Allison Orris
@aorris.bsky.social
Senior Fellow @centeronbudget focusing on Medicaid and the Affordable Care Act. Previously CMS and OMB/OIRA. She/her
Reposted by Allison Orris
Reports that the White House is working on a proposal to extend premium tax credit enhancements shows the Administration is acknowledging the urgent need to address premium spikes for millions of marketplace enrollees. But big questions remain.🧵
November 24, 2025 at 10:18 PM
Reports that the White House is working on a proposal to extend premium tax credit enhancements shows the Administration is acknowledging the urgent need to address premium spikes for millions of marketplace enrollees. But big questions remain.🧵
Reposted by Allison Orris
The GAO released a report last week on health savings accounts (HSAs) reaffirming that HSAs do little to help people with low and moderate incomes – who would be hurt the most if Congress lets premium tax credit enhancements expire.
GAO-25-107480, HEALTH SAVINGS ACCOUNTS: Information on Features and Use,
and Characteristics of Account Holders
files.gao.gov
November 24, 2025 at 8:42 PM
The GAO released a report last week on health savings accounts (HSAs) reaffirming that HSAs do little to help people with low and moderate incomes – who would be hurt the most if Congress lets premium tax credit enhancements expire.
Reposted by Allison Orris
Some recent Republican responses to the marketplace premium tax credit issue would shift more people to bronze plans with Health Savings Accounts as an alternative to silver plans with PTC enhancements and cost sharing reductions. So how do these plans stack up in real terms?
November 24, 2025 at 9:25 PM
Some recent Republican responses to the marketplace premium tax credit issue would shift more people to bronze plans with Health Savings Accounts as an alternative to silver plans with PTC enhancements and cost sharing reductions. So how do these plans stack up in real terms?
Reposted by Allison Orris
Here they go again: Republicans in Congress are reviving the ACA repeal debate. After enacting unprecedented cuts to Medicaid, they are looking for ways to eliminate federal premium tax credits that some help about 20M people afford marketplace plans.
November 20, 2025 at 10:16 PM
Here they go again: Republicans in Congress are reviving the ACA repeal debate. After enacting unprecedented cuts to Medicaid, they are looking for ways to eliminate federal premium tax credits that some help about 20M people afford marketplace plans.
Reposted by Allison Orris
Today, the Senate Finance Committee held a hearing on rising health care costs. But the real, urgent focus should be that 20 million people would face higher premium costs if the PTC enhancements expire at the end of the year.
Here’s how real people will are affected.
Here’s how real people will are affected.
November 19, 2025 at 9:05 PM
Today, the Senate Finance Committee held a hearing on rising health care costs. But the real, urgent focus should be that 20 million people would face higher premium costs if the PTC enhancements expire at the end of the year.
Here’s how real people will are affected.
Here’s how real people will are affected.
Reposted by Allison Orris
I also have a new blog on CMS guidance issued on Nov 14th indicating in part how CMS will implement H.R. 1's restrictions on state use of provider taxes to help finance their #Medicaid programs, which will shift costs to states and lead to damaging Medicaid cuts: ccf.georgetown.edu/2025/11/18/c...
CMS Issues New Guidance on H.R. 1’s Restrictions on State Use of Provider Taxes to Finance Medicaid
On November 14, 2025, the Centers for Medicare & Medicaid Services (CMS) issued new guidance with some new detail about how it will implement provisions in H.R. 1 — the budget reconciliation la…
ccf.georgetown.edu
November 18, 2025 at 7:18 PM
I also have a new blog on CMS guidance issued on Nov 14th indicating in part how CMS will implement H.R. 1's restrictions on state use of provider taxes to help finance their #Medicaid programs, which will shift costs to states and lead to damaging Medicaid cuts: ccf.georgetown.edu/2025/11/18/c...
Reposted by Allison Orris
As millions shop for ACA marketplace coverage, vague proposals to replace premium tax credits with cash "accounts" would raise costs and leave people without affordable options; policymakers should extend proven tax credit enhancements instead. www.cbpp.org/blog/vague-o...
Vague Offers of Cash Fail to Address Looming Premium Spikes for Marketplace Enrollees
President Trump and some congressional Republicans have floated ending or cutting marketplace tax credits that help more than 20 million people afford coverage and instead giving people a fixed sum...
www.cbpp.org
November 18, 2025 at 5:52 PM
As millions shop for ACA marketplace coverage, vague proposals to replace premium tax credits with cash "accounts" would raise costs and leave people without affordable options; policymakers should extend proven tax credit enhancements instead. www.cbpp.org/blog/vague-o...
My colleague @shelbytgonzales.bsky.social unpacks the new effort to rescind Biden Admin's #PublicCharge rule and how doing so will create fear and confusion among people who are immigrants and their families.
By moving to rescind the Biden Admin’s #PublicCharge rule, which largely restored long-standing policy after courts blocked a harmful rule put forward in the first Trump rule, the Administration is reigniting fear and confusion among people who are immigrants and their families.
November 18, 2025 at 3:51 PM
My colleague @shelbytgonzales.bsky.social unpacks the new effort to rescind Biden Admin's #PublicCharge rule and how doing so will create fear and confusion among people who are immigrants and their families.
New interactive map from @CenterOnBudget showing out-of-pocket premium increases in every congressional district due to premium tax credit enhancements expiring. Explore it here: www.cbpp.org/research/hea...
Marketplace Enrollees Across the Country Face Steep Premium Increases Unless Tax Credit Enhancements Are Extended
Annual premium increase, 60-year-old couple with income of $85,000 (401% FPL), by congressional district, 119th Congress Note: FPL = federal poverty level. Examples are based on 2026 average...
www.cbpp.org
November 13, 2025 at 10:14 PM
New interactive map from @CenterOnBudget showing out-of-pocket premium increases in every congressional district due to premium tax credit enhancements expiring. Explore it here: www.cbpp.org/research/hea...
Reposted by Allison Orris
My colleague @nicolerapfogel.bsky.social talked with CQ this week about why Republican HSA and cash account proposals are no substitute for extending the soon-to-expire PTC enhancements that more than 20 million ACA marketplace enrollees rely on to keep coverage affordable.
As I told CQ, the Republican HSA and other cash account proposals are no real alternative to extending PTC enhancements and won't make health coverage more affordable.
“These proposals are somewhat unserious. They lack the details, they're unclear on the mechanisms, they don't make policy sense.”
“These proposals are somewhat unserious. They lack the details, they're unclear on the mechanisms, they don't make policy sense.”
CQ NEWS House GOP not ready to embrace Senate’s health account idea
Republicans, who had been unified on the need to reopen the government, seemed less united Wednesday on the next step — how to address the upcoming health care subsidy cliff.
plus.cq.com
November 13, 2025 at 8:57 PM
My colleague @nicolerapfogel.bsky.social talked with CQ this week about why Republican HSA and cash account proposals are no substitute for extending the soon-to-expire PTC enhancements that more than 20 million ACA marketplace enrollees rely on to keep coverage affordable.
Reposted by Allison Orris
Making decisions about ACA marketplace coverage for 2026 is complicated, since the PTC enhancements that expire in Dec haven't yet been extended. We created a running list of FAQs to answer ?s about deadlines, automatic re-enrollment, and more. www.healthreformbeyondthebasics.org/marketplace-...
Marketplace Open Enrollment for 2026 - Beyond the Basics
Updated November 10, 2025 1. What are premium tax credits (PTCs)? Premium tax credits, also known as PTCs, help individuals and families with low and
www.healthreformbeyondthebasics.org
November 12, 2025 at 4:36 PM
Making decisions about ACA marketplace coverage for 2026 is complicated, since the PTC enhancements that expire in Dec haven't yet been extended. We created a running list of FAQs to answer ?s about deadlines, automatic re-enrollment, and more. www.healthreformbeyondthebasics.org/marketplace-...
Reposted by Allison Orris
Read more from @centeronbudget.bsky.social about why HSAs and other proposals won’t make coverage more affordable and do little to help the people who would hurt the most from expiring premium tax credit enhancements.
Expanding Health Savings Accounts Would Do Little to Improve Access to Affordable Health Care
Amid the urgent debate over whether Congress will act to prevent cost increases for millions of people in 2026 marketplace plans, some Republicans are promoting expansions of health savings accounts.....
www.cbpp.org
November 13, 2025 at 8:22 PM
Read more from @centeronbudget.bsky.social about why HSAs and other proposals won’t make coverage more affordable and do little to help the people who would hurt the most from expiring premium tax credit enhancements.
Reposted by Allison Orris
BREAKING: We took the Trump-Vance administration back to court and WON AGAIN.
The court was clear today: the President must stop playing politics with the lives of 42 million people in America.
The court was clear today: the President must stop playing politics with the lives of 42 million people in America.
November 6, 2025 at 9:58 PM
BREAKING: We took the Trump-Vance administration back to court and WON AGAIN.
The court was clear today: the President must stop playing politics with the lives of 42 million people in America.
The court was clear today: the President must stop playing politics with the lives of 42 million people in America.
Reposted by Allison Orris
Check out @centeronbudget.bsky.social's new graphics -- examples of the cost increases that marketplace enrollees in all 50 states and D.C. will face if Congress doesn't extend premium tax credit enhancements. h/t @gidlukens.bsky.social www.cbpp.org/research/res...
Marketplace Enrollees Face Steep Premium Increases Unless Tax Credit Enhancements Are Extended
Click on a state to find it in the grid...
www.cbpp.org
November 6, 2025 at 2:27 PM
Check out @centeronbudget.bsky.social's new graphics -- examples of the cost increases that marketplace enrollees in all 50 states and D.C. will face if Congress doesn't extend premium tax credit enhancements. h/t @gidlukens.bsky.social www.cbpp.org/research/res...
Reposted by Allison Orris
Shutdowns hurt people and it will be good news when the government reopens.
But it is vital that Congress also address both the looming massive spike in health care costs for 20M *and* deliver a funding deal that the President can’t undo the parts he just doesn’t like. 🧵
But it is vital that Congress also address both the looming massive spike in health care costs for 20M *and* deliver a funding deal that the President can’t undo the parts he just doesn’t like. 🧵
November 6, 2025 at 7:21 PM
Shutdowns hurt people and it will be good news when the government reopens.
But it is vital that Congress also address both the looming massive spike in health care costs for 20M *and* deliver a funding deal that the President can’t undo the parts he just doesn’t like. 🧵
But it is vital that Congress also address both the looming massive spike in health care costs for 20M *and* deliver a funding deal that the President can’t undo the parts he just doesn’t like. 🧵
Reposted by Allison Orris
#OpenEnrollment for 2026 marketplace plans started Nov 1 in most states. B/c Congressional Rs haven’t extended PTC enhancements, ppl are seeing higher costs as they review their options. If you’re in need of marketplace coverage, here are some key dates to keep in mind during this uncertain time:
November 6, 2025 at 7:00 PM
#OpenEnrollment for 2026 marketplace plans started Nov 1 in most states. B/c Congressional Rs haven’t extended PTC enhancements, ppl are seeing higher costs as they review their options. If you’re in need of marketplace coverage, here are some key dates to keep in mind during this uncertain time:
Reposted by Allison Orris
New data: CBPP analyzed USDA’s contingency fund spending plan & found it is only going to release 2/3 of the funding they committed to in court filings, cutting families’ SNAP benefits far more than necessary, violating USDA’s own regulations & shortchanging millions of families.
November 5, 2025 at 4:40 PM
New data: CBPP analyzed USDA’s contingency fund spending plan & found it is only going to release 2/3 of the funding they committed to in court filings, cutting families’ SNAP benefits far more than necessary, violating USDA’s own regulations & shortchanging millions of families.
Reposted by Allison Orris
Open enrollment for #ACA marketplace plans has begun, and without congressional action to extend premium tax credit enhancements, millions are facing steep premium increases for 2026.
November 5, 2025 at 2:57 PM
Open enrollment for #ACA marketplace plans has begun, and without congressional action to extend premium tax credit enhancements, millions are facing steep premium increases for 2026.
Reposted by Allison Orris
Last Friday, the Food and Nutrition Service (FNS) finally provided states guidance on how to implement the harsh, anti-immigrant restrictions to food assistance in the harmful Republican megabill.
fns-prod.azureedge.us
November 4, 2025 at 5:35 PM
Last Friday, the Food and Nutrition Service (FNS) finally provided states guidance on how to implement the harsh, anti-immigrant restrictions to food assistance in the harmful Republican megabill.
Reposted by Allison Orris
It is illegal to not follow a court order and it is just wrong to delay food assistance to children, seniors, veterans, working parents, and people with disabilities.
The president says he will defy court orders and illegally withhold SNAP benefits despite there being money in the SNAP contingency fund that the Trump is required to use.
November 4, 2025 at 6:25 PM
It is illegal to not follow a court order and it is just wrong to delay food assistance to children, seniors, veterans, working parents, and people with disabilities.
Reposted by Allison Orris
Under #Medicaid’s new work requirement, many eligible people could lose coverage. Our guide explains how states can reduce losses by minimizing burden, streamlining verification processes, and using accessible communication methods. www.cbpp.org/research/hea...
November 3, 2025 at 6:14 PM
Under #Medicaid’s new work requirement, many eligible people could lose coverage. Our guide explains how states can reduce losses by minimizing burden, streamlining verification processes, and using accessible communication methods. www.cbpp.org/research/hea...
Reposted by Allison Orris
It is a relief that the Administration is finally agreeing to do the bare minimum and follow the law by using the #SNAP contingency reserve to partially fund November SNAP benefits & nutrition assistance in Puerto Rico & American Samoa.
November 3, 2025 at 8:11 PM
It is a relief that the Administration is finally agreeing to do the bare minimum and follow the law by using the #SNAP contingency reserve to partially fund November SNAP benefits & nutrition assistance in Puerto Rico & American Samoa.
Reposted by Allison Orris
Just in time for your summer reading list (ie, coming June 2026). Thanks to Joseph Pomp and the rest of the editorial team at Harvard University Press.
www.hup.harvard.edu/books/978067...
www.hup.harvard.edu/books/978067...
The President's Echo System — Harvard University Press
A sharp analysis of the propaganda partnerships between US presidents and private organizations that fueled the Cold War and paved the way for the War on Terror.How do US presidents motivate public su...
www.hup.harvard.edu
November 3, 2025 at 4:14 PM
Just in time for your summer reading list (ie, coming June 2026). Thanks to Joseph Pomp and the rest of the editorial team at Harvard University Press.
www.hup.harvard.edu/books/978067...
www.hup.harvard.edu/books/978067...
Reposted by Allison Orris
October 31, 2025 at 8:22 PM
Reposted by Allison Orris
As I was saying:
The Trump Administration’s assertion that it can't use SNAP’s contingency reserves for SNAP benefits is contrary to:
▪️The plain language of the law
▪️Their own (now deleted) shutdown plan
▪️Guidance from prior Administrations
We have the receipts:
▪️The plain language of the law
▪️Their own (now deleted) shutdown plan
▪️Guidance from prior Administrations
We have the receipts:
SNAP’s Contingency Reserve Is Available for Regular SNAP Benefits, as USDA and OMB Have Ruled in Past
The Administration must use all available options to fund November benefits for the 1 in 8 people in the U.S. who need SNAP to afford their grocery bill.
www.cbpp.org
October 31, 2025 at 8:27 PM
As I was saying: