How do average premiums and subsidies vary by metal level? Is gold, silver or bronze the most popular plan type? Healthinsurance.org has a new tool to see how these factors vary by state: www.healthinsurance.org/obamacare/ma...

They also noted NO on requiring a prescription. It seems like this means that the situation remains about the same as it is currently. In some states you will have to get a prescription and is others you won’t. I am still unsure about this TBH.

There is still massive confusion around the practical outcome of ACIP’s vote on COVID19 vaccines today. Some are reporting that ACIP made no recommendations at all. This is the exact wording of what they voted “yes” on. Shared clinical decisionmaking could mean talking to a pharmacist.

ACIP voted this afternoon to stop recommending that all adults get the COVID vaccine. But they voted against requiring people to have a prescription to get the vaccine. Their recommendations still have to be approved by the CDC's acting director.

ACIP has been discussing COVID vaccine recommendations today (follow @elizabethjacobs.bsky.social for details). Here's my overview of how ACIP recommendations shape health insurance coverage, and what you can expect if you're trying to get a COVID vaccine: www.healthinsurance.org/faqs/can-you...

If you buy your own health insurance and want to be able to contribute to an HSA (which lowers your MAGI used to determine subsidy eligibility), know that ALL Marketplace Bronze (and catastrophic) plans will be HSA-eligible starting next year www.healthinsurance.org/faqs/can-i-b...

"Some members seemed confused about the data they were being presented. After their vote on the program that provides free vaccines for children, some members asked what they just voted on."

🚨 Dear Democrats: I'm the guy who's moving heaven & earth to get the #ACA enhanced tax credits extended, and I'm telling you NOT to cave for a short-term fix: acasignups.net/25/09/11/dea...

Should you let your health insurance automatically renew? The short answer is no, but here are more details about how this works and why it's in your best interest to actively compare your options each year: www.healthinsurance.org/faqs/should-...

Several states offer state-funded health insurance subsidies on top of the federal subsidies that are provided under the ACA. Here's my overview, including details about how each state's program works and potential changes for 2026: www.healthinsurance.org/faqs/which-s...

How and when does the Big Ugly Bill change our health care? On #CareTalk live Rachel Madley Center for Health & Democracy explains w/ me @healthcarevoices.org @mswmedia.com & Diane @socialsecurityworks.org @louisenorris.bsky.social @healthinsuranceorg.bsky.social#CareTalkanswer health ins q’s.

New Hampshire, Oregon, and Utah all enacted legislation this year to protect patients from surprise out-of-network bills for ground ambulance services: www.healthinsurance.org/glossary/no-... (18 other states already had consumer protection rules in place)

A full-time student in Georgia who has tried to sign up for Georgia Pathways Medicaid and keeps getting rejected due to admin roadblocks — even though he meets the work requirement rules (full-time student counts as working) abcnews.go.com/Health/georg...

🚨🚨🚨 UPDATED: Across 32 states, avg. 2026 #ACA exchange plan filings for unsubsidized enrollees average a stunning +21.6%. That's an additional $133/mo ON TOP OF the hundreds or THOUSANDS of dollars in lost subsidies for the millions of enrollees currently subsidized. acasignups.net/rate_changes...

Marketplace insurers in Arkansas have proposed a weighted avg rate ↑ of 36% for 2026 www.healthinsurance.org/aca-marketpl... Gov. Sanders calls this "outrageous" & wants her insurance commissioner to reject the proposals. Rate proposals would be lower if Congress extended the subsidy enhancements.

How prior authorization works for people with Medicare: www.medicareresources.org/glossary/med...

Next year, Marketplace enrollees are going to have a pay a larger percentage of their income in premiums (assuming Congress doesn't extend the current subsidy enhancements). Here's my overview of how it all works, including examples: www.healthinsurance.org/faqs/is-the-...

Many disabled people aren't on SSI (burdensome, long wait time), so this isn't just going after able-bodied people. We know from experience that many working people will fall through the cracks because of administrative burden. In AR in 2018, there were 13 separate steps to report work hours!

🚨🚨🚨 NEW: WARNING: 2026 #ACA net premium hikes w/out IRA subsidies will be even worse than I thought: acasignups.net/25/07/30/war...

Next year, Marketplace enrollees are going to have a pay a larger percentage of their income in premiums (assuming Congress doesn't extend the current subsidy enhancements). Here's my overview of how it all works, including examples: www.healthinsurance.org/faqs/is-the-...

My summary of some of the most immediate health policy changes in the "Big Beautiful Bill," including some that already took effect and others that will take effect for 2026 coverage www.healthinsurance.org/blog/one-big...

For people who are going to be hit by the return of the "subsidy cliff" next year, the full brunt of these rate increases is going to come out of their own pockets, in addition to losing the entire subsidy they're getting this year.

House GOP working on a follow-up budget bill expected to contain some of the cuts to Medicare and Medicaid that didn't make it into the "Big Beautiful Bill" www.beckershospitalreview.com/finance/hous... Here's more about some of those potential Medicaid cuts: www.healthinsurance.org/blog/the-mos...

Even if everything he said about work requirements were true (it isn't), work requirements are only ~1/3 of the total Medicaid cuts, w/ the other 2/3 also kicking ppl off Medicaid. (Work reqs kick both ppl who are working & ppl who are in exempted groups off Medicaid because of the new red tape.)

The U.S. health coverage/care system "was built through deliberate choices driven by deeply held beliefs about who deserved care and who didn’t." drjessicaknurick.substack.com/p/we-were-ne... Excellent overview of the history of American healthcare/coverage by @drjessicaknurick.bsky.social

The changes next month include the removal of the special enrollment period for low-income applicants, and the termination of coverage for 10,000 DACA recipients.

The U.S. has cut off most active resettlement aid to refugees. Our local Welcome Corps pod, SOMA-U Refugee Support, is helping an Ethiopian family of 3 find housing and childcare here in Essex County NJ. Both parents are working but they need a few months' help. Can you? gofund.me/d7087d9a

North Carolina’s former health secretary, Kody Kinsley, explains the heavy lift and hard choices ahead of states as they rush to put Republicans’ new health reforms in place. tradeoffs.org/2025/07/10/b...

My summary of the Marketplace rule changes that HHS finalized, including changes that take effect next month: www.healthinsurance.org/blog/new-fed...

In other words, red states like Arkansas, Indiana or Ohio, which already had Medicaid work requirement waivers approved during Trump 1.0 until they were shut down by federal judges, could potentially dust them off/reapply & launch theirs anytime over the next 18 months.

34 million?? Not even close. There are only about 2 million able-bodied adults on Medicaid who aren't working, going to school, serving as a caregiver, or chronically ill: www.kff.org/medicaid/iss... Some are in their early 60s, retired, & waiting for Medicare. Probably not ideal farm workers.

If your employer is offering an ICHRA, here's an overview of the type of health coverage you need in order to utilize the ICHRA benefit: www.healthinsurance.org/faqs/which-h...

If your employer is offering an ICHRA, here's an overview of the type of health coverage you need in order to utilize the ICHRA benefit: www.healthinsurance.org/faqs/which-h...

The lawsuit filed today by the Am Academy of Pediatrics, Am Assn of Public Health & others challenging HHS's overhaul of federal vaccine recommendations gives a comprehensive account of how much these recommendations matter under various fed laws/programs. publications.aap.org/aapnews/news...

We know that significant Medicaid funding cuts are coming due to the #OBBBA, and 71 million Americans rely on Medicaid for their health coverage. But what does Medicaid cover and how does it compare to Marketplace and employer coverage? Here's my summary: www.healthinsurance.org/faqs/what-do...

I think I saw this on tiktok but someone said, "you may not need medicaid, but your local hospital does"

Even if you aren't among the millions of people who will lose coverage, your premiums will ↑ due to higher uninsured rates/more uncompensated care. Even if your hospital won't close, it will be crowded by people from areas where hospitals close. Federal funding cuts to health care affect us all.

They asked "21 of the country’s largest health insurance groups" if they would continue coverage, & only one gave a definitive "yes" answer. Yikes. Vaccine ROI starts to pay off almost immediately (as opposed to preventive services that result in avoiding illnesses years or decades down the road).

If you're on Quora, I've started answering health policy questions on that platform. Here's my answer to a question about the premium subsidy enhancements that are scheduled to expire at the end of this year: www.quora.com/Does-the-Big...

Not that anyone cares, but now that JD Vance has cast the tiebreaking vote for $1 trillion in Medicaid cuts, I'm reupping these Vance quotes from 2017, in which he flatly declared that Medicaid cuts like these betray Trumpism's promises to the working class: newrepublic.com/article/1954...

Even if you aren't among the millions of people who will lose coverage, your premiums will ↑ due to higher uninsured rates/more uncompensated care. Even if your hospital won't close, it will be crowded by people from areas where hospitals close. Federal funding cuts to health care affect us all.

The ACA worked to address this sort of disparity for people who don't have employer-sponsored insurance. Marketplace premiums are income-based. Out-of-pocket costs can be much lower for people with lower incomes. And Medicaid expansion slashes out-of-pocket costs for those with the lowest incomes.

This is simply false. Everyone on Medicaid had their eligibility redetermined post-pandemic (& annually since then). There is very little fraud in terms of enrollment. And most people with Medicaid are already working. They would lose coverage due to paperwork & problems with reporting their work.

Medicaid eligibility does not end at the poverty level. For children & pregnant women, it extends far above FPL. And the ACA increased it to 138% of FPL for most adults. The fact that there are more people on Medicaid than people under the poverty level just means Medicaid is working as designed.

Here's my summary of the ACA's preventive care mandate, including what has to be covered and the litigation that has played out over the last couple of years, culminating with today's SCOTUS ruling: www.healthinsurance.org/faqs/what-is...

Curious about ICHRAs? Here's my updated overview of the pros and cons for employers and employees: www.healthinsurance.org/faqs/what-ar...

Here's my summary of the ACA's preventive care mandate, including what has to be covered and the litigation that has played out over the last couple of years, culminating with today's SCOTUS ruling: www.healthinsurance.org/faqs/what-is...

Georgia’s #Medicaid work requirement serves as an example of how Medicaid work requirements could threaten health care for nearly 16 million people nationwide. #GreatRead from @propublica: www.propublica.org/article/geor...

People in wheelchairs staged a sit-in at the Senate yesterday, protesting Medicaid cuts. They were arrested and their hands zip-tied: www.snopes.com/fact-check/m...