Health Affairs January 27, 2026
Editor’s Note
This article is the latest in the Health Affairs Forefront featured topic, “Health Policy at a Crossroads,” produced with the support of the Commonwealth Fund and the Robert Wood Johnson Foundation. Articles in this topic offer timely analysis of regulatory, legislative, and judicial developments in health policy under the Trump-Vance Administration and the 119th Congress
One piece of the Affordable Care Act (ACA) that has received little attention is “heath care choice compacts.” Section 1333 of the ACA allows states to enter agreements under which Marketplace plans following the rules of one state can be sold in other states in the compact. This is a version of what’s often referred to as “selling insurance across state lines.”
While...
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