New Wakely Estimates on 2026 ACA Enrollment Patterns
Wakely released a new report on key trends in 2026 ACA market enrollment. Data collected by Wakely found that, on average, about 86% of individual market enrollees had paid their first January premium. Furthermore, Wakely estimated that enrollment could drop nationally from 17% to 26%. However, results may differ significantly by state due to substantial variation across states.
Farm Bureau Plan
One factor that may influence individual market enrollment is the expansion of alternative options. KFF released a story on the growth of farm bureau health plans. These plans include underwriting and therefore can offer lower premiums to eligible members. Last year, Missouri, Alabama, Florida, and Ohio passed laws permitting the offering of farm bureau plans.
CMS Rule Releases
On April 10, CMS released a proposed rule updating the Medicare Inpatient Prospective Payment System (IPPS) for FY 2027. The rule proposes a net 2.4% increase in inpatient payment rates for hospitals that are meaningful users of electronic health records and that successfully report quality data.
Congress Watch
Hill watchers are closely monitoring a potential reconciliation bill. The bill’s primary purpose would be to fund the Immigration and Customs Enforcement (ICE) and border patrol but could include health items to offset the cost of the bill.
CMS Rule Watch
Two major CMS rules are currently sitting at OMB and therefore are likely to be released in the next month or so.
- Establishing State Community Engagement Requirements– This is the rule that will establish the work requirement standards that states must meet starting next year. The rule must be finalized by June 1st and therefore will take the form of an interim final rule (i.e., there will be no proposed rule/space for comments).
- The final 2027 Notice of Benefit and Payment Parameters, which will influence 2027 individual market pricing is currently at OMB. There are questions about whether some of the major policy changes related to catastrophic and bronze plans will be finalized during this round of regulations.
