Larry Levitt

Math issue aside, the Trump Administration hasn’t actually cut drug prices.

I’d give anything to have health insurance data as timely and as accurate as our employment data.

As the job market stalls, remember that a major piece of the Republican tax and spending law that just passed is a work requirement for Medicaid enrollees.

The Trump Admin's May executive order on drug pricing laid out several regulatory actions the Admin planned to take if "significant progress" toward MFN pricing was not achieved voluntarily. One (but not the only) way to read these letters is as an extension of time for such voluntary progress. /1

President Trump has sent letters to drug company executive demanding that they lower prices, or else...(the "or else" part is still kind of unclear)

Medicare and Medicaid were created 60 years ago today. Medicaid now covers more people than Medicare. But, when we created this timeline for @kff.org's San Francisco headquarters, we couldn't find any news headlines from 1965 that mentioned Medicaid.

Few people will shed tears for health insurers reporting lower profits and seeing their stock drop. But, this is a sign of higher underlying health care prices and costs, which means consumers will end up paying more in premiums and out-of-pocket costs.

A Massive Health Care Shock Is Coming And there is little time—and maybe not enough will from Republicans—to avert it.

Here comes another big health care debate, with insurance for a few million more people at stake

And the clock is ticking www.thebulwark.com/p/a-massive-...

How Much More Would People Pay in Premiums if the ACA's Enhanced Subsidies Expired? | KFF With the enhanced subsidies for enrollees in ACA Marketplace plans set to expire at the end of 2025, this calculator illustrates how much out-of-pocket premiums would increase if Congress does not ext...

With growing interest in what will happen if enhanced ACA premium tax credits are allowed to expire at the end of this year, we have a calculator that estimates increased costs by zip code, income, and age.
www.kff.org/interactive/...

I hadn't until now focused on the fact that we're coming up on the 60th anniversary of both the Grateful Dead and Medicare and Medicaid.

New: The Republican tax and spending mega-law will cut Medicaid in every state, but the effects are biggest in states that have expanded Medicaid under the ACA.
www.kff.org/medicaid/iss...

Countdown Clock Begins for Giant Health Insurance Premium Increases In around 90 days, millions of Americans will learn about out-of-pocket cost hikes of more than 75 percent on average.

90 days. That's how long we have until close to 20 million households get notices that their health insurance is going up, way up, by an average of more than 75%.
Even those without ACA subsidies will see the raw cost of insurance up around 15%.
Expect a 4-alarm fire this fall. From me:

The key difference between this estimate and the projection based on the House bill (10.9 million) is likely that the policy that would have penalized states who cover undocumented immigrants using state (not federal) dollars violated the Byrd rule and was stripped from the final bill.

Estimated Budgetary Effects of Public Law 119-21, to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14, Relative to CBO’s January 2025 Baseline Public Law 119-21 as enacted on July 4, 2025

Here is CBO's final score of the Republican megabill. It incudes their estimate that there will be 10 million more people uninsured. But, we don't yet have any details of coverage losses by year or by type of coverage.
www.cbo.gov/publication/...

The CBO coverage loss estimate is somewhat lower than before because the Senate parliamentarian said some provisions didn't comply with budget rules. In particular, she ruled against a provision that penalized states that use their own money to provide health care to immigrants.

New: The Congressional Budget Office's official estimate of the Republican tax and spending bill finds it would increase the number of people uninsured by 10 million by 2034.

Unlike many of the Medicaid cuts in the Republican tax and spending bill, which are delayed until after the midterm election, ACA premium spikes due to expiration of enhanced premium tax credits will hit January 1, 2026.

Individual market insurers requesting largest premium increases in more than 5 years - Peterson-KFF Health System Tracker Early indications are that individual market insurers will be increasing premiums in 2026 by more than they have since 2018, the last time policy uncertainty contributed to sharp premium increases. Ac...

New: Early reports from ACA insurers show the biggest premium increases in years, driven by:

*An expected sicker pool of enrollees if enhanced premium tax credits are allowed to expire at the end of this year
* Tariffs
* Higher health care costs
www.healthsystemtracker.org/brief/indivi...

ChatGPT isn't ready to replace KFF's health policy experts.

This policy will discourage lawfully present immigrants who are eligible for Medicaid from signing up, or signing their kids up, leaving them without health insurance. That, of course, is a feature, not a bug.

9 states have waivers that allow for multi-year continuous #Medicaid eligibility for children. New CMS guidance says no new such waivers will be approved and current waivers are time-limited. www.kff.org/report-secti...

“CMS is not required to publish information about how the funds are distributed—such as by posting the amount sent to each state or why certain state applications were approved or denied—though it could choose to do so. States are required to submit annual reports to CMS…”

How did Martin Luther put it? "The right hand giveth..."

"The law also does not define 'rural' when describing the scope of the program, meaning that states or the administration could do so broadly."

Lack of clear definitions can be a problem if imposter hospitals apply for the program. We've seen it happen for some of the residency program funding.

A Closer Look at the $50 Billion Rural Health Fund in the New Reconciliation Law | KFF The new reconciliation law includes a $50 billion rural health fund. This brief describes the rural health fund, explains what the law says about the allocation of funds, and highlights outstanding qu...

The temporary $50 billion rural health fund in the Republican tax and spending bill gets distributed from 2026 to 2030. But, 63% of the Medicaid cuts hit after 2030.
www.kff.org/medicaid/iss...

The 92% figure comes from our KFF analysis.

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

Certainly. But an even bigger deal when the payments get ratcheted down later.

True. But, the Medicaid rule repeals only apply to provisions that have not yet gone into effect, meaning there are losses in coverage relative to baseline, but not current coverage. The moratorium on new state-directed payments takes effect immediately, but the ratcheting down occurs later.

That’s a fair point. Anticipated cuts and the uncertainty could lead some hospitals on the edge to close or insurers to pull out of the ACA marketplaces.

One big exception: If enhanced ACA premium tax credits are allowed to expire at the end of this year, out-of-pocket premiums will immediately increase by an average of more than 75% and millions will end up uninsured.