Larry Levitt
@larrylevitt.bsky.social
Executive Vice President for Health Policy, KFF. Cal Bear.
https://www.kff.org/person/larry-levitt/
https://www.kff.org/person/larry-levitt/
Reposted by Larry Levitt
KFF’s @larrylevitt.bsky.social advises signing up now, because once enrollment open ends you won’t have another chance.
You can sign as a hedge, in case a deal is passed, and decide to drop out later if there’s no deal.
You can sign as a hedge, in case a deal is passed, and decide to drop out later if there’s no deal.
November 25, 2025 at 12:28 AM
KFF’s @larrylevitt.bsky.social advises signing up now, because once enrollment open ends you won’t have another chance.
You can sign as a hedge, in case a deal is passed, and decide to drop out later if there’s no deal.
You can sign as a hedge, in case a deal is passed, and decide to drop out later if there’s no deal.
It's always harder to get things done in Washington than to stop things. In the case of the ACA right now, inaction means 22 million people will see their out-of-pocket premiums increase by 114% on average on January 1.
November 24, 2025 at 9:38 PM
It's always harder to get things done in Washington than to stop things. In the case of the ACA right now, inaction means 22 million people will see their out-of-pocket premiums increase by 114% on average on January 1.
People have to sign up for ACA marketplace coverage by December 15 to have health insurance January 1. Even if Congress passed an extension with tweaks to the premium tax credits, computer systems could not be reprogrammed immediately.
November 24, 2025 at 6:45 PM
People have to sign up for ACA marketplace coverage by December 15 to have health insurance January 1. Even if Congress passed an extension with tweaks to the premium tax credits, computer systems could not be reprogrammed immediately.
I was genuinely interested to see President Trump's health plan today. Guess we'll have to wait longer.
November 24, 2025 at 6:37 PM
I was genuinely interested to see President Trump's health plan today. Guess we'll have to wait longer.
Reposted by Larry Levitt
(Yes, it's stupidly complicated, but no, funding CSRs would not do anything to reduce out-of-pocket costs relative to status quo; it would instead raise premiums for some enrollees in most states.)
November 24, 2025 at 3:54 PM
(Yes, it's stupidly complicated, but no, funding CSRs would not do anything to reduce out-of-pocket costs relative to status quo; it would instead raise premiums for some enrollees in most states.)
Reposted by Larry Levitt
CMS just issued a notice that it will start sharing personal data of Medicaid enrollees with ICE for immigration enforcement, including data on immigration status, location, and phone numbers. @kff.org Quick Take discusses the impact this could have on immigrant families
www.kff.org/quick-take/c...
www.kff.org/quick-take/c...
CMS Plans to Share Data with ICE Could Exacerbate Immigrant Families’ Fears About Accessing Health Coverage and Care
This policy change will likely exacerbate fears among immigrant families about health officials and providers sharing patient information with ICE, increasing their reluctance to access health coverag...
www.kff.org
November 21, 2025 at 10:14 PM
CMS just issued a notice that it will start sharing personal data of Medicaid enrollees with ICE for immigration enforcement, including data on immigration status, location, and phone numbers. @kff.org Quick Take discusses the impact this could have on immigrant families
www.kff.org/quick-take/c...
www.kff.org/quick-take/c...
Reposted by Larry Levitt
The Scott proposal hews most closely to Trump’s various remarks.
“While ACA plans would still be required to cover people with pre-existing conditions under the Scott proposal, it is likely that the ACA Marketplace would collapse in states that seek a waiver under his approach.”
“While ACA plans would still be required to cover people with pre-existing conditions under the Scott proposal, it is likely that the ACA Marketplace would collapse in states that seek a waiver under his approach.”
Proposals from Senators Scott and Cassidy to convert ACA premium tax credits into health accounts present trade-offs that benefit healthy people at the expense of sick people. Senator Scott's proposal, in particular, would destabilize the insurance market in some states.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
November 21, 2025 at 10:48 PM
The Scott proposal hews most closely to Trump’s various remarks.
“While ACA plans would still be required to cover people with pre-existing conditions under the Scott proposal, it is likely that the ACA Marketplace would collapse in states that seek a waiver under his approach.”
“While ACA plans would still be required to cover people with pre-existing conditions under the Scott proposal, it is likely that the ACA Marketplace would collapse in states that seek a waiver under his approach.”
Proposals from Senators Scott and Cassidy to convert ACA premium tax credits into health accounts present trade-offs that benefit healthy people at the expense of sick people. Senator Scott's proposal, in particular, would destabilize the insurance market in some states.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
November 21, 2025 at 10:43 PM
Proposals from Senators Scott and Cassidy to convert ACA premium tax credits into health accounts present trade-offs that benefit healthy people at the expense of sick people. Senator Scott's proposal, in particular, would destabilize the insurance market in some states.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
ACA enrollment growth since enhanced premium tax credits were put in place is dramatically skewed towards red states. Yet, no Republican voted for the ACA originally, or for the enhanced tax credits.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
November 21, 2025 at 3:24 PM
ACA enrollment growth since enhanced premium tax credits were put in place is dramatically skewed towards red states. Yet, no Republican voted for the ACA originally, or for the enhanced tax credits.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
Reposted by Larry Levitt
No one likes prior authorization review. But could we get rid of it? My new column: www.kff.org/from-drew-al...
Why We Are Stuck with Prior Authorization Review
Prior authorization review frustrates patients and physicians, but we likely can’t just eliminate it. In his new column, President and CEO Dr. Drew Altman discusses why, and why the focus is now inste...
www.kff.org
November 20, 2025 at 3:10 PM
No one likes prior authorization review. But could we get rid of it? My new column: www.kff.org/from-drew-al...
The trillion dollars in health care cuts passed by Republicans earlier this year are backloaded and mostly won't take effect before the midterms. Letting enhanced ACA tax credits expire would take effect January 1, leading to big out-of-pocket premium increases and more people uninsured.
November 20, 2025 at 3:30 PM
The trillion dollars in health care cuts passed by Republicans earlier this year are backloaded and mostly won't take effect before the midterms. Letting enhanced ACA tax credits expire would take effect January 1, leading to big out-of-pocket premium increases and more people uninsured.
Reposted by Larry Levitt
We also need to know *which* subsidies are in play. As I understand it:
Paragon has proposed converting CSRs to HSA contributions
Cassidy has proposed converting ePTCs to HSA contributions
Trump has proposed (I think? this is least clear) converting *all* subsidies to HSA contributions.
Paragon has proposed converting CSRs to HSA contributions
Cassidy has proposed converting ePTCs to HSA contributions
Trump has proposed (I think? this is least clear) converting *all* subsidies to HSA contributions.
Wonky but important question for understanding the effects of proposals to convert ACA premium tax credits to health savings accounts: How big would the contributions be? Would they vary by income, age, and geography in the same way as the premium tax credits?
November 19, 2025 at 3:50 PM
We also need to know *which* subsidies are in play. As I understand it:
Paragon has proposed converting CSRs to HSA contributions
Cassidy has proposed converting ePTCs to HSA contributions
Trump has proposed (I think? this is least clear) converting *all* subsidies to HSA contributions.
Paragon has proposed converting CSRs to HSA contributions
Cassidy has proposed converting ePTCs to HSA contributions
Trump has proposed (I think? this is least clear) converting *all* subsidies to HSA contributions.
Right. Under the Cassidy plan, there would no longer be enhanced ACA premium tax credits. But, people who buy bronze plans with high deductibles would instead get a government contribution into an HSA account.
November 19, 2025 at 3:25 PM
Right. Under the Cassidy plan, there would no longer be enhanced ACA premium tax credits. But, people who buy bronze plans with high deductibles would instead get a government contribution into an HSA account.
Wonky but important question for understanding the effects of proposals to convert ACA premium tax credits to health savings accounts: How big would the contributions be? Would they vary by income, age, and geography in the same way as the premium tax credits?
November 19, 2025 at 2:58 PM
Wonky but important question for understanding the effects of proposals to convert ACA premium tax credits to health savings accounts: How big would the contributions be? Would they vary by income, age, and geography in the same way as the premium tax credits?
Reposted by Larry Levitt
Really excited to share our latest survey of immigrants work @kff.org. We're able to see how immigrants are faring now amid increased immigration enforcement compared to 2023. Check out our KFF reports below and stories from @nytimes.com
Our brand new survey of immigrants in partnership with @nytimes.com explores immigrants views and experiences under the second Trump administration. It finds increased fear, health and economic challenges amid immigration enforcement, but a remarkable resilience as well
www.kff.org/kff-nytimes-...
www.kff.org/kff-nytimes-...
KFF/New York Times 2025 Survey of Immigrants | KFF
KFF/New York Times 2025 Survey of Immigrants The 2025 Survey of Immigrants, a partnership between KFF and The New York Times, takes an in-depth look at the experiences of immigrants during the first y...
www.kff.org
November 18, 2025 at 6:00 PM
Really excited to share our latest survey of immigrants work @kff.org. We're able to see how immigrants are faring now amid increased immigration enforcement compared to 2023. Check out our KFF reports below and stories from @nytimes.com
Reposted by Larry Levitt
Our brand new survey of immigrants in partnership with @nytimes.com explores immigrants views and experiences under the second Trump administration. It finds increased fear, health and economic challenges amid immigration enforcement, but a remarkable resilience as well
www.kff.org/kff-nytimes-...
www.kff.org/kff-nytimes-...
KFF/New York Times 2025 Survey of Immigrants | KFF
KFF/New York Times 2025 Survey of Immigrants The 2025 Survey of Immigrants, a partnership between KFF and The New York Times, takes an in-depth look at the experiences of immigrants during the first y...
www.kff.org
November 18, 2025 at 3:59 PM
Our brand new survey of immigrants in partnership with @nytimes.com explores immigrants views and experiences under the second Trump administration. It finds increased fear, health and economic challenges amid immigration enforcement, but a remarkable resilience as well
www.kff.org/kff-nytimes-...
www.kff.org/kff-nytimes-...
Reposted by Larry Levitt
New survey from @kff.org and @nytimes.com reveals deepening anxiety and fear among immigrants of all statuses amid the Trump administration’s intensified immigration enforcement and restrictive policies
www.kff.org/kff-nytimes-...
www.kff.org/kff-nytimes-...
KFF/New York Times 2025 Survey of Immigrants | KFF
KFF/New York Times 2025 Survey of Immigrants The 2025 Survey of Immigrants, a partnership between KFF and The New York Times, takes an in-depth look at the experiences of immigrants during the first y...
www.kff.org
November 18, 2025 at 3:30 PM
New survey from @kff.org and @nytimes.com reveals deepening anxiety and fear among immigrants of all statuses amid the Trump administration’s intensified immigration enforcement and restrictive policies
www.kff.org/kff-nytimes-...
www.kff.org/kff-nytimes-...
Leaving aside the issue that people buying insurance would buy it from insurance companies. This sounds like an effort to let people bypass the ACA. Healthy people could buy cheaper insurance that doesn't cover pre-existing conditions, sending the ACA into a premium death spiral.
November 18, 2025 at 3:02 PM
Leaving aside the issue that people buying insurance would buy it from insurance companies. This sounds like an effort to let people bypass the ACA. Healthy people could buy cheaper insurance that doesn't cover pre-existing conditions, sending the ACA into a premium death spiral.
The biggest criticism of the ACA from the start was that health insurance still wasn't affordable for many. The enhanced premium tax credits, slated to expire at the end of this year, helped address that. But, the tradeoff is higher federal spending.
November 16, 2025 at 4:01 PM
The biggest criticism of the ACA from the start was that health insurance still wasn't affordable for many. The enhanced premium tax credits, slated to expire at the end of this year, helped address that. But, the tradeoff is higher federal spending.
Reposted by Larry Levitt
contrarian.substack.com/p/sticker-sh... always informative!!
Sticker Shock: Larry Levitt on the Rising Healthcare Process & A Broken System
"People die sooner without health insurance than they do with insurance."
contrarian.substack.com
November 13, 2025 at 9:56 PM
contrarian.substack.com/p/sticker-sh... always informative!!
Reposted by Larry Levitt
Please remind those in the back that ACA is “Obamacare”
The ACA did 3 big things in the insurance market:
1. Guaranteed access irrespective of pre-existing conditions.
2. Required benefits like maternity and mental health, and prohibited lifetime and annual limits.
3. Provided tax credits to help people afford insurance.
1. Guaranteed access irrespective of pre-existing conditions.
2. Required benefits like maternity and mental health, and prohibited lifetime and annual limits.
3. Provided tax credits to help people afford insurance.
November 15, 2025 at 8:42 PM
Please remind those in the back that ACA is “Obamacare”
The ACA did 3 big things in the insurance market:
1. Guaranteed access irrespective of pre-existing conditions.
2. Required benefits like maternity and mental health, and prohibited lifetime and annual limits.
3. Provided tax credits to help people afford insurance.
1. Guaranteed access irrespective of pre-existing conditions.
2. Required benefits like maternity and mental health, and prohibited lifetime and annual limits.
3. Provided tax credits to help people afford insurance.
November 15, 2025 at 8:09 PM
The ACA did 3 big things in the insurance market:
1. Guaranteed access irrespective of pre-existing conditions.
2. Required benefits like maternity and mental health, and prohibited lifetime and annual limits.
3. Provided tax credits to help people afford insurance.
1. Guaranteed access irrespective of pre-existing conditions.
2. Required benefits like maternity and mental health, and prohibited lifetime and annual limits.
3. Provided tax credits to help people afford insurance.
Reposted by Larry Levitt
With the government reopening with only “promises” in place to protect affordable healthcare, millions of Americans are still at risk of losing coverage. @larrylevitt.bsky.social explains just how bad things could get.
https://contrarian.substack.com/p/sticker-shock-larry-levitt-on-the
https://contrarian.substack.com/p/sticker-shock-larry-levitt-on-the
Sticker Shock: Larry Levitt on the Rising Healthcare Process & A Broken System
"People die sooner without health insurance than they do with insurance."
contrarian.substack.com
November 14, 2025 at 12:02 AM
With the government reopening with only “promises” in place to protect affordable healthcare, millions of Americans are still at risk of losing coverage. @larrylevitt.bsky.social explains just how bad things could get.
https://contrarian.substack.com/p/sticker-shock-larry-levitt-on-the
https://contrarian.substack.com/p/sticker-shock-larry-levitt-on-the
As President Trump and Republicans in Congress promise further details of their health care proposals, remember that all health reform plans have trade-offs. As details get filled in, the winners and losers become clearer.
November 13, 2025 at 5:02 PM
As President Trump and Republicans in Congress promise further details of their health care proposals, remember that all health reform plans have trade-offs. As details get filled in, the winners and losers become clearer.
A bipartisan deal on ACA premium tax credits is far from certain. If it happens, it will mean threading a very thin needle.
@citizencohn.bsky.social
www.thebulwark.com/p/here-is-ho...
@citizencohn.bsky.social
www.thebulwark.com/p/here-is-ho...
November 12, 2025 at 3:05 PM
A bipartisan deal on ACA premium tax credits is far from certain. If it happens, it will mean threading a very thin needle.
@citizencohn.bsky.social
www.thebulwark.com/p/here-is-ho...
@citizencohn.bsky.social
www.thebulwark.com/p/here-is-ho...