Potential Overhaul Looms for Affordable Care Act Amid Legislative Changes
Millions of Americans relying on the Affordable Care Act for health coverage could soon face significant changes. These alterations, affecting enrollment processes, required documentation, and premium costs, are driven by new legislation and policy proposals.
The “One Big Beautiful Bill,” a comprehensive spending and tax package advocated by President Donald Trump, has already passed the House and awaits Senate consideration. This bill seeks to reshape ACA policies, alongside proposed regulations from the Trump administration and the possible end of pandemic-era premium subsidies.
As reported by the Congressional Budget Office, these changes could lead to a significant drop in coverage, with millions potentially losing insurance by 2034.
Experts, such as Katie Keith from Georgetown University’s O’Neill Institute, warn that these legislative moves could severely restrict access to ACA plans. State-run marketplaces and the National Association of Insurance Commissioners have also voiced concerns about increased costs and reduced access.
Automatic Re-enrollment Might Be Discontinued
The proposed legislation could end the current practice of automatic re-enrollment for ACA policyholders. According to KFF data, over 10 million people were automatically re-enrolled for 2025. The new bill would require policyholders to annually provide detailed personal information, potentially delaying or eliminating their premium tax credits.
Experts like Sabrina Corlette from Georgetown University express concerns that the new requirements could lead to a rise in uninsured individuals, as many might find the process too burdensome. Proponents of the bill argue that these changes are necessary to prevent fraud and abuse in the current system.
Life Events May Lead to Coverage Delays
Currently, individuals experiencing life changes such as marriage or childbirth are provisionally eligible for premium tax credits. The new bill would require documentation before receiving these credits, possibly delaying coverage, especially for newborns awaiting Social Security numbers.
This change has prompted concern among policy experts, with potential delays in coverage for new parents highlighted in a white paper by Jason Levitis and Christen Linke Young.
A Shortened Enrollment Period
The proposed legislation aims to reduce the open enrollment period, ending it by December 15. Additionally, a special enrollment period for lower-income individuals, introduced by the Biden administration, may be eliminated, heightening fears of increased fraud.
While some argue that reducing these periods could limit fraudulent activities, others, including the National Association of Insurance Commissioners, believe that improving marketplace security could address these concerns.
Possible Increases in Premiums and Costs
With the expiration of enhanced pandemic-era premium subsidies, many anticipate higher premiums and out-of-pocket costs. The House bill does not propose extending these subsidies, which have significantly increased ACA enrollment since 2020. The CBO estimates that maintaining the subsidies would be costly, but their expiration could lead to a 75% increase in premiums and a rise in the uninsured population.
Amid these potential changes, stakeholders continue to debate the best path forward for the Affordable Care Act and its beneficiaries. For more information, visit KFF Health News.
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