Policy Watch
Quick-hitting policy analysis, polling, and updates on the key issues facing the country.
Explaining Cost-Sharing Reductions and Silver Loading in ACA Marketplaces
The House of Representatives recently passed a budget reconciliation bill that would appropriate funding for cost-sharing reductions that insurers are required to provide to low-income enrollees in the Affordable Care Act marketplace. This policy watch explains what these cost-sharing reductions are, how they relate to federal spending, and what effect appropriating funding might have on premiums and the uninsured rate.
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Expansions to Health Savings Accounts in House Budget Reconciliation: Unpacking the Provisions and Costs to Taxpayers
The House budget reconciliation bill contains various expansions to Health Savings Accounts (HSAs). This policy watch explains what HSAs are, how they have been used, what the key changes to HSAs would be, and how much they would cost the federal government.
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An Update on PEPFAR Reauthorization
This Policy Watch provides an update on the status of PEPFAR reauthorization, which expired on March 25, 2025, allowing certain provisions to lapse.
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Implementing Work Requirements on a National Scale: What We Know from State Waiver Experience
On May 18, the House Budget Committee advanced a budget reconciliation bill that includes significant changes to the Medicaid program. As anticipated, Medicaid work requirement provisions are included and preliminary estimates released by the Congressional Budget Office (CBO) show that this provision would reduce federal spending by $280 billion over ten years, nearly half of all estimated Medicaid savings in the bill. The provisions raise many operational and implementation questions, particularly considering the experience of Arkansas and Georgia with implementing work requirements through waivers.
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Potential Impacts of 2025 Budget Reconciliation on Health Coverage for Immigrant Families
This policy watch discusses key provisions in the draft 2025 budget reconciliation legislation that are aimed at limiting health coverage for immigrant families.
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How Will the 2025 Budget Reconciliation Affect the ACA, Medicaid, and the Uninsured Rate?
This analysis details the number of people who would become uninsured from policy changes in the ACA Marketplace and Medicaid. The Congressional Budget Office estimates that, taken together, these changes will result in at least 13.7 million more uninsured people in the year 2034 than would otherwise be the case.
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