Medicaid, ACA Changes in Budget Bill Aren't Enough to Satisfy Conservatives

May 16
May 16, 2025

After the House Energy and Commerce and Ways and Means committees passed their portions of Republicans’ domestic policy bill on May 14, it appeared as though major changes to the Medicaid program and Affordable Care Act marketplaces had moved closer to becoming a policy reality. However, conservative House members blocked the package from advancing past the Budget Committee, leaving the future of the "big, beautiful bill" uncertain.

For the private health insurers that cover most Medicaid beneficiaries and all ACA exchange enrollees, experts say the largest business headaches in the health care provisions that the GOP originally agreed upon could come from not only the cumulative weight of all the policy proposals but also the less-noticed portions of the legislation.
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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.