By JoAnn Volk, Sabrina Corlette, and Justin Giovannelli
On September 4, 2025, the U.S. Division of Well being and Human Providers (HHS) launched steerage increasing eligibility for catastrophic well being plans. These plans have been created by the Reasonably priced Care Act (ACA) and are at the moment accessible to a narrowly outlined universe of people primarily based on age and particular circumstances, and are designed to offer fundamental safety from catastrophic well being prices. Noting a necessity to assist individuals “handle the numerous rise in medical insurance premiums,” HHS’ steerage considerably expands the universe of people eligible for these plans, with potential implications for customers’ entry to premium tax credit, states’ particular person insurance coverage markets, and premiums for each catastrophic and particular person market “steel degree” (bronze, silver, gold and platinum) plans.
Of their newest Skilled Perspective for the Robert Wooden Johnson Basis’s State Well being & Worth Methods program, CHIR’s JoAnn Volk, Sabrina Corlette, and Justin Giovannelli overview HHS’ new steerage and assess the implications for customers, insurance coverage markets, and state insurance coverage regulators. You possibly can learn the complete submit right here.
