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Saturday, September 13, 2025

New Steering Expands Pool of People Eligible to Buy Catastrophic Plans


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 had been created by the Reasonably priced Care Act (ACA) and are at the moment accessible to a narrowly outlined universe of people based mostly on age and particular circumstances, and are designed to supply fundamental safety from catastrophic well being prices. Noting a necessity to assist folks “handle the numerous rise in medical insurance premiums,” HHS’ steerage considerably expands the universe of people eligible for these plans, with potential implications for shoppers’ entry to premium tax credit, states’ particular person insurance coverage markets, and premiums for each catastrophic and particular person market “metallic stage” (bronze, silver, gold and platinum) plans.

Of their newest Knowledgeable Perspective for the Robert Wooden Johnson Basis’s State Well being & Worth Methods program, CHIR’s JoAnn Volk, Sabrina Corlette, and Justin Giovannelli evaluation HHS’ new steerage and assess the implications for shoppers, insurance coverage markets, and state insurance coverage regulators. You’ll be able to learn the complete submit right here.

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