Sarah Lueck
@sarahl202.bsky.social
VP for Health Policy at the Center on Budget and Policy Priorities. DSM native and @WSJ alumna. Views expressed here are mine. she/her
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 Sarah Lueck
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 Sarah Lueck
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?
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.
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 Sarah Lueck
How concerned are people about rising health insurance premiums? With premium tax credit enhancements about to expire and ACA marketplace open enrollment underway, search volumes for terms like “health premium increase” are (almost) off the charts.
November 4, 2025 at 2:25 PM
How concerned are people about rising health insurance premiums? With premium tax credit enhancements about to expire and ACA marketplace open enrollment underway, search volumes for terms like “health premium increase” are (almost) off the charts.
Republican leaders in Congress say they will address marketplace health care premium increases once the government is re-opened. But it’s hard to square that commitment with some of their recent comments.
October 14, 2025 at 9:19 PM
Republican leaders in Congress say they will address marketplace health care premium increases once the government is re-opened. But it’s hard to square that commitment with some of their recent comments.
If premium tax credit enhancements expire, millions of people with the lowest incomes would lose $0 premium plans and be at risk of becoming uninsured. Gains in coverage, especially in states that haven’t expanded #Medicaid, would be at risk. www.cbpp.org/blog/people-...
People With Low Incomes May Lose $0 Premium Plans — a Lifeline — Unless Congress Acts | Center on Budget and Policy Priorities
Without congressional action, PTC enhancements will expire at the end of 2025. This will cause millions —many of these lowest-income enrollees especially — to become uninsured, or to face impossible c...
www.cbpp.org
October 14, 2025 at 1:16 PM
If premium tax credit enhancements expire, millions of people with the lowest incomes would lose $0 premium plans and be at risk of becoming uninsured. Gains in coverage, especially in states that haven’t expanded #Medicaid, would be at risk. www.cbpp.org/blog/people-...
Attn: Idaho
Marketplace enrollees in the Gem State are facing big premium increases if Congress does not act.
Marketplace enrollees in the Gem State are facing big premium increases if Congress does not act.
Idaho’s 2026 ACA marketplace open enrollment begins Oct 15. People are already window shopping, seeing next year’s premiums spike due to expiring tax credit enhancements. A typical 60-year-old couple making $85,000 in Idaho will face a $17,900 increase in annual premiums. (1/4)
October 8, 2025 at 4:09 PM
Attn: Idaho
Marketplace enrollees in the Gem State are facing big premium increases if Congress does not act.
Marketplace enrollees in the Gem State are facing big premium increases if Congress does not act.
Reposted by Sarah Lueck
NEW from @centeronbudget.bsky.social: Without Congressional action, premium tax credit enhancements will expire, raising costs for nearly all marketplace enrollees and putting millions of those with the lowest incomes at risk of becoming uninsured when they lose $0 premium plans.
People With Low Incomes May Lose $0 Premium Plans — a Lifeline — Unless Congress Acts | Center on Budget and Policy Priorities
Everyone should be able to get the health care they need to thrive, and for that to happen, it must be affordable, high quality, and easily accessible for all. Premium tax credit (PTC) enhancements...
www.cbpp.org
September 30, 2025 at 3:10 PM
NEW from @centeronbudget.bsky.social: Without Congressional action, premium tax credit enhancements will expire, raising costs for nearly all marketplace enrollees and putting millions of those with the lowest incomes at risk of becoming uninsured when they lose $0 premium plans.
Reposted by Sarah Lueck
NEW from @jenniferlsullivan.bsky.social and me for @centeronbudget.bsky.social: With Congress poised to take away premium tax credit enhancements soon, ~4M people will lose coverage and costs will rise for nearly all ACA marketplace enrollees unless Congress acts.🧵
Five Key Changes to ACA Marketplaces Amid Uncertainty Over Premium Tax Credit Enhancements | Center on Budget and Policy Priorities
Recent policy changes, most notably enhancements to premium tax credits to reduce enrollees’ health insurance premiums, have driven record-breaking enrollment gains and delivered reduced costs, simpli...
www.cbpp.org
September 23, 2025 at 2:52 PM
NEW from @jenniferlsullivan.bsky.social and me for @centeronbudget.bsky.social: With Congress poised to take away premium tax credit enhancements soon, ~4M people will lose coverage and costs will rise for nearly all ACA marketplace enrollees unless Congress acts.🧵
Despite claims to the contrary, premium tax credits are well targeted to people with low & moderate incomes who need the most help with health costs. Three-quarters of people getting the credits have incomes below 300% FPL (~$47K for an individual). >90% have incomes below 400% FPL (~$63K)
September 17, 2025 at 4:06 PM
Despite claims to the contrary, premium tax credits are well targeted to people with low & moderate incomes who need the most help with health costs. Three-quarters of people getting the credits have incomes below 300% FPL (~$47K for an individual). >90% have incomes below 400% FPL (~$63K)
The latest CBO estimates make clear that the so-called “Big Beautiful Bill” is anything but--it would cause widespread harm with more than $1T in cuts to Medicaid & ACA marketplaces and higher costs for families trying to afford health care and groceries.
July 21, 2025 at 9:41 PM
The latest CBO estimates make clear that the so-called “Big Beautiful Bill” is anything but--it would cause widespread harm with more than $1T in cuts to Medicaid & ACA marketplaces and higher costs for families trying to afford health care and groceries.
Senate Republicans made a horrible bill even worse. Let's count the ways:
July 2, 2025 at 3:02 PM
Senate Republicans made a horrible bill even worse. Let's count the ways:
TSen. Scott amendment effectively repeals Medicaid expansion in only a few years. New analysis here: www.cbpp.org/research/med...
June 30, 2025 at 12:25 AM
TSen. Scott amendment effectively repeals Medicaid expansion in only a few years. New analysis here: www.cbpp.org/research/med...
New Congressional Budget Office (CBO) numbers confirm what we already knew – the reconciliation bill is getting worse, not better. The Senate bill will cut health care more deeply than the House bill and leave more people uninsured. www.cbo.gov/publication/...
Estimated Budgetary Effects of an Amendment in the Nature of a Substitute to H.R. 1, the One Big Beautiful Bill Act, Relative to the Budget Enforcement Baseline for Consideration in the Senate
As posted on the website of the Senate Committee on the Budget on June 27, 2025
www.cbo.gov
June 29, 2025 at 7:45 PM
New Congressional Budget Office (CBO) numbers confirm what we already knew – the reconciliation bill is getting worse, not better. The Senate bill will cut health care more deeply than the House bill and leave more people uninsured. www.cbo.gov/publication/...
Reposted by Sarah Lueck
The latest Senate Republican plan retains a deeply harmful provision that tramples over state rights’ to make decisions about how to use their own funds to ensure their state residents can access comprehensive health coverage.
June 28, 2025 at 8:45 PM
The latest Senate Republican plan retains a deeply harmful provision that tramples over state rights’ to make decisions about how to use their own funds to ensure their state residents can access comprehensive health coverage.
Senate Republican leaders appear to be barreling ahead with their harmful reconciliation bill. Reminder that the Republican health agenda would take us backward on covering the uninsured, largely reversing #ACA gains. 👎
(h/t @pkrugman.bsky.social for the graphic idea)
(h/t @pkrugman.bsky.social for the graphic idea)
June 28, 2025 at 7:46 PM
Senate Republican leaders appear to be barreling ahead with their harmful reconciliation bill. Reminder that the Republican health agenda would take us backward on covering the uninsured, largely reversing #ACA gains. 👎
(h/t @pkrugman.bsky.social for the graphic idea)
(h/t @pkrugman.bsky.social for the graphic idea)
Reposted by Sarah Lueck
Senate Republicans are rushing to pass a bill that would take #SNAP food assistance away entirely from millions of low-income people & cut food benefits for millions more. Some states could even end SNAP entirely. But Senators still have time to reject these harmful policies.
The Senate is barreling toward a vote on an unfinished bill that wld take away health coverage & food assistance from millions, raise families’ costs, & make ppl in our nation worse off. There’s still time for senators to say no to this bill. My statement: www.cbpp.org/press/statem...
Senate Republicans Can Still Abandon Disastrous, Rushed Reconciliation Bill | Center on Budget and Policy Priorities
The Senate is barreling toward a vote on a still-not-finished bill that would take away health coverage and food assistance from millions of people who need it, raise families’ costs, and make a large...
www.cbpp.org
June 28, 2025 at 4:53 PM
Senate Republicans are rushing to pass a bill that would take #SNAP food assistance away entirely from millions of low-income people & cut food benefits for millions more. Some states could even end SNAP entirely. But Senators still have time to reject these harmful policies.
June 28, 2025 at 4:54 PM
Reposted by Sarah Lueck
Every major bill language release is happening under the cover of night. Tracks since the bill is so unpopular.
Are Senators really going to set millions of families backwards by taking health coverage & food asst away from them? Is that why they got into politics? Really?
Are Senators really going to set millions of families backwards by taking health coverage & food asst away from them? Is that why they got into politics? Really?
The Senate is barreling toward a vote on an unfinished bill that wld take away health coverage & food assistance from millions, raise families’ costs, & make ppl in our nation worse off. There’s still time for senators to say no to this bill. My statement: www.cbpp.org/press/statem...
Senate Republicans Can Still Abandon Disastrous, Rushed Reconciliation Bill | Center on Budget and Policy Priorities
The Senate is barreling toward a vote on a still-not-finished bill that would take away health coverage and food assistance from millions of people who need it, raise families’ costs, and make a large...
www.cbpp.org
June 28, 2025 at 4:28 PM
Every major bill language release is happening under the cover of night. Tracks since the bill is so unpopular.
Are Senators really going to set millions of families backwards by taking health coverage & food asst away from them? Is that why they got into politics? Really?
Are Senators really going to set millions of families backwards by taking health coverage & food asst away from them? Is that why they got into politics? Really?
The reconciliation bill puts health benefits for tipped workers at risk. ⬇️
The White House is touting tax benefits for tipped workers in the reconciliation bill, but 2 million tipped workers could be among those at risk of losing health coverage because of the #Medicaid and #ACA marketplace cuts in the bill. (1/3) www.nbcwashington.com/news/busines...
June 26, 2025 at 8:43 PM
The reconciliation bill puts health benefits for tipped workers at risk. ⬇️
Reposted by Sarah Lueck
As Senate Republican leaders rush their bill to a vote, they are focused on band-aid fixes to clear process hurdles. Instead, they should stop moving forward with harmful legislation that takes health care away from millions of people.
June 26, 2025 at 5:58 PM
As Senate Republican leaders rush their bill to a vote, they are focused on band-aid fixes to clear process hurdles. Instead, they should stop moving forward with harmful legislation that takes health care away from millions of people.
$1 trillion > $15 billion
And a capped fund that Congress could shrink or cannibalize in the future isn’t a substitute for the foundation of rural hospital stability: Medicaid. www.cbpp.org/blog/trackin...
And a capped fund that Congress could shrink or cannibalize in the future isn’t a substitute for the foundation of rural hospital stability: Medicaid. www.cbpp.org/blog/trackin...
June 25, 2025 at 2:54 PM
$1 trillion > $15 billion
And a capped fund that Congress could shrink or cannibalize in the future isn’t a substitute for the foundation of rural hospital stability: Medicaid. www.cbpp.org/blog/trackin...
And a capped fund that Congress could shrink or cannibalize in the future isn’t a substitute for the foundation of rural hospital stability: Medicaid. www.cbpp.org/blog/trackin...
Reposted by Sarah Lueck
Now that I'm verified on BlueSky (‼️), I want to highlight how rural communities will be harmed by the GOP's budget bill and why people shouldn't just "get over it" or that "we're all going to die."
See my piece on the impact on rural economies:
www.cbpp.org/research/fed...
See my piece on the impact on rural economies:
www.cbpp.org/research/fed...
House Republican Reconciliation Bill Would Harm Rural Households, Communities, and Economies | Center on Budget and Policy Priorities
The bill continues the pattern under this Administration of hurting the people the President pledged to help.
www.cbpp.org
June 24, 2025 at 8:35 PM
Now that I'm verified on BlueSky (‼️), I want to highlight how rural communities will be harmed by the GOP's budget bill and why people shouldn't just "get over it" or that "we're all going to die."
See my piece on the impact on rural economies:
www.cbpp.org/research/fed...
See my piece on the impact on rural economies:
www.cbpp.org/research/fed...