Today marks the 16th anniversary of the #ACA. The law covers record numbers of people in #Medicaid and the marketplaces, bans insurer discrimination against people with health conditions, and helps millions afford their health costs. Unfortunately this is all now at risk.

Even as President Trump talks up his health proposals, key decisions he has already made are making care unaffordable for millions. Federal policies he backed will leave some 15M uninsured. If they stood in a line, it would reach from Chicago to Buenos Aires. #CBPPSOTU

Tonight, during the State of the Union address, we’ll hear President Trump’s priorities for the year ahead. It’s worth comparing what he says to the extreme actions his Administration took last year.

Marketplace enrollees’ premiums have skyrocketed following the recent expiration of PTC enhancements. Some have suggested health savings accounts and less generous plans as a more affordable alternative to comprehensive coverage. Here’s why that line of reasoning is flawed: 🧵

This week, the House is expected to vote on a bill to extend the Premium Tax Credit enhancements. This would reduce 2026 premiums for the average #ACA marketplace enrollee by more than half, improving affordability for millions of people struggling with health costs. www.cbpp.org/research/hea...

With marketplace premium spikes on the verge of hitting 20M+ people Jan. 1, House Speaker Johnson is reportedly considering a bill from Rep.Fitzpatrick with a 2-year extension of PTC enhancements. But the bill raises big concerns. www.politico.com/live-updates...

Reports that the White House is working on a proposal to extend premium tax credit enhancements shows the Administration is acknowledging the urgent need to address premium spikes for millions of marketplace enrollees. But big questions remain.🧵

The GAO released a report last week on health savings accounts (HSAs) reaffirming that HSAs do little to help people with low and moderate incomes – who would be hurt the most if Congress lets premium tax credit enhancements expire.

Some recent Republican responses to the marketplace premium tax credit issue would shift more people to bronze plans with Health Savings Accounts as an alternative to silver plans with PTC enhancements and cost sharing reductions. So how do these plans stack up in real terms?

Here they go again: Republicans in Congress are reviving the ACA repeal debate. After enacting unprecedented cuts to Medicaid, they are looking for ways to eliminate federal premium tax credits that some help about 20M people afford marketplace plans.

Check out @centeronbudget.bsky.social's new graphics -- examples of the cost increases that marketplace enrollees in all 50 states and D.C. will face if Congress doesn't extend premium tax credit enhancements. h/t @gidlukens.bsky.social www.cbpp.org/research/res...

How concerned are people about rising health insurance premiums? With premium tax credit enhancements about to expire and ACA marketplace open enrollment underway, search volumes for terms like “health premium increase” are (almost) off the charts.

Republican leaders in Congress say they will address marketplace health care premium increases once the government is re-opened. But it’s hard to square that commitment with some of their recent comments.

If premium tax credit enhancements expire, millions of people with the lowest incomes would lose $0 premium plans and be at risk of becoming uninsured. Gains in coverage, especially in states that haven’t expanded #Medicaid, would be at risk. www.cbpp.org/blog/people-...

Attn: Idaho Marketplace enrollees in the Gem State are facing big premium increases if Congress does not act.

NEW from @centeronbudget.bsky.social: Without Congressional action, premium tax credit enhancements will expire, raising costs for nearly all marketplace enrollees and putting millions of those with the lowest incomes at risk of becoming uninsured when they lose $0 premium plans.

NEW from @jenniferlsullivan.bsky.social and me for @centeronbudget.bsky.social: With Congress poised to take away premium tax credit enhancements soon, ~4M people will lose coverage and costs will rise for nearly all ACA marketplace enrollees unless Congress acts.🧵

Despite claims to the contrary, premium tax credits are well targeted to people with low & moderate incomes who need the most help with health costs. Three-quarters of people getting the credits have incomes below 300% FPL (~$47K for an individual). >90% have incomes below 400% FPL (~$63K)

The latest CBO estimates make clear that the so-called “Big Beautiful Bill” is anything but--it would cause widespread harm with more than $1T in cuts to Medicaid & ACA marketplaces and higher costs for families trying to afford health care and groceries.

Senate Republicans made a horrible bill even worse. Let's count the ways:

TSen. Scott amendment effectively repeals Medicaid expansion in only a few years. New analysis here: www.cbpp.org/research/med...

New Congressional Budget Office (CBO) numbers confirm what we already knew – the reconciliation bill is getting worse, not better. The Senate bill will cut health care more deeply than the House bill and leave more people uninsured. www.cbo.gov/publication/...

The latest Senate Republican plan retains a deeply harmful provision that tramples over state rights’ to make decisions about how to use their own funds to ensure their state residents can access comprehensive health coverage.

Senate Republican leaders appear to be barreling ahead with their harmful reconciliation bill. Reminder that the Republican health agenda would take us backward on covering the uninsured, largely reversing #ACA gains. 👎 (h/t @pkrugman.bsky.social for the graphic idea)

Senate Republicans are rushing to pass a bill that would take #SNAP food assistance away entirely from millions of low-income people & cut food benefits for millions more. Some states could even end SNAP entirely. But Senators still have time to reject these harmful policies.

Every major bill language release is happening under the cover of night. Tracks since the bill is so unpopular. Are Senators really going to set millions of families backwards by taking health coverage & food asst away from them? Is that why they got into politics? Really?

The reconciliation bill puts health benefits for tipped workers at risk. ⬇️

As Senate Republican leaders rush their bill to a vote, they are focused on band-aid fixes to clear process hurdles. Instead, they should stop moving forward with harmful legislation that takes health care away from millions of people.

$1 trillion > $15 billion And a capped fund that Congress could shrink or cannibalize in the future isn’t a substitute for the foundation of rural hospital stability: Medicaid. www.cbpp.org/blog/trackin...

Now that I'm verified on BlueSky (‼️), I want to highlight how rural communities will be harmed by the GOP's budget bill and why people shouldn't just "get over it" or that "we're all going to die." See my piece on the impact on rural economies: www.cbpp.org/research/fed...

The "one big beautiful bill," which would leave some 16m uninsured, is making people say some ugly things. Sen. McConnell: "They'll get over it." Sen. Ernst: "Well, we all are going to die." CMS Administrator Oz: "Prove that you matter."

Reports from last night are that Republicans dropped this plan to cut Medicaid matching rates. But make no mistake: the draft Senate bill - and it's House equivalent - still cut more than $800B from #Medicaid and will leave millions of people without health coverage.

Rather than course correct, Senate Republican leaders are rushing to advance a bill that is in some ways even more destructive and harmful than the unpopular House Republican bill. The Senate must reject it.

@clinkeyoung.bsky.social writes: "Ultimately, the 2017 ACA repeal effort failed over some Republican Senators’ unwillingness to inflict major cuts on the American health care system. The weeks ahead will determine whether that remains true in 2025." www.brookings.edu/articles/new...

The numbers are in. The House reconciliation bill is reaching coverage losses close to repeal of the #ACA ⬇️

Must-read report: The huge cuts to health care and food assistance in the House Republican reconciliation bill-which partly pay for tax breaks for the wealthy-would force states to pick up billions in new costs & make a series of painful tradeoffs. www.cbpp.org/research/sta...

Huge hit to health care providers and an increase in uncompensated care as a result of the House-passed reconciliation bill and failure to address the expiring premium tax credits.

Five ways the House reconciliation bill takes away health coverage and raises costs.

Totally agree. Lots of us cisgender people also get gender affirming care.

House Republicans’ latest changes to the already harmful health provisions of their budget reconciliation bill layer on last minute cuts, swifter coverage losses, more cost increases, and restrictions on care.🧵 www.cbpp.org/research/hea...

Official CBO analysis confirms the obvious: House Republican tax and budget bill isn't shared sacrifice. It makes poor people poorer and rich people richer. It does this by cutting health care & nutrition to help finance tax cuts skewed to the wealthy. www.cbo.gov/publication/...

A harsh add to the House budget bill: penalizing states that cover lawfully residing children, but only if they have expanded #Medicaid. VA, ME, CA, NY, PA, NC and many more would be penalized. Pregnant adults and children, and our communities as a whole would suffer.

The Medicaid and marketplace changes in the House bill are extremely concerning because they will block or take coverage away from millions of eligible people. Don't sleep on the marketplace provisions, especially this one ⬇️

Right now, House Ag is marking up a bill that would cut #SNAP by hundreds of billions of dollars. One talking point is that it would address fraud. However, there is nothing in the bill to support SNAP clients who are victims of fraud via skimming www.13wmaz.com/article/news...

How many people in your congressional district are at risk under the House R proposal to take health coverage away from people not meeting a work requirement? Check out the new @centeronbudget.bsky.social analysis by @gidlukens.bsky.social and Elizabeth Zhang

High stakes in the legislative debate about to unfold in the House. We will be watching. #ACA #Medicaid

House Ag bill would take away or cut #SNAP food benefits for millions of low-income people struggling to afford groceries—families w/ children, seniors, ppl w/ disabilities, veterans & workers in low-wage jobs.⬇️

14 states would lose $75B in federal #Medicaid funding under this piece of House Republicans' sweeping budget legislation. Just for doing their own, wholly state-funded coverage programs for people w/o documented immigration status.

The House W&M bill includes a slew of tax cuts for wealthy ppl. One glaring omission: an extension of enhanced premium tax credits. And that's a major reason 13.7M would be uninsured per CBO's early look at proposals in the House E&C bill. democrats-energycommerce.house.gov/sites/evo-su...