ACA
HHS released the final 2027 Notice of Benefit and Payment Parameters. Overall, the rule is estimated to reduce ACA enrollment by 1.2 million to 2.0 million.
- The final rule made a number of changes, including:
- Codifying several OBBBA provisions such as, removing APTC eligibility for certain non-citizens
- Finalizing requirements for CSR reporting and silver-loading
- Increasing flexibility around bronze/catastrophic plans
- KFF released its estimate of 2026 ACA Exchange enrollment. Overall, KFF estimates 2026 enrollment will decline by 5 million enrollees on average.
Medicaid
- CMS released a proposed rule to reduce state directed payments. The proposed rule would reduce Medicaid spending by over $700 billion over 10 years, including the effects of OBBBA.
Medicare
- The Supreme Court rejected drug companies’ appeals challenging Medicare drug price negotiations. This resolves at least the constitutional questions surrounding implementation of the drug pricing law.
- The GAO released a report recommending site-neutral payment reform. The report estimates that federal savings could approach $157 billion over 10 years. Site-neutral payment reform is one of the issues that could be taken up in a future reconciliation bill.
