Health Plan Weekly

After Aetna Shares Exit Plans, CMS Memo Hints at New ACA Market Headwind

  • May 09
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    May 09, 2025

    When CVS Health Corp.’s Aetna said on May 1 that it will leave the Affordable Care Act exchanges next year, it sparked new concerns about the future of the marketplace under President Donald Trump. But not long after that announcement, CMS quietly issued a bulletin that policy experts say could have an even bigger negative impact on the exchanges. 

    The key part of the bulletin, which was issued May 2, has to do with cost-sharing reductions (CSR), which is one of two types of subsidies provided to ACA exchange enrollees based on their income level. (The other type of subsidy is advance premium tax credits, or APTCs.) As their name indicates, CSRs help reduce cost-sharing levels — such as deductibles, copays and coinsurance — for lower-income individuals.  

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    • Leslie Small

    Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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Reporter, Radar on Medicare Advantage and Spotlight on Market Access

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