Four Proposed Changes to Medicare in the One Big Beautiful Bill Act — and What Ended Up in the Signed Bill
Now signed into law, the One Big Beautiful Bill Act ultimately stripped out many of the proposals in the House bill. Here’s a look at what was proposed and what ultimately was included.
Medicare provides healthcare for 68.6 million beneficiaries. The One Big Beautiful Bill, which was signed into law by President Trump last week, promised sweeping changes to Medicare, but only one change ultimately made it into the final version.
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Congress allows first-dollar telehealth coverage for high deductible health plans in reconciliation bill
Congress has made permanent a pandemic-era telehealth provision for millions of Americans with high-deductible health plans.
In its massive tax package signed into law on July 4, Congress included a last-minute provision to allow employer-sponsored health plans to offer covered telehealth services before employees meet their deductibles.
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Supreme Court Upholds Preventive Services Requirement Under ACA
On June 27, 2025, the Supreme Court issued its highly anticipated decision in Kennedy v. Braidwood Management, Inc. By a vote of 6-3, the Court upheld the Affordable Care Act’s (ACA’s) long-standing requirement that insurers and health plans cover certain recommended preventive services without cost sharing. The United States (US) Preventive Services Task Force (Task Force), the majority held, is an entity within the Department of Health and Human Services (HHS) whose members are inferior officers under the US Constitution and subject to the direction and supervision of the Secretary of HHS. This “chain of command” is consistent with the Constitution’s Appointments Clause and thus constitutional.
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Centene stock sinks as insurer withdraws 2025 guidance
Centene pulled back its guidance for the year after receiving an actuarial report suggesting its growth in the Affordable Care Act marketplaces will be lower than expected.
The insurer said an analysis from Wakely predicted that market growth in 22 of its states will fall short of expectations, and “aggregate market mobility” in those regions will not align with Centene’s expectations around risk adjustment revenue transfers.
Based on the report, Centene said it expects the 2025 risk adjustment transfer to be about $1.8 billion lower than its expectations, making for a $2.75 impact on earnings per share.
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Master the New Tax Law: Free Webinar on HR 1
Master the New Tax Law for Client Conversations
Open to All Financial Professionals!
At NAIFA, we take our duty of service to the industry seriously. Some issues are so important that they need to be shared with everyone for the betterment of the profession. That is why we are offering this critical element to all financial professionals.
Elevate your client discussions with our focused webinar on the now-enacted HR 1! Designed for financial professionals, this session will equip you with the insights to confidently guide clients through the new tax and retirement planning landscape.
Date: Thursday, July 24th
Time: 12:00 p.m. Eastern
Featuring: Kathleen Bilderback (Counsel, Sandberg Phoenix) Nick Sutter (Associate, Steptoe)
CLICK TO REGISTER »
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UC Health, Blue Shield extend contract deadline, stave off disruption of care
UC Health and Blue Shield of California, which are at an impasse over the terms of a new contract that could disrupt health care for thousands of Californians, have extended the deadline for reaching a new agreement from July 9 to Aug. 9.
This means the thousands of Californians who get medical care at UC Health through Blue Shield of California — including many in the Bay Area who go to UCSF and One Medical, a UCSF affiliate — have an additional 30 days of breathing room before potentially having to find a different health insurer or pay out-of-network rates for services if UC Health and Blue Shield cannot reach a new contract.
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MEDICARE
Blue Shield of California cuts Medicare Advantage broker commissions
Blue Shield of California is cutting broker commissions for new enrollments into Medicare Advantage PPO plans in Alameda, Orange and San Diego counties, effective July 1.
The new policy does not affect commission payments of existing membership, according to a June memo sent to brokers.
Several large insurers have cut MA commissions recently, including UnitedHealthcare, Elevance Health and Aetna.
CMS has recently implemented a range of broker regulations, including setting a fixed compensation amount for agents and brokers, restricting the sharing of beneficiary data without prior consent and prohibiting volume-based bonuses for steering enrollees. In June, the agency raised limits for payments to brokers for 2026.
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Future Estimated Part B Premiums Chart
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Six Medicare Changes Coming in 2026
Learn about the benefits that become permanent features of Medicare in 2026 and other changes as they are released.
Knowing how Medicare is evolving and which benefits you can rely on will help you focus on whether Original Medicare or a particular Medicare Advantage plan will serve you best. Medical costs are increasing every year, and several factors are contributing to this trend. Inflation and advancements in medical technology, such as biosimilars, are helping to drive up costs.
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What Does Medicare Not Cover? Eight Things You Should Know
Medicare Part A and Part B leave gaps in your healthcare coverage. But Medicare Advantage has problems, too.
Medicare Part A and Part B, also known as Original Medicare or Traditional Medicare, cover a large portion of your medical expenses after you turn 65, but that doesn’t mean Medicare covers everything.
Part A (hospital insurance) helps pay for inpatient hospital stays, stays in skilled nursing facilities, surgery, hospice care and even some home healthcare. Part B (medical insurance) helps pay for doctors’ visits, outpatient care, some preventive services, and some medical equipment and supplies. Most folks can start signing up for Medicare three months before the month they turn 65.
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CMS finalizes rule aimed at ‘improper’ sign-ups on the ACA exchanges
The Centers for Medicare & Medicaid Services (CMS) has finalized a rule that it says will address “the surge of improper enrollments” on Affordable Care Act (ACA) exchanges as well as take on wasteful spending.
The agency said late Friday that there are likely millions of people who were improperly enrolled in ACA exchange plans. The CMS said 5 million people may have been enrolled improperly in ACA plans in 2024 alone, citing data from the Paragon Health Institute, a think tank promoting a free market approach to healthcare.
The Paragon study estimates those potential improper enrollments cost taxpayers $20 billion last year.
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