Issue Briefs | Oct 24, 2025

Policy Changes in the Marketplaces: Monitoring Impacts

Elizabeth Lukanen and Emily Zylla, SHADAC

Recent federal policy actions, including H.R.1, the 2025 Marketplace Integrity and Affordability Rule, and the pending expiration of the enhanced premium tax credits, are poised to significantly reshape the health insurance landscape across all states. State-Based Marketplaces (SBMs) can be at the forefront of documenting how federal policy changes impact affordability, access, and coverage stability in their states. This issue brief outlines four priority strategies for SBMs, including: 1) publishing a core set of enrollment, financial assistance, and customer service measures; 2) investing in longer-term impact metrics that capture broader policy effects; 3) incorporating targeted consumer surveys to understand lived experiences and 4) pursuing sustained, longitudinal monitoring efforts through research and evaluation partnerships.


Expert Perspectives

May 22, 2026

The Power of Transparency: How States Can Use Data Dashboards to Effectively Monitor H.R. 1

H.R. 1 will bring wide-reaching changes to the Medicaid program and as these provisions take effect, states will face questions about how the changes are impacting both the Medicaid program and the individuals who rely on it for coverage. This expert perspective outlines the case for state H.R. 1 data dashboards, provides practical design guidance, and highlights successful examples of recent state dashboards.