The Budget Reconciliation Bill Will Cause Harm to the Health Care System
The One Big Beautiful Bill Act (Pub. Law No. 119-21) makes sweeping changes to the Medicaid program, the Marketplace plans, and private insurance.
Eliminating Autoenrollment in Marketplace Plans Harms Marketplaces and Consumers
July 10, 2025
The One Big Beautiful Bill Act (Pub. Law No. 119-21) prohibits states from auto-enrolling people into Marketplace plans (regardless of whether the Marketplace is state-based or federally run). Eliminating auto-enrollment would add additional burdens to Marketplaces (which are already facing other increased administrative burdens under new federal laws).
Consumers who have come to rely on auto-enrollment will be forced to undergo a cumbersome enrollment process in order to keep their coverage. These changes come at a time when the administration has slashed funding for enrollment navigators, meaning that consumers will have fewer resources to help them traverse the enrollment process. Increased paperwork requirements can deter younger, healthier people from enrolling in coverage, which harms the risk pool and increases health insurance premiums.