New @Paragon_Inst PIC shows that the ACA is a much bigger & more expensive program than when Joe Biden took office.
When people talk about enrollment declines, they are referring to a dip from 2025 to 2026.
Feb 2026 enrollment is up 80% from Feb 2020 enrollment! 1/2
ACA subsidies have a major structural problem.
Premium subsidies automatically increase as premiums increase, weakening incentives to control costs while shifting higher spending onto taxpayers.
Congress should eliminate silver loading & directly appropriate cost-sharing reductions.
That would reduce market distortions and reduce benchmark premiums significantly. This table shows the premium reductions by state.
President Obama proposed limiting the provider tax money laundering scam in his 2012 budget.
Last year’s Congress enacted a nearly identical reform to what he put forward.
paragoninstitute.org/newsletter/lea…
"Provider tax" is a misnomer. The cost falls on privately insured patients (higher prices) and federal taxpayers (higher matching payments) — not the providers.
Learn more: t2m.io/6sGBBT3
"Provider tax" is a misnomer. The cost falls on privately insured patients (higher prices) and federal taxpayers (higher matching payments) — not the providers.
Learn more:
Our new report discusses the many bad incentives in Medicaid, with states often using Medicaid to reward special interests rather than obtaining good value for enrollees & taxpayers.
Washington now finances >70% of Medicaid, up from the historic 60% share.
OBBB made historic progress by:
✓ limiting provider tax schemes
✓ capping most state-directed payments
✓ strengthening eligibility rules
✓ improving program integrity
Congress should build on these reforms.
Next steps:
• End the discrimination against the most vulnerable
• Further dismantle Medicaid financing gimmicks
• Improve accountability
• Strengthen eligibility integrity
• Restore incentives for states to obtain value—not maximize federal reimbursements.
Another extremely positive proposed rule from @CMSGov to reduce Medicare payments that distort the entire health sector.
The proposal advances site-neutral payments and 340B reforms.
Will save seniors and taxpayers billions.
cms.gov/newsroom/press…
This report contains our recommendations to put federal health programs on a sustainable fiscal path. The added benefit would be improved incentives for states, insurers, providers, and consumers.
It tackles Medicare, Medicaid, the ACA, the ESI exclusion, 340B, and the MLR.
NEW REPORT: Restoring Fiscal Sustainability to Federal Health Programs
Federal health programs increasingly reward higher spending rather than greater value. The result is rising deficits, greater consolidation, weaker competition, and growing dependence on federal borrowing.
New ASPE report: Under President Trump and Secretary Kennedy's leadership, nearly 3 million fraudulent Obamacare enrollees have been removed or blocked by HHS.
New ASPE report: The United States accounts for 80% of revenues for innovative drug products launched between 2020 and 2025 when compared to peer nations.
🚨 Fraud Watch 🚨
A telemedicine company owner who wrote health care compliance books was sentenced for a $136M+ Medicare fraud scheme—billing for unnecessary braces and drugs after pressuring beneficiaries to accept as many as possible.
TRACK MORE:
NEW REPORT: Restoring Fiscal Sustainability to Federal Health Programs
Federal health programs increasingly reward higher spending rather than greater value. The result is rising deficits, greater consolidation, weaker competition, and growing dependence on federal borrowing.
The Inflation Reduction Act made Medicare's fiscal outlook even worse.
Figure 4 shows that the Medicare Trustees now project Part D spending to reach 1.0% of GDP, versus 0.6% projected just one year earlier.
The IRA's Part D redesign increased both taxpayer costs and premiums.
Medicare can be strengthened without reducing access.
Our recommendations include:
• Site-neutral payments
• Reforming the IRA's Part D redesign
• Better targeting hospital subsidies
• Improving Medicare Advantage
• Stronger program integrity
