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
President Trump’s one-page health care plan not only fails to extend enhanced premium tax credits (PTCs), more than doubling out-of-pocket premiums on the ACA marketplace. It also cuts PTCs even further by changing how existing cost-sharing reductions are funded. (1/3) tinyurl.com/37x7wbcz
January 15, 2026 at 9:17 PM
President Trump’s one-page health care plan not only fails to extend enhanced premium tax credits (PTCs), more than doubling out-of-pocket premiums on the ACA marketplace. It also cuts PTCs even further by changing how existing cost-sharing reductions are funded. (1/3) tinyurl.com/37x7wbcz
Reposted by Allison Orris
This “affordability” framework for a second reconciliation bill (i.e. a “Second Big Beautiful Bill”) follows the same structure as its predecessor:
1.)Making it harder for Americans to afford health care, food & groceries.
2.)Tax cuts for rich people. 🧵
1.)Making it harder for Americans to afford health care, food & groceries.
2.)Tax cuts for rich people. 🧵
🐘📈 Republicans in the House have started about a second party-line reconciliation package.
In other words: A "One Big Beautiful Bill 2.0."
The Republican Study Committee put out its framework for a bill.
Here is everything in it, and how much it costs or saves on th3e federal budget:
In other words: A "One Big Beautiful Bill 2.0."
The Republican Study Committee put out its framework for a bill.
Here is everything in it, and how much it costs or saves on th3e federal budget:
Republican Study Committee reconciliation proposals
Figures in red represent increases to the national debt over 10 years, and in teal represent savings.
datawrapper.dwcdn.net
January 13, 2026 at 10:09 PM
This “affordability” framework for a second reconciliation bill (i.e. a “Second Big Beautiful Bill”) follows the same structure as its predecessor:
1.)Making it harder for Americans to afford health care, food & groceries.
2.)Tax cuts for rich people. 🧵
1.)Making it harder for Americans to afford health care, food & groceries.
2.)Tax cuts for rich people. 🧵
Reposted by Allison Orris
The House passed a measure today to extend the Premium Tax Credit enhancements for three years. The bipartisan vote shows there’s strong support for immediate action to make millions of people’s health care more affordable. All eyes are now on the Senate. x.com/JakeSherman/...
January 8, 2026 at 10:45 PM
The House passed a measure today to extend the Premium Tax Credit enhancements for three years. The bipartisan vote shows there’s strong support for immediate action to make millions of people’s health care more affordable. All eyes are now on the Senate. x.com/JakeSherman/...
Reposted by Allison Orris
This week, the House is expected to vote on a bill to extend the Premium Tax Credit enhancements. This would reduce 2026 premiums for the average #ACA marketplace enrollee by more than half, improving affordability for millions of people struggling with health costs. www.cbpp.org/research/hea...
Marketplace Enrollees In Every Congressional District 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
January 6, 2026 at 6:00 PM
This week, the House is expected to vote on a bill to extend the Premium Tax Credit enhancements. This would reduce 2026 premiums for the average #ACA marketplace enrollee by more than half, improving affordability for millions of people struggling with health costs. www.cbpp.org/research/hea...
Reposted by Allison Orris
Today’s #JobsReport covers the month of November and some of October. Due to the shutdown, only data surveyed from firms, not households, was collected in October, so we don’t have the unemployment rate for October. (1/9)
a woman says it 's all gone in a dark room
ALT: a woman says it 's all gone in a dark room
media.tenor.com
December 16, 2025 at 8:20 PM
Today’s #JobsReport covers the month of November and some of October. Due to the shutdown, only data surveyed from firms, not households, was collected in October, so we don’t have the unemployment rate for October. (1/9)
Reposted by Allison Orris
The House Republicans’ response to expiring premium tax credit enhancements simply doesn’t respond to expiring PTC enhancements.
Instead, they recycle old Republican policy priorities and do nothing to address the impending marketplace affordability crisis.
Instead, they recycle old Republican policy priorities and do nothing to address the impending marketplace affordability crisis.
House Republican Health Care Bill Fails to Address Marketplace Affordability
The health bill House Republicans are preparing to bring to the floor this week not only fails to prevent imminent premium spikes for more than 20 million people in marketplace plans, but would raise....
www.cbpp.org
December 16, 2025 at 8:06 PM
The House Republicans’ response to expiring premium tax credit enhancements simply doesn’t respond to expiring PTC enhancements.
Instead, they recycle old Republican policy priorities and do nothing to address the impending marketplace affordability crisis.
Instead, they recycle old Republican policy priorities and do nothing to address the impending marketplace affordability crisis.
Reposted by Allison Orris
This week is critical for health coverage affordability. CBPP’s @jenniferlsullivan.bsky.social breaks down what’s at stake as Congress votes on extending premium tax credit enhancements & the 3 key dates marketplace enrollees need to know when choosing 2026 coverage: www.youtube.com/watch?v=6QY5...
3 Key Dates to Keep in Mind When Choosing Your Health Coverage Plan for 2026
YouTube video by Center on Budget and Policy Priorities
www.youtube.com
December 11, 2025 at 5:00 PM
This week is critical for health coverage affordability. CBPP’s @jenniferlsullivan.bsky.social breaks down what’s at stake as Congress votes on extending premium tax credit enhancements & the 3 key dates marketplace enrollees need to know when choosing 2026 coverage: www.youtube.com/watch?v=6QY5...
Reposted by Allison Orris
A recent WSJ op-ed reaches the wrong conclusion about a GAO report on #ACA marketplaces. The report details vulnerabilities that call for targeted action – it doesn’t show widespread fraud, and it shouldn’t be used as an excuse to raise ppl’s premiums. tinyurl.com/4rnrpkt2
December 10, 2025 at 3:55 PM
A recent WSJ op-ed reaches the wrong conclusion about a GAO report on #ACA marketplaces. The report details vulnerabilities that call for targeted action – it doesn’t show widespread fraud, and it shouldn’t be used as an excuse to raise ppl’s premiums. tinyurl.com/4rnrpkt2
Reposted by Allison Orris
Senators Crapo & Cassidy have now released bill language for their health "plan". Besides nothing on expiring Marketplace credits and HSAs, it adds 3 harmful #Medicaid cuts from House version of H.R. 1 that were dropped in final law due to Senate rules (1/x): www.finance.senate.gov/download/hea...
[2025-12-08] Download: Health Care Freedom for Patients Act | The United States Senate Committee on Finance | The United States Senate Committee on Finance
[2025-12-08] Download: Health Care Freedom for Patients Act | The United States Senate Committee on Finance
www.finance.senate.gov
December 9, 2025 at 12:29 AM
Senators Crapo & Cassidy have now released bill language for their health "plan". Besides nothing on expiring Marketplace credits and HSAs, it adds 3 harmful #Medicaid cuts from House version of H.R. 1 that were dropped in final law due to Senate rules (1/x): www.finance.senate.gov/download/hea...
Reposted by Allison Orris
Sens Cassidy and Crapo are circulating a health proposal that would do little to address the premium spikes millions of ACA marketplace enrollees will face starting Jan 1, and would further increase many people’s out of pocket costs for health care over time. www.axios.com/2025/12/08/s...
Scoop: Senate GOP chairs circulate health plan as ACA subsidies hang in the balance
Two key Republican chairmen circulated the plan as the GOP struggles to unite around health policies.
www.axios.com
December 8, 2025 at 9:03 PM
Sens Cassidy and Crapo are circulating a health proposal that would do little to address the premium spikes millions of ACA marketplace enrollees will face starting Jan 1, and would further increase many people’s out of pocket costs for health care over time. www.axios.com/2025/12/08/s...
Reposted by Allison Orris
New HHS data on ACA marketplace enrollment for 2026 so far suggest a similar number of ppl have selected a plan compared to last year even as they see higher premium costs that reflect expiration of PTC enhancements. But don't make too much if it.
Marketplace 2026 Open Enrollment Period Report: National Snapshot | CMS
Marketplace 2026 Open Enrollment Period Report: National Snapshot
www.cms.gov
December 5, 2025 at 10:17 PM
New HHS data on ACA marketplace enrollment for 2026 so far suggest a similar number of ppl have selected a plan compared to last year even as they see higher premium costs that reflect expiration of PTC enhancements. But don't make too much if it.
Reposted by Allison Orris
Instead of a clean extension of PTC enhancements (which makes silver plans more affordable), some Republicans have proposed encouraging people to buy down to less generous bronze plans.
Don’t be fooled: While bronze plans often have lower premiums, people face much higher costs when they get care.
Don’t be fooled: While bronze plans often have lower premiums, people face much higher costs when they get care.
December 2, 2025 at 8:52 PM
Instead of a clean extension of PTC enhancements (which makes silver plans more affordable), some Republicans have proposed encouraging people to buy down to less generous bronze plans.
Don’t be fooled: While bronze plans often have lower premiums, people face much higher costs when they get care.
Don’t be fooled: While bronze plans often have lower premiums, people face much higher costs when they get care.
Reposted by Allison Orris
ACA marketplace plans w/ $0 premiums help ppl get & stay covered. Recent Republican proposals would require minimum premiums or fail to extend premium tax credit enhancements based on the false claim that ppl who don’t use medical care are “phantom enrollees.” 🧵https://tinyurl.com/4uc68zbf
People With Low Incomes May Lose $0 Premium Plans — a Lifeline — Unless Congress Acts
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...
tinyurl.com
December 2, 2025 at 5:26 PM
ACA marketplace plans w/ $0 premiums help ppl get & stay covered. Recent Republican proposals would require minimum premiums or fail to extend premium tax credit enhancements based on the false claim that ppl who don’t use medical care are “phantom enrollees.” 🧵https://tinyurl.com/4uc68zbf
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.