Health Affairs December 18, 2025
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 analyses of regulatory, legislative, and judicial developments in health policy under the Trump-Vance administration and the 119th Congress. Health Affairs Forefront alone reviews all submissions then selects, edits, and publishes them only if they meet Forefront’s editorial standards.
Fifteen years after passage of the Affordable Care Act (ACA), the insurance exchanges created under the legislation now cover more than 24 million Americans in all 50 states and the District of Columbia.
But all is not well. Health care costs are the...
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