Assessing the 50-State Medicaid Coverage and Expenditure Impacts of the Senate Version of the One Big Beautiful Bill Act
On June 27, the Senate Budget Committee (SBC) released its version of the One Big Beautiful Bill Act (OBBBA) and on Saturday, June 28, the Senate approved a motion to proceed with debate over the Senate bill language. The Senate version of the OBBBA, which may still undergo further revisions through the amendment process, is expected to come up for a final vote in the Senate as early as Monday, June 30. Using its Medicaid Financing model, Manatt Health (Manatt) has prepared new state-by-state estimates [including the District of Columbia (D.C.) and excluding Tennessee due to data limitations] on the impact of the Medicaid provisions included in the Senate version of the OBBBA.
Assessing the 50-State Medicaid Expenditure Impacts of the Senate Finance Committee Bill Compared to H.R.1
On June 16, the Senate Finance Committee (SFC) released its budget reconciliation legislation. Several new policies in the SFC bill language would yield deeper Medicaid cuts than House-passed legislation, H.R.1, the One Big Beautiful Bill Act. Using its Medicaid Financing model, Manatt Health has prepared estimates on the impact of the Medicaid provisions included in SFC budget reconciliation legislative language.
Final Federal Marketplace Integrity Rule: Implications for States
The Centers for Medicare & Medicaid Services (CMS) has finalized a set of policy and operational changes relating to the Affordable Care Act and health insurance Marketplaces, effective August 2025. CMS estimates that as a result of the rule, between 725,000 and 1.8 million people will lose insurance coverage in 2026 and federal spending on premium tax credits will be reduced between $10.3 billion and $12.4 billion in 2026. This regulatory analysis summarizes the provisions of the rule and highlights considerations for state officials.
House Budget Bill Medicaid Proposals: State-by-State Estimates of Impacts on Expenditures and Enrollment
On Thursday, May 22, the House passed its “One Big Beautiful Bill Act” through the budget reconciliation process. As the Senate moves to take up the legislation, Manatt Health—with support and input from State Health and Value Strategies—has updated its toolkit for states, estimating the state-by-state impact over the next 10 years of most of the major provisions in the bill. The estimates take into account the interactions across the provisions included in the Manatt model.
Marketplace and Private Insurance Provisions in the House Reconciliation Bill
On Thursday, May 29, State Health and Value Strategies hosted the second in a two-part webinar series. During the webinar, experts reviewed proposed changes to policies governing the Affordable Care Act Marketplace and what they might mean for health insurance Marketplace and Division of Insurance officials.
Medicaid Provisions in the House Reconciliation Bill
On Thursday, May 22, State Health and Value Strategies hosted the first in a two-part webinar series. During the webinar, experts from Manatt Health reviewed changes proposed in the House reconciliation bill to Medicaid eligibility, payment and financing, and coverage.
Analyzing the Impact of Potential Medicaid Cuts: A Toolkit for States
Congress is considering significant cuts to Medicaid as part of the legislative process—called “budget reconciliation”—being used to advance President Trump’s key legislative priorities. To support states in informing and validating their own fiscal and program impact estimates of federal policy changes, Manatt Health has developed, with support and input from State Health and Value Strategies, a new toolkit providing national and state-by-state data on the potential impact of key cuts under consideration in Congress. The toolkit is designed to help state officials prepare or review their own estimates and to offer estimates to states not undertaking their own analyses.
Analyzing the Impact of Potential Medicaid Cuts
On Thursday, May 1, State Health and Value Strategies hosted a webinar to discuss significant cuts to Medicaid under consideration by Congress as part of the budget reconciliation process. Manatt Health has developed, with support and input from SHVS, a new toolkit providing national and state-by-state modeling on the potential impacts of proposals. Key proposals discussed include those to reduce the federal medical assistance percentage rate, establish a per-capita cap financial approach for enrolled Medicaid populations, and make work reporting requirements a condition of Medicaid eligibility. During the webinar, experts from Manatt Health reviewed the new toolkit, including proposal-specific modeling data sources and assumptions, and national and state model findings.
Implications of the Enhanced PTC Expiration on the Rate Review Process
On Friday, April 18, State Health and Value Strategies hosted a webinar to discuss the Affordable Care Act enhanced premium tax credits (PTCs) which are currently set to expire at the end of 2025 without Congressional action, and the implications on states’ rate review process. If the enhancements expire, Marketplace premiums will increase and enrollment could substantially decrease. During the webinar, experts from Manatt Health brought together state departments of insurance and Marketplace officials to discuss ways to handle this uncertainty in the rate filing season and help states make sure their constituents understand how the loss of enhanced PTCs will impact various groups.
New CMS Proposed Rule: ACA Marketplace Integrity
On Tuesday, April 1, State Health and Value Strategies hosted a webinar on the Centers for Medicare & Medicaid Services’ (CMS) recently proposed regulation that would require several policy and operational changes for the Affordable Care Act Marketplaces and insurance rules. Many of the provisions would extend to State-Based Marketplaces and mandate adjustments to state insurance standards. During the webinar, experts from the Urban Institute and Georgetown University’s Center on Health Insurance Reforms (CHIR) provided a detailed overview of CMS’ proposed rule and discussed key operational and policy considerations for states.