How the Medicaid reconciliation bill could help wither away the Affordable Care Act

Fierce Healthcare – Tuesday, May 20, 2025
By Noah Tong

Understandably, the legislation plodding through Congress is most closely associated with reductions in Medicaid spending, but there is new scrutiny on how the megabill could impact the state of the health insurance marketplace.

Policy observers see the next six months as hugely pivotal, with a series of actions and provisions potentially responsible for cutting enrollment in the Affordable Care Act (ACA) exchange by one-third, said KFF President and CEO Drew Altman. Marketplace enrollment has increased 113% over the last five years to 24.3 million covered individuals.

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