Fact Check: "New ACA policies could save taxpayers $12 billion next year!"
What We Know
The claim that "New ACA policies could save taxpayers $12 billion next year" stems from a recent announcement by the Centers for Medicare & Medicaid Services (CMS). According to their press release, the newly finalized 2025 Marketplace Integrity and Affordability Final Rule is projected to save taxpayers up to $12 billion in 2026. This savings is attributed to measures aimed at combating improper enrollments in the Affordable Care Act (ACA) Exchanges, which have been linked to wasteful federal spending. The rule is designed to restore oversight and accountability in the ACA marketplaces, ensuring that taxpayer dollars are used only for eligible individuals.
The CMS report highlights that improper enrollments have led to significant financial losses, estimating that around 5 million people may have been improperly enrolled in 2024, costing taxpayers up to $20 billion (CMS). The new policies include stricter verification processes and the elimination of certain enrollment loopholes.
Analysis
While the claim suggests immediate savings for the next year, the projected savings of $12 billion are specifically noted for the year 2026, not the upcoming year 2025. This distinction is crucial as it implies that while the policies may start to take effect in 2025, the financial benefits will not be realized until 2026. The CMS press release does not explicitly state that these savings will be realized in the next fiscal year, which is a common point of confusion.
Moreover, the reliability of the CMS as a source is generally high, given its role as a federal agency responsible for health care policy. However, the projections of savings are based on estimates that can be influenced by various factors, including the actual implementation of the new policies and the response of the insurance market. The HFMA article corroborates the CMS's projections but also notes that the final rule's impact on the insured rate may lead to a loss of coverage for between 725,000 and 1.8 million individuals, which could have broader implications for the health insurance landscape.
The claim's wording could lead to misunderstandings about the timeline of the projected savings, as it implies immediate financial relief when the actual savings are contingent on the successful implementation of the new policies and will not be fully realized until 2026.
Conclusion
The claim that "New ACA policies could save taxpayers $12 billion next year" is Partially True. While it is accurate that new ACA policies are projected to save taxpayers up to $12 billion, this figure pertains to the year 2026, not the next fiscal year. The policies are designed to combat improper enrollments and improve the integrity of the ACA marketplace, but the timeline for realizing these savings is crucial for understanding the claim's accuracy.
