehill.com/policy/healthcare/5668719-aca-obamacare-subsidies-expire
CA Medicaid Drops GLP-1s For Weight Loss
Medi-Cal or California Medicaid will no longer cover GLP-1s for weight loss as of Jan. 1. Wegovy, Zepbound and Saxenda were removed from the Medi-Cal Rx Contract Drugs List and are no longer eligible for coverage for weight loss or weight-loss indications. Coverage for other disease states, such as heart disease and diabetes, will remain.
The move comes just as the Trump administration struck concessions with brand drug makers on such drugs and are launching a Medicaid model covering drugs for obesity in 2026. The CA policy is likely to change when the model launches.
#glp1s #weightlossdrugs #branddrugmakers #medicaid #ca
https://www.beckerspayer.com/payer/medicaid/california-medicaid-ends-weight-loss-drug-coverage/
Frustrated With Capitol Hill Dysfunction, Lawmakers Retire
The 2026 midterms are shaping up to be very interesting with a near record number of lawmakers deciding to retire or not seek re-election. More than 50 lawmakers on both sides of the aisle have announced decisions to leave their seats. Thirty Republicans and 23 Democrats so far are leaving.
#congress #2026midterms
https://thehill.com/homenews/house/5668214-gop-lawmakers-fleeing-congress/
— Marc S. Ryan
