Hospitals are about to hit a perfect storm of two powerful climate conditions set both hit in 2026; the One Big Beautiful Bill Act (OBBBA) and revisions to the Patient Protection and Affordable Care Act (ACA).
Together, these laws overhaul Medicaid eligibility, Marketplace enrollment, and subsidy structures beginning in 2026 and 2027 fundamentally altering how hospitals manage a growing population expected to have limited to no coverage resulting in uncompensated care and increasing emergency service utilization.
Enacted as Public Law 119-21, the OBBBA represents the largest Medicaid policy reversal in a decade. Its core provisions include:
According the AMA, there is an estimated 12–16 million people who are projected to lose coverage nationwide. The highest impact will fall on low-income adults, older pre-Medicare adults, and individuals with disabilities who cannot meet new verification requirements.
Hospitals, particularly rural and safety-net facilities are anticipated to have an increase in self-pay encounters, charity care cases, and extended inpatient stays. For care management teams, this translates to higher discharge complexity and expanded coordination with community agencies and free clinics who continue to deal with anemic operating margins.
In parallel, revisions to the Affordable Care Act will be tightening enrollment and verification procedures:
These changes will also increase the uninsured rate, particularly among lower-income workers cycling between Medicaid and Marketplace eligibility.
Listen live on October 28 when Tiffany Ferguson delivers this report during Talk Ten Tuesday, 10 am Eastern with Chuck Buck and Angela Comfort.
Hotly anticipated performance targets and payment amounts for the Centers for Medicare & Medicaid Services (CMS) Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model
I often begin my day with an environmental scan. Last week, an article from Becker’s Clinical Leadership caught my eye, “Hospital mortality, infectionrates improve despite
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