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Course Details

Course Information
  • smart_display Format

    On-Demand

  • signal_cellular_alt Difficulty Level

    Intermediate

  • work Practice Area

    Health

Date & Time
  • event Date

    Thursday, June 26, 2025

  • schedule Time

    1:00 p.m. ET./10:00 a.m. PT

  • timer Program Length

    90 minutes

Credit Information

  • This 90-minute webinar is eligible in most states for 1.5 CLE credits.

$297.00

This course is $0 with these passes:

CLE
ALL

This CLE webinar will examine recent actions by the Trump administration related to the Affordable Care Act (ACA), examining policy actions that include rescinding Biden-era measures, slashing funding for ACA navigators, and propounding a proposed rule that would make sweeping changes to ACA marketplace enrollment and eligibility. The expert panel will provide insight into how the administration's actions will likely impact the healthcare industry and marketplace participants.

Faculty

Rachel Carey
Counsel
Mcdonald Hopkins LLC

Ms. Carey's practice spans the health care landscape, with a particular focus on regulatory compliance, reimbursement and related health care issues. She provides clients with practical and value-additive counsel, leveraging her extensive legal experience and background working at managed-care organizations to offer key insights into developing best reimbursement practices. She regularly works with various health care providers, from independent practitioners and start-ups to large health systems, long-term care providers, and substance abuse treatment and behavioral health providers. Ms. Carey's practice extends to drafting policies and procedures for health systems and academic medical centers, including different state life-sustaining treatment and graduate medical education policies. She is regularly called upon to address health system issues requiring a deep technical knowledge of health care programs, such as COVID and telemedicine flexibilities, CMS waiver appeals and adding new service lines to comply with enrollment regulations.

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Lisa Campbell
Principal, Health Services Co-Chair
Groom Law Group Chtd - Washington

Ms. Campbell is co-chair of the firm’s Health Services group. She advises clients on all aspects of the Affordable Care Act (ACA), including the insurance market reforms, qualified health plan standards, exchange rules, consumer assistance programs for the federal marketplace, and ACA section 1557 nondiscrimination rules. Ms. Campbell also works with clients on the Federal Mental Health Parity and Addiction Equity Act (MHPAEA), state insurance law, and Medicare and Medicaid. She represents health insurance companies, employers, consultants, and trade associations on federal and state laws regulating health coverage. Ms. Campbell also provides advice on advocacy with federal and state agencies, compliance programs, government enforcement, and regulatory initiatives.

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Description

The Trump administration has taken recent action related to the ACA that will impact millions, including rescinding Biden-era measures that increased ACA enrollment, slashing funding for ACA navigators, and issuing a proposed rule that will significantly impact ACA eligibility and enrollments across the country. 

The CMS proposed rule, one of the most notable actions, purportedly taken to crack down on fraud in the program, would shorten the annual open enrollment period by one month, end the availability of the monthly special enrollment period (SEP) for individuals with household incomes below 150 percent of the federal poverty level, and require all marketplaces to reinstitute pre-enrollment verifications of eligibility for SEPs and further verifications of income when there is no tax data available for verification.

Additionally, the proposed rule would further administration priorities by adding sex-trait modification to the list of services that may not be covered as essential health benefits beginning in plan year 2026; and would revert to a previous definition of "lawfully present" that excludes DACA recipients for purposes of enrolling in marketplace coverage.

Critics of the proposed rule claim its effect will be to shrink participation in the exchanges. And any impact on fraud will be minimal as the proposed rule only nominally affects agents and brokers, while the prior administration's rule made it more difficult for insurance agents to make unauthorized changes to consumers' coverage and expanded CMS' ability to punish bad actors.

Listen as our expert panel closely examines the new administration's actions related to the ACA including the recently proposed rule reportedly aimed at maintaining the integrity of the ACA. The panel will provide insight into the potential impact on the healthcare industry and offer best practices for compliance.

Outline

I.      Introduction: new administration and the ACA

II.    Rescinding Biden-era measures

III.   Funding cut for ACA navigators

IV.  CMS proposed rule related to ACA eligibility and enrollment

A.    Purpose

B.    Proposed changes

1.    Addressing improper enrollments

2.    Furthering administration policies

V.    Impact on healthcare industry and marketplace participants

VI.  Practitioner takeaways


Benefits

The panel will review these and other important considerations:

  • The new administration has taken what policy actions related to the ACA?
  • What are key changes in the proposed CMS rule that will impact ACA eligibility and enrollment?
  • How do the proposed rule changes advance the new administration's healthcare agenda?
  • What is the potential impact of the administration's actions on healthcare providers and ACA marketplace participants?