There’s a lot of health insurance news surrounding the ‘Big Beautiful Bill’. I’m going to go over the key points, and do my best to keep it short and simple.
The ‘Big Beautiful Bill’ (yes that’s it’s real name!) has not been written into law yet. The bill has been passed by the House of Representatives and then underwent some changes at the Senate, and now it’s back in the hands of the House who can make more changes if they see fit. So it could still be sometime before we see a final version of this bill. All that to say, none of what I’m about to tell you is set in stone! The Big Beautiful Bill also covers a ton of topics, but I am ONLY going to talk about what it might mean for health insurance.
First, let’s talk about Medicaid.
- Requires (most) adult recipients of Medicaid to work at least 80 hours per month and provide documentation to demonstrate they’re meeting that requirement.
- Would end the year-round special enrollment period to enroll in Medicaid, meaning you would have to experience a QLE and meet income requirements
- Requires Medicaid recipients to renew their Medicaid eligibility every 6 months instead of annually
- Limits retroactive Medicaid coverage to one or two months instead of the current 90 day allowance.
- Prohibits Medicaid funds to be paid to providers who meet specific criteria related to family planning.
- Prohibits Medicaid funds to be paid for gender affirming care, which was previously left up to the states.
- Reduces federal funding for Medicaid for states that use their own funds to offer Medicaid coverage to undocumented individuals.
Next, we’ll talk about the ACA:
- Open enrollment will be shorter, ending December 15th instead of January 15th.
- Increased documentation requirements to prove special enrollment eligibility and income verification
- Ends auto-renewals during open enrollment by requiring reverification of income, family size, immigration status, etc. at renewal.
- Prohibits marketplace plans from covering gender affirming care and for abortion except in specific situations.
- Limits eligibility for marketplace plans for immigrants such as DACA recipients, refugees, asylees, etc.,
- Premium tax credits to decrease, increasing consumer premiums for marketplace plans.
Medicare:
- Restricts eligibility to citizens and specific immigrants.
- Provides funding for AI and data scientists to reduce improper payments
- Could implement a 4% sequestration
Health Savings Accounts:
- bronze plans would be HAS eligible
- Medicare eligible people only enrolled in Part A may continue to make HAS contributions
- HAS contribution limits would effectively double, but this doesn’t apply over a certain income threshold
- Introduces a capped allowance for HSA dollars to be used for gym memberships
- Allows one spouse to make HAS contributions even if the other spouse has an FSA
- Allows married couples in which both individuals are eligible to make catch up contributions to make these contributions to the same HAS
- Allows for FSA and HRA funds to rollover to an HAS in certain scenarios
Again, none of this is set in stone and this is just a summary of the potential changes. A lot could still change, and if/when it’s written into law, we’ll revisit these updates in more detail.
