Lisa Dubay

Expiring ACA Premium Tax Credits Could Lead to Nearly 340,000 Jobs Lost Across the U.S. in 2026 Unless Congress acts quickly to extend the enhanced ACA marketplace premium tax credits, nearly 5 million people could lose health insurance coverage in 2026.

"researchers have estimated that the end of enhanced tax credits will lead to 7.3 mill people losing their ACA coverage in 2026, of whom 4.8 mill would become uninsured. The loss of the additional subsidies are projected to increase how much...enrollees must pay...from an avg of $888 to $1,904/year"

New estimates from my @urbaninstitute.bsky.social ky.social colleagues showing that 4.8 million people will become uninsured if the enhanced premium tax credits are not extended. www.urban.org/research/pub...

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)

Just want to say -- I look for your estimates every week. You are very much appreciated. Glad to see you on bluesky, I've been going to twitter just to see your posts!

Most people on Medicaid with incomes above 100 percent of the FPL are kids, pregnant women, and elderly who are getting help with Medicare deductibles and co-insurance or who are spending down their income and assets for long-term care (Medicaid pays some portion of 69 percent of LTSS.

One more thread on a new provision in Senate reconciliation bill that Senate GOP will misleadingly tout as expanding access to home- and community-based services for seniors and people with disabilities (section 71123) but in context of the bill, it won't be meaningful (1/x)

Estimated Budgetary Effects of a Bill to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14, the One Big Beautiful Bill Act As ordered reported by the House Committee on the Budget on May 18, 2025

New CBO estimates of reconciliation bill reported by Budget Committee Sunday: gross #Medicaid cuts of $792B before interactions with ACA changes. Total of $803B in net health care cuts. Estimates don't account for Rules Committee changes with even harsher Medicaid cuts. www.cbo.gov/publication/...?

Which States Would Be Affected by a House Proposal to Cut Federal Medicaid Funding for States That Cover Undocumented Immigrants? KFF data show that as of April 2025, 14 states plus DC use state-only dollars to provide health coverage to children regardless of immigration status, including 7 states that also do so for at least s...

My new @kff.org quick take discusses the House's proposed penalty to reduce Medicaid financing for states covering undocumented immigrants with their own funds and identifies which states would be affected:
www.kff.org/quick-take/w...

Who Gains and Who Loses under a Tax Cut Extension with Medicaid and SNAP Spending Reductions In this brief, we estimate the combined impact of three major proposals on taxpayers’ after-tax, after-transfer incomes to show who would benefit and who would lose.

Excellent piece by @urbaninstitute.bsky.social on the distributional effects of tax cut extensions paid for by cuts to #Medicaid and #SNAP. Lowest income families would face losses in income after taxes and benefits and highest income familes would see large gains. www.urban.org/research/pub...

Combined Impact of Medicaid Cuts Under Consideration Would End Expansion and Take Away Coverage for Nearly 21 Million Low-Income People In analyzing the draconian Medicaid cuts under consideration by House Republicans for inclusion in budget reconciliation legislation, it is often easier to examine each specific proposal in isolati…

Thread on my new blog on how taking a step back and looking at the combined effect of several #Medicaid cuts under consideration by House GOP yields a clear conclusion: they would together end the #Medicaid expansion and terminate coverage for 21 million people: ccf.georgetown.edu/2025/05/01/c...

Fact Sheet on CMS Marketplace Rule -- Final 4-11-25.pdf | Powered by Box

Trump administration proposal would be "death by a thousand cuts" for the Affordable Care Act - up to 2M people would lose coverage, millions more would face higher costs. @jasonlevitis.bsky.social @clinkeyoung.bsky.social and I sum it up: georgetown.app.box.com/file/1831720...

Latest estimates on economic impact on states of proposed cuts to Medicaid and SNAP

How Dismantling the Education Department Could Affect Disabled Students across the US Though states and local governments are primarily responsible for K–12 education, the US Department of Education is critical to ensuring disabled children in every community have access to a free, app...

What are the effects of dismantling the Department of #Education on students with #disabilities?

An Urban Wire post examines the potential impacts of disrupting the Department of Education’s key functions of enforcing critical civil rights laws and distributing IDEA #funding to the states.

Interested in promoting upward mobility? Come hear about how to shape policy making and create change in your community with my @urbaninstitute.bsky.social colleagues.

Important new research on the impact of federal work requirements for Medicaid beneficiares on coverage from my @urbaninstitute.bsky.social colleagues @jh4.bsky.social, Genevieve Kenney, and Michael Karpman.

Dont' miss this timely virtual event ! Featuring @edwincpark.bsky.social, Genevieve Kenney, Sara Rosenbaum @milkeninstitute.org , and @greggbloche.bsky.social

Reupping my blog from yesterday. The major #Medicaid cuts under consideration to meet the budget resolution target of at least $880b in cuts are the same Medicaid cuts from failed 2017 repeal bills. House GOP leaders are just trying to disguise them as anti-fraud. ccf.georgetown.edu/2025/02/24/s...

See what would happen in your Congressional Distrct with link at the bottom of the page.

Reducing Federal Support for Medicaid Expansion Would Shift Costs to States and Likely Result in Coverage Losses Leadership in the House of Representatives has proposed substantial federal funding cuts to the Medicaid program over the next 10 years. This report focuses on the proposal to reduce the 90 percent fe...

E&C committee was asked to cut $880 billion to make way for tax cuts. Latest paper from my @urbaninstitute.bsky.social colleagues on what would happen to insurance coverage if the 90 percent FMAP for the Medicaid expansion was eliminated. www.urban.org/research/pub...

DOT’s Plan to Distribute Funding by Birth and Marriage Rates Would Leave Communities Most In Need Behind If enacted, the new US Department of Transportation memo would prioritize funding to whiter, higher-income, more car-dependent areas over communities of color and people who walk, bike, or take public...

The US DOT says it's planning to prioritize areas with high marriage & high birth rates for funding.

Our new analysis @urbaninstitute.bsky.social shows this would disproportionately fund:
—Communities with a higher white resident share
—Low-density areas
—High-income areas
—Car-dependent areas

ha, ha, ha !

Very excited about this new collaboration between @urbaninstitute.bsky.social and Georgetown Law! Keep your eyes on this space!

Household Spending on Premiums Would Surge if Enhanced Premium Tax Credits Expire In this brief, we estimate household premiums for people with Marketplace coverage in 2025 with and without enhanced PTCs by income and state to gauge the impact on families if the more generous credi...

Congress is considering extending the enhanced premium tax credits. According to my @urbaninstitute.bsky.social colleagues, households' spending on insurance premiums would surge if the EPTCs are not extended. www.urban.org/research/pub...

Thanks @ddiamond.bsky.social ! If you want to see how many people would lose coverage in your state check out this map from my @urbaninstitute.bsky.social colleagues: www.urban.org/data-tools/h...

The big three public health programs, Medicaid, Medicare and the Marketplace ACA subsidies are lifting about 39 million people out of poverty.

How Pending Health-Related Lawsuits Could be Impacted by the Incoming Trump Administration | KFF This brief provides an overview of current lawsuits in health policy including preventive services, abortion care, gender affirming care, Medicare drug price negotiations, nursing home staffing rules,...

What the new administration could mean for health related lawsuits including preventive services, MTALA, medication abortion, family planning and more...https://www.kff.org/medicare/issue-brief/how-pending-health-related-lawsuits-could-be-impacted-by-the-incoming-trump-administration/

Who Would Lose Coverage If Enhanced Premium Tax Credits Expire? The expiration of the pandemic-era enhanced premium tax credits risks leaving 4 million people without health insurance.

Enhanced premium tax credits are set to expire at the end of 2025. See my @urbaninstitute.bsky.social @urbaninstitute.bsky.social colleagues' great interative map of who would lose coverage. www.urban.org/data-tools/h...

In case you are interested in what the public thinks about the importance of the Medicaid program, look here:

Advocates and experts are working to rally support for Medicaid, citing its coverage for kids, rural Americans and the disabled.

“Medicaid is the backbone of many aspects of our health system,” @joanalker1.bsky.social told me, noting that about 1 in 4 Americans are covered through the program.

With Medicaid facing severe threats next year, I will be periodically posting facts about the program which demonstrate the many critical roles that Medicaid plays.

Medicaid covers 62% of all nursing home residents. #healthpolicy

www.kff.org/medicaid/iss...