Dallas-based Tenet Healthcare expects a 20% reduction in ACA exchange enrollment this year with the expiration of enhanced premium tax credits set to pressure hospital earnings and payer mix. The company is projecting adjusted EBITDA of up to $4.8 billion…
ACA
The House Judiciary Committee issued subpoenas Feb. 9 to eight health insurers, seeking documents about potential fraud issues related to ACA marketplace subsidies. The subpoenas target Blue Shield of California, Centene, CVS Health, Elevance Health, GuideWell, Health Care Service Corp.,…
CMS unveiled a proposed rule Feb. 9 that would reshape the ACA marketplace for plan year 2027, expanding insurer flexibility on plan design, tightening eligibility verification, and re-introducing several program integrity measures that were blocked by a federal court last…
Montana has clawed back more than $23 million in fraudulent claims after PacificSource flagged more than 200 suspicious ACA enrollments tied to as much as $54.7 million in unjustified claims. A state investigation identified a scheme in which out-of-state individuals…
About 4,000 Maryland Health Benefit Exchange customers “were mistakenly notified” of 2026 auto-renewal for CareFirst BCBS coverage, the insurer told Becker’s Feb. 5. CareFirst attributed the error to a “data synchronization issue” with the marketplace and said these individuals did…
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Negotiations to extend the ACA enhanced tax credits that expired at the end of 2025 have collapsed, likely ending hopes of a revival, The Wall Street Journal reported Feb. 5. A bipartisan group of senators were discussing a plan to…
Enhanced ACA premium tax credits expired Dec. 31, leaving millions of marketplace enrollees facing higher premiums in 2026. A bipartisan group of senators continues negotiating, and Republicans are preparing a “best and final” offer on a two-year extension with income…
Sen. Bernie Moreno, R-Ohio, said his party is preparing to make its “best and final offer” to extend the ACA enhanced tax credits, Politico reported Jan. 28. Mr. Moreno has been a lead negotiator in a bipartisan effort in the…
Nearly 23 million people have enrolled in ACA marketplace plans for 2026, down from 24.2 million in 2025, according to the latest data from CMS published Jan. 28. For the 30 HealthCare.gov states, the data is through Jan. 15. For…
New Mexico has seen the biggest increase in ACA enrollment from 2025 to 2026, while North Carolina has seen the largest decrease, according to KFF. The ranking below uses preliminary CMS data comparing similar periods during the 2025 and 2026…