Edwin Park
@edwincpark.bsky.social
Health policy especially Medicaid, CHIP and the Affordable Care Act. Research Professor at the Center for Children and Families (CCF) at Georgetown University’s McCourt School of Public Policy.
ccf.georgetown.edu
ccf.georgetown.edu
Pinned
Edwin Park
@edwincpark.bsky.social
· Sep 19
Medicaid, CHIP, and Affordable Care Act Marketplace Cuts and Other Health Provisions in the Budget Reconciliation Law, Explained
Editor’s Note: this brief was updated on August 13, 2025 to reflect additional Congressional Budget Office coverage estimates of the reconciliation law issued on August 11, 2025 In partnership with…
ccf.georgetown.edu
ICYMI: from Georgetown CCF and CHIR our comprehensive analysis of the budget reconciliation law's draconian #Medicaid, CHIP, ACA Marketplace cuts as well as other health provisions. We now have an easier-to-print PDF version. ccf.georgetown.edu/2025/07/22/m...
Reposted by Edwin Park
Q: At the end of this year, those extended Obamacare subsidies expire. What's your message to those 24m Americans who will see their premiums go up?
TRUMP: Don't make it sound so bad. Obviously you're a sycophant for Democrats. You're obviously a provider of bad news for Republicans.
TRUMP: Don't make it sound so bad. Obviously you're a sycophant for Democrats. You're obviously a provider of bad news for Republicans.
December 12, 2025 at 11:07 PM
Q: At the end of this year, those extended Obamacare subsidies expire. What's your message to those 24m Americans who will see their premiums go up?
TRUMP: Don't make it sound so bad. Obviously you're a sycophant for Democrats. You're obviously a provider of bad news for Republicans.
TRUMP: Don't make it sound so bad. Obviously you're a sycophant for Democrats. You're obviously a provider of bad news for Republicans.
So only provision directly related to ACA Marketplaces is one appropriating cost sharing reductions which would effectively reduce underlying subsidies for those with lower incomes and make even more people uninsured. Like Crapo-Cassidy nothing at all on extending the expiring enhanced credits.
Speaker Johnson is eying a vote on a health care package *next week*, per House Republican leadership aides. Underlying bill will include policies like codifying AHPs, approving CSRs, PBM transparency. (NO Crapo-Cassidy.)
Plus an amendment on extending ACA funds; no details yet.
Plus an amendment on extending ACA funds; no details yet.
December 12, 2025 at 10:25 PM
So only provision directly related to ACA Marketplaces is one appropriating cost sharing reductions which would effectively reduce underlying subsidies for those with lower incomes and make even more people uninsured. Like Crapo-Cassidy nothing at all on extending the expiring enhanced credits.
Reposted by Edwin Park
With marketplace premium spikes on the verge of hitting 20M+ people Jan. 1, House Speaker Johnson is reportedly considering a bill from Rep.Fitzpatrick with a 2-year extension of PTC enhancements. But the bill raises big concerns. www.politico.com/live-updates...
House Republicans weigh vote on Obamacare extension
GOP moderates are exploring a last ditch attempt to get a vote to extend expiring subsidies.
www.politico.com
December 12, 2025 at 7:23 PM
With marketplace premium spikes on the verge of hitting 20M+ people Jan. 1, House Speaker Johnson is reportedly considering a bill from Rep.Fitzpatrick with a 2-year extension of PTC enhancements. But the bill raises big concerns. www.politico.com/live-updates...
Reposted by Edwin Park
Get ready to learn a very wonky term: "effectuated enrollment." It's the number of people who sign up for ACA coverage or get auto-renewed and then pay their premiums. It's going to matter a lot if enhanced tax credits expire and people face an average increase in premium payments of 114%.
December 10, 2025 at 7:48 PM
Get ready to learn a very wonky term: "effectuated enrollment." It's the number of people who sign up for ACA coverage or get auto-renewed and then pay their premiums. It's going to matter a lot if enhanced tax credits expire and people face an average increase in premium payments of 114%.
Reminder GOP Congress/Trump could have easily extended enhanced Marketplace credits as part of H.R. 1. They ignored budget rules barring adding to deficits in future decades by asserting that "current policy" extensions of expiring tax cuts wouldn't count. Could have done the same with the credits.
December 10, 2025 at 4:04 PM
Reminder GOP Congress/Trump could have easily extended enhanced Marketplace credits as part of H.R. 1. They ignored budget rules barring adding to deficits in future decades by asserting that "current policy" extensions of expiring tax cuts wouldn't count. Could have done the same with the credits.
Like the Senate Crapo/Cassidy plan House GOP "ideas" don't include extending enhanced Marketplace credits at all. Proposals like appropriating cost-sharing reductions and codifying Trump Admin rules would further hike premium costs for those with lower incomes and further deter participation.
New: House Speaker Mike Johnson presented Republican members with a list of 10 options to address health care costs, two sources told NOTUS.
None of them involved extending ACA subsidies.
https://www.notus.org/congress/mike-johnson-health-care-cost-suggestions-aca-subsidies
None of them involved extending ACA subsidies.
https://www.notus.org/congress/mike-johnson-health-care-cost-suggestions-aca-subsidies
Mike Johnson Skips ACA Subsidies in Plans to Tackle Health Care Costs
The speaker’s ideas to lower health care costs include “innovation,” according to a photo of the slide shared with NOTUS.
www.notus.org
December 10, 2025 at 3:50 PM
Like the Senate Crapo/Cassidy plan House GOP "ideas" don't include extending enhanced Marketplace credits at all. Proposals like appropriating cost-sharing reductions and codifying Trump Admin rules would further hike premium costs for those with lower incomes and further deter participation.
This plan doesn't extend the expiring enhanced Marketplace credits at all & instead contributes $ to HSAs for enrollees who may not even have HSAs & can't use that $ for premiums. By appropriating cost-sharing reductions, it further lowers underlying credit amounts & raises premium costs even more.
Thune says Republicans will hold a vote on the Cassidy-Crapo health care plan Thursday as a counterproposal to Dems three-year extension of ACA tax credits
December 9, 2025 at 7:53 PM
This plan doesn't extend the expiring enhanced Marketplace credits at all & instead contributes $ to HSAs for enrollees who may not even have HSAs & can't use that $ for premiums. By appropriating cost-sharing reductions, it further lowers underlying credit amounts & raises premium costs even more.
Reposted by Edwin Park
A few thoughts on new Medicaid work req guidance from CMS
Topline it says v. little so states remain in a bind with huge demands and little guidance to go on.
But some takeaways:
1. Confirms that states will have access to 90/10 fed match for new IT systems (vendors are 😀).
🧵
Topline it says v. little so states remain in a bind with huge demands and little guidance to go on.
But some takeaways:
1. Confirms that states will have access to 90/10 fed match for new IT systems (vendors are 😀).
🧵
The Trump Administration has released preliminary guidance on mandatory Medicaid work requirements. We will read and share thoughts soon here and on our website ccf.georgetown.edu
medicaid.gov/federal-poli...
medicaid.gov/federal-poli...
medicaid.gov
December 8, 2025 at 11:05 PM
A few thoughts on new Medicaid work req guidance from CMS
Topline it says v. little so states remain in a bind with huge demands and little guidance to go on.
But some takeaways:
1. Confirms that states will have access to 90/10 fed match for new IT systems (vendors are 😀).
🧵
Topline it says v. little so states remain in a bind with huge demands and little guidance to go on.
But some takeaways:
1. Confirms that states will have access to 90/10 fed match for new IT systems (vendors are 😀).
🧵
Reposted by Edwin Park
Senators Crapo & Cassidy have now released bill language for their health "plan". Besides nothing on expiring Marketplace credits and HSAs, it adds 3 harmful #Medicaid cuts from House version of H.R. 1 that were dropped in final law due to Senate rules (1/x): www.finance.senate.gov/download/hea...
[2025-12-08] Download: Health Care Freedom for Patients Act | The United States Senate Committee on Finance | The United States Senate Committee on Finance
[2025-12-08] Download: Health Care Freedom for Patients Act | The United States Senate Committee on Finance
www.finance.senate.gov
December 9, 2025 at 12:29 AM
Senators Crapo & Cassidy have now released bill language for their health "plan". Besides nothing on expiring Marketplace credits and HSAs, it adds 3 harmful #Medicaid cuts from House version of H.R. 1 that were dropped in final law due to Senate rules (1/x): www.finance.senate.gov/download/hea...
Senators Crapo & Cassidy have now released bill language for their health "plan". Besides nothing on expiring Marketplace credits and HSAs, it adds 3 harmful #Medicaid cuts from House version of H.R. 1 that were dropped in final law due to Senate rules (1/x): www.finance.senate.gov/download/hea...
[2025-12-08] Download: Health Care Freedom for Patients Act | The United States Senate Committee on Finance | The United States Senate Committee on Finance
[2025-12-08] Download: Health Care Freedom for Patients Act | The United States Senate Committee on Finance
www.finance.senate.gov
December 9, 2025 at 12:29 AM
Senators Crapo & Cassidy have now released bill language for their health "plan". Besides nothing on expiring Marketplace credits and HSAs, it adds 3 harmful #Medicaid cuts from House version of H.R. 1 that were dropped in final law due to Senate rules (1/x): www.finance.senate.gov/download/hea...
Senate Republican health "plan" doesn't extend expiring enhanced Marketplace premium credits at all. Just $ for Health Savings Accounts while cutting federal #Medicaid $ for states using their own funds to cover undocumented immigrants & prohibiting Medicaid coverage of gender affirming care (1/2)
December 8, 2025 at 6:36 PM
Senate Republican health "plan" doesn't extend expiring enhanced Marketplace premium credits at all. Just $ for Health Savings Accounts while cutting federal #Medicaid $ for states using their own funds to cover undocumented immigrants & prohibiting Medicaid coverage of gender affirming care (1/2)
Reposted by Edwin Park
NEW: Rural health is in crisis. Congress created a $50B rescue package and gave states just weeks to compete for a slice of it.
$3.75B hinges on whether states pass a series of Trump-approved policies, including restrictions on SNAP.
www.politico.com/news/2025/12...
$3.75B hinges on whether states pass a series of Trump-approved policies, including restrictions on SNAP.
www.politico.com/news/2025/12...
‘Sort of blackmail’: Billions in rural health funding hinge on states passing Trump-backed policies
Democrats and health advocates described the strategy as highly unusual, and some fear it could be wielded to favor political allies.
www.politico.com
December 8, 2025 at 1:44 PM
NEW: Rural health is in crisis. Congress created a $50B rescue package and gave states just weeks to compete for a slice of it.
$3.75B hinges on whether states pass a series of Trump-approved policies, including restrictions on SNAP.
www.politico.com/news/2025/12...
$3.75B hinges on whether states pass a series of Trump-approved policies, including restrictions on SNAP.
www.politico.com/news/2025/12...
Reposted by Edwin Park
Proposed changes to public charge rules are expected to reduce participation in public programs.
A recent KFF/NYT poll found 1 in 10 immigrant adults say they disenrolled from or avoided enrolling in assistance programs due to immigration-related fears: https://on.kff.org/4pmhzK8
A recent KFF/NYT poll found 1 in 10 immigrant adults say they disenrolled from or avoided enrolling in assistance programs due to immigration-related fears: https://on.kff.org/4pmhzK8
December 6, 2025 at 5:04 PM
Proposed changes to public charge rules are expected to reduce participation in public programs.
A recent KFF/NYT poll found 1 in 10 immigrant adults say they disenrolled from or avoided enrolling in assistance programs due to immigration-related fears: https://on.kff.org/4pmhzK8
A recent KFF/NYT poll found 1 in 10 immigrant adults say they disenrolled from or avoided enrolling in assistance programs due to immigration-related fears: https://on.kff.org/4pmhzK8
Reposted by Edwin Park
The decision by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention to downgrade its recommendations to protect infants from hepatitis B is a dangerous move that will harm children.
Click here to read AAP's full statement: bit.ly/3Y9ZQJT
Click here to read AAP's full statement: bit.ly/3Y9ZQJT
December 5, 2025 at 4:15 PM
The decision by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention to downgrade its recommendations to protect infants from hepatitis B is a dangerous move that will harm children.
Click here to read AAP's full statement: bit.ly/3Y9ZQJT
Click here to read AAP's full statement: bit.ly/3Y9ZQJT
Reposted by Edwin Park
A key mission of @kff.org public opinion work is to amplify the voices of the people directly impacted by healthy policy debates. Today we release a great example of this- a survey of ACA Marketplace Enrollees
www.kff.org/public-opini...
www.kff.org/public-opini...
2025 KFF Marketplace Enrollees Survey | KFF
This survey explores how ACA Marketplace enrollees expect to respond if their premium payments doubled as expected in 2026 when enhanced premium tax credits are set to expire. About a third would very...
www.kff.org
December 4, 2025 at 1:38 PM
A key mission of @kff.org public opinion work is to amplify the voices of the people directly impacted by healthy policy debates. Today we release a great example of this- a survey of ACA Marketplace Enrollees
www.kff.org/public-opini...
www.kff.org/public-opini...
Even if an above-the-line deduction where you don’t have to itemize, it would provide the biggest benefit to those with the highest incomes/in highest tax brackets while providing no or modest benefits to those with lower incomes (who now most benefit from the enhanced Marketplace credits). 1/2
Sen. Josh Hawley, R-Mo., is proposing a new tax deduction for healthcare costs as lawmakers face an end-of-year deadline to address an expiring Affordable Care Act tax credit.
Read more: https://taxnotes.co/48llQHP
Read more: https://taxnotes.co/48llQHP
December 4, 2025 at 5:12 PM
Even if an above-the-line deduction where you don’t have to itemize, it would provide the biggest benefit to those with the highest incomes/in highest tax brackets while providing no or modest benefits to those with lower incomes (who now most benefit from the enhanced Marketplace credits). 1/2
H.R. 1's rural health fund was always an inadequate & temporary fig leaf for rural hospitals. But then Trump Admin capped payments to providers at 15%. Now it provides little info about states' applications raising questions about where the $ will really go. kffhealthnews.org/news/article...
Feds Promised ‘Radical Transparency’ but Are Withholding Rural Health Fund Applications - KFF Health News
Proposals from states that have shared their applications to a new $50 billion rural health program include using drones to deliver medication, installing refrigerators to expand access to healthy pro...
kffhealthnews.org
December 3, 2025 at 9:46 PM
H.R. 1's rural health fund was always an inadequate & temporary fig leaf for rural hospitals. But then Trump Admin capped payments to providers at 15%. Now it provides little info about states' applications raising questions about where the $ will really go. kffhealthnews.org/news/article...
Reposted by Edwin Park
Some Republicans now eyeing *January* as next chance to get something done -- after crushing premium hikes for ~20M have already taken effect.
December 2, 2025 at 11:03 PM
Some Republicans now eyeing *January* as next chance to get something done -- after crushing premium hikes for ~20M have already taken effect.
Reposted by Edwin Park
NEW: Hopes fade in Congress for a health care deal before premiums soar in January
Two weeks before recess, they're nowhere close.
Senate to vote on a bill of Dems' choosing; expected to fail.
Enhanced ACA funds set to expire, as many Republicans want.
www.nbcnews.com/politics/con...
Two weeks before recess, they're nowhere close.
Senate to vote on a bill of Dems' choosing; expected to fail.
Enhanced ACA funds set to expire, as many Republicans want.
www.nbcnews.com/politics/con...
Hopes fade in Congress for a health care deal before premiums soar in January
Billions of dollars in tax credits under the Affordable Care Act are poised to expire at the end of the year. Lawmakers in both parties say they're nowhere close to a deal to renew them.
www.nbcnews.com
December 2, 2025 at 8:40 PM
NEW: Hopes fade in Congress for a health care deal before premiums soar in January
Two weeks before recess, they're nowhere close.
Senate to vote on a bill of Dems' choosing; expected to fail.
Enhanced ACA funds set to expire, as many Republicans want.
www.nbcnews.com/politics/con...
Two weeks before recess, they're nowhere close.
Senate to vote on a bill of Dems' choosing; expected to fail.
Enhanced ACA funds set to expire, as many Republicans want.
www.nbcnews.com/politics/con...
From @kff.org updated analysis of the harmful impact of H.R. 1's restrictions on state use of provider taxes to finance their #Medicaid programs including the mandatory reduction in existing provider taxes in most Medicaid expansion states starting in October 2027: www.kff.org/medicaid/5-k...
December 1, 2025 at 5:08 PM
From @kff.org updated analysis of the harmful impact of H.R. 1's restrictions on state use of provider taxes to finance their #Medicaid programs including the mandatory reduction in existing provider taxes in most Medicaid expansion states starting in October 2027: www.kff.org/medicaid/5-k...
Doulas Provide Crucial Care to Mothers. #Medicaid Cuts Could Change That www.nytimes.com/2025/11/23/n...
Doulas Provide Crucial Care to Mothers. Medicaid Cuts Could Change That.
www.nytimes.com
November 30, 2025 at 10:08 PM
Doulas Provide Crucial Care to Mothers. #Medicaid Cuts Could Change That www.nytimes.com/2025/11/23/n...
Reposted by Edwin Park
Gone are the days of seniors walking down the road from their house to see the town doctor. https://cnn.it/3MdyJuI
November 30, 2025 at 5:00 PM
Gone are the days of seniors walking down the road from their house to see the town doctor. https://cnn.it/3MdyJuI
Reposted by Edwin Park
When a politician says: we’ll deregulate health insurance and send you a “freedom account” check, ask: freedom to buy what? If insurers don’t offer real policies or can cherry-pick only healthy people, that money is a coupon for a store that’s not open.
November 28, 2025 at 12:52 PM
When a politician says: we’ll deregulate health insurance and send you a “freedom account” check, ask: freedom to buy what? If insurers don’t offer real policies or can cherry-pick only healthy people, that money is a coupon for a store that’s not open.
Reposted by Edwin Park
I was genuinely interested to see President Trump's health plan today. Guess we'll have to wait longer.
November 24, 2025 at 6:37 PM
I was genuinely interested to see President Trump's health plan today. Guess we'll have to wait longer.
When the G.O.P. #Medicaid Cuts Arrive, These Hospitals Will Be Hit Hardest www.nytimes.com/2025/11/18/u...
When the G.O.P. Medicaid Cuts Arrive, These Hospitals Will Be Hit Hardest
www.nytimes.com
November 23, 2025 at 3:40 PM
When the G.O.P. #Medicaid Cuts Arrive, These Hospitals Will Be Hit Hardest www.nytimes.com/2025/11/18/u...