Gov. Mikie Sherrill signed the measure into law Tuesday, establishing a new assessment on larger employers whose workers and their dependents receive Medicaid coverage instead of employer-sponsored insurance. State officials included an estimated $145 million in anticipated revenue from the program in the fiscal year budget approved earlier this week.

The policy reflects broader concerns among several Democratic-led states about Medicaid financing following recent federal policy changes that are expected to increase state spending obligations and affect insurance coverage for millions of Americans.

Medicaid is jointly funded by federal and state governments and provides health coverage for eligible low-income individuals and families. State leaders argue that employers whose workforces rely heavily on the program benefit from taxpayer-funded healthcare without bearing the full cost through employer-sponsored insurance.

New Employer Assessment Takes Effect

Under New Jersey’s new law, employers with at least 50 workers or covered dependents enrolled in Medicaid will be required to pay an annual assessment based on the number of beneficiaries associated with their workforce.

The fee begins at $325 per covered individual for employers with between 50 and 249 Medicaid beneficiaries and rises to as much as $725 per person annually for employers with at least 500 beneficiaries.

State lawmakers designed the measure to generate additional funding for Medicaid while attempting to limit unintended employment consequences. The legislation exempts temporary, seasonal and part-time workers from the assessment and prohibits employers from making hiring, firing or other employment decisions based on an individual’s Medicaid enrollment.

Federal Policy Changes Shape State Decisions

New Jersey’s action comes as several other states examine similar approaches to financing Medicaid amid shifting federal requirements.

In California, lawmakers approved legislation directing the state administration to develop options for a comparable employer assessment next year, although no immediate fee has been enacted. The proposal follows concerns that federal Medicaid policy changes signed into law by President Donald Trump could increase financial pressure on state healthcare programs.

California State Sen. John Laird, who sponsored the legislation, argued that employers offering health insurance should not shoulder additional tax burdens while some larger companies benefit from employees relying on publicly funded coverage.

The Congressional Budget Office has projected that more than 10 million people could become uninsured by 2034 under the federal law. Among its provisions are work, education or volunteer activity requirements for certain Medicaid beneficiaries, along with expanded documentation requirements to demonstrate eligibility. The budget office’s estimate has become part of the debate over how states may finance Medicaid in the coming years.

Beyond California, lawmakers in Colorado and Oregon approved similar proposals in one legislative chamber during the most recent session, although neither measure ultimately became law. Comparable legislation was also introduced in Washington state, while Connecticut Gov. Ned Lamont has proposed incorporating an employer assessment into a future state budget.

Business Groups Raise Concerns

Business organizations have criticized New Jersey’s approach, arguing that employers may be charged even when workers voluntarily choose Medicaid over an available employer-sponsored health plan.

Christopher Emigholz, chief government affairs officer for the New Jersey Business and Industry Association, said in a statement that employers could be penalized for decisions outside their control if employees decline workplace health coverage in favor of Medicaid.

Opponents contend the additional assessment could increase operating costs for businesses already managing higher labor and healthcare expenses.

Some Policy Advocates Warn of Unintended Effects

Opposition has also emerged from some left-leaning policy organizations that generally support Medicaid expansion.

Gideon Lukens, a health policy analyst at the Center on Budget and Policy Priorities, said the assessment could unintentionally influence hiring decisions involving workers from lower-income households or single-parent families. He also warned that some individuals might avoid enrolling in Medicaid if they believe doing so could affect employment opportunities.

Lukens said taxes or fees tied to a particular activity often create incentives to reduce the behavior being taxed, raising concerns about possible unintended labor market effects.

New Jersey’s legislation attempts to address those concerns by explicitly prohibiting employment decisions based on Medicaid enrollment status.

Similar Policies Have Been Tried Before

Employer assessments linked to Medicaid participation are not new, although previous efforts have had mixed outcomes.

Massachusetts introduced a similar employer fee in 2018 that applied to certain workers covered through Medicaid or a state-subsidized health insurance exchange. The program expired the following year and was not renewed.

Maryland pursued an earlier version of the policy in 2006 that primarily affected Walmart. An industry challenge ultimately halted the measure after a federal court ruled that it conflicted with federal law governing self-insured employee health plans.

Supporters of more recent proposals believe newer legislative approaches may avoid those legal issues by structuring employer assessments differently and avoiding references to self-insured health plans.

As states continue evaluating how to finance Medicaid amid changing federal requirements, New Jersey’s new employer assessment is likely to remain closely watched by policymakers weighing similar strategies elsewhere.

Tags: Medicaid, New Jersey, Healthcare Policy, Employer Health Coverage, Medicaid Funding, Public Health Financing, California Legislature, Congressional Budget Office, Gov. Mikie Sherrill, Employer Assessment, Health Insurance, State Budgets,

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About 3 million fewer Americans were enrolled in Affordable Care Act (ACA) health insurance plans in February compared with the same period a year earlier, according to new data released Friday by the U.S. Department of Health and Human Services (HHS). The figures highlight the first major enrollment decline following the expiration of enhanced federal premium subsidies at the start of the year.

The HHS report found ACA marketplace enrollment fell 13%, from 22.1 million people in February 2025 to 19.2 million in February 2026. The department said the decrease may have been influenced by federal efforts to eliminate fraudulent or “phantom” enrollments from the marketplace.

However, health policy experts argue that rising insurance costs after the expiration of federal subsidies played a much larger role in reducing coverage.

Higher Premiums Linked to Enrollment Decline

According to Cynthia Cox, vice president and director of the ACA program at healthcare research nonprofit KFF, millions of consumers experienced substantial premium increases after the enhanced subsidies ended on Jan. 1.

Cox said survey findings indicate that many individuals who left ACA plans did so because they could no longer afford their monthly insurance payments.

She noted that many households faced premium increases reaching double- or even triple-digit percentages, making continued coverage financially difficult for many families.

The latest federal data provide one of the clearest pictures yet of the impact because they reflect enrollment after the marketplace’s grace period for unpaid premiums had expired.

Government Data Reflects Post-Payment Enrollment

The enrollment figures, compiled in April but measuring coverage during February, capture individuals who successfully maintained their health insurance after paying their first premiums of the year.

Earlier government estimates released in January had already indicated weakening enrollment trends. At that time, approximately 800,000 fewer people had signed up for ACA coverage than during the same enrollment period a year earlier, marking the first annual decline in marketplace enrollment in four years.

The February data suggest that additional policyholders lost coverage after failing to keep up with higher premium payments.

More Enrollment Losses Could Follow

KFF expects enrollment to continue declining throughout 2026.

According to Cox, total ACA marketplace enrollment could fall to roughly 17.5 million people before the end of the year if current trends continue.

The Affordable Care Act marketplace has become an increasingly important source of health insurance for working-age Americans who do not receive employer-sponsored coverage and do not qualify for Medicaid.

Those relying on ACA plans include self-employed workers, gig economy employees, farmers, ranchers, hairstylists, freelancers, and other individuals purchasing insurance independently.

Subsidy Expiration Became a Political Issue

The enhanced ACA subsidies that expired this year were the subject of significant debate in Congress last fall.

Democrats and some Republicans supported extending the financial assistance, arguing it would help keep health insurance affordable for millions of Americans.

The expiration comes as healthcare affordability remains a prominent issue for voters ahead of the November elections. Rising medical costs and insurance premiums continue to rank among the public’s leading economic concerns alongside broader cost-of-living pressures.

While federal officials point to anti-fraud efforts as one factor behind lower enrollment, healthcare analysts say the higher premiums following the end of enhanced subsidies appear to have had a substantial impact on the number of Americans maintaining Affordable Care Act coverage.

Tags: Affordable Care Act, Obamacare, Health Insurance, Department of Health and Human Services, Healthcare Policy, Health Insurance Premiums, Congress, Medicaid, Health Coverage, Federal Subsidies

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Published: October 13, 2025, 22:10 EDT

AstraZeneca has reached an agreement with the Trump administration to lower prescription drug prices for Medicaid, marking a significant move in the administration’s ongoing effort to make medicines more affordable. The deal, announced Friday at the White House, also spares the British drugmaker from potential tariffs threatened by President Donald Trump.

White House Announces Agreement With AstraZeneca

President Trump, alongside AstraZeneca Chief Executive Pascal Soriot, unveiled the agreement in the Oval Office. The arrangement will allow Medicaid to receive “most-favored-nation” pricing—ensuring that the U.S. government pays no more than the lowest price offered in comparable developed nations.

“For many years, Americans have paid the highest prices in the world for prescription drugs, by far,” Trump said during the announcement. “This deal will cut prices to the lowest level anywhere in the world—that’s what we get.”

Soriot described the negotiations as “tough but productive,” noting that the administration’s persistence pushed the company toward a comprehensive solution.

Part of Broader Push to Lower Prescription Costs

The AstraZeneca deal follows a similar agreement made by Pfizer last month, both stemming from a May executive order requiring drugmakers to reduce prices voluntarily or face federal payment restrictions. The policy has been described by the administration as an incentive-based approach to reforming pharmaceutical pricing.

Trump said tariffs played a key role in bringing companies to the table. “The tariffs were a big reason he came here,” he said, referring to Soriot.

Policy experts and consumer advocates have cautiously welcomed the development but warned that structural safeguards are needed to ensure long-term affordability rather than temporary reductions driven by executive action.

AstraZeneca’s Expanding U.S. Presence

Headquartered in Cambridge, United Kingdom, AstraZeneca is known for its portfolio of cancer treatments, including Tagrisso (lung cancer), Lynparza (ovarian cancer), and Calquence (chronic lymphocytic leukemia). Together, those drugs generated over $7.5 billion in U.S. sales last year, according to company data.

As part of its long-term U.S. investment strategy, AstraZeneca announced a $4.5 billion manufacturing facility near Charlottesville, Virginia. Virginia Governor Glenn Youngkin joined the Oval Office event to celebrate the project, which is expected to generate 3,600 new jobs in its initial phase.

The company said the Virginia plant is central to its $50 billion investment plan in the United States through 2030. AstraZeneca aims to reach $80 billion in annual revenue by that time, with roughly half coming from the U.S. market.

Political and Industry Reactions

President Trump credited his administration’s policies for encouraging major drugmakers to agree to voluntary cost reductions. He also criticized Democrats for attempting to claim political credit for similar pricing reforms initiated during the Biden administration.

One of AstraZeneca’s cancer drugs had already seen a price adjustment under Medicare negotiations launched during President Biden’s term. Despite that, Trump insisted the new agreement reflects his administration’s distinct approach to direct negotiation with pharmaceutical companies.

Economic analysts have noted that AstraZeneca’s decision to cancel an earlier vaccine facility expansion in the U.K. may have influenced its pivot toward deeper U.S. investments, citing favorable tax and regulatory conditions under the current administration.

Launch of TrumpRX.gov for Direct Drug Purchases

The White House also previewed a new online platform, TrumpRX.gov, designed to allow Americans to purchase medications directly from manufacturers. The website, set to launch in January 2026, will initially feature drugs from Pfizer and AstraZeneca.

According to officials, the portal aims to streamline pharmaceutical distribution by reducing intermediaries and ensuring lower retail prices for consumers.

The TrumpRX.gov landing page currently displays large photos of President Trump and a “Coming Soon” banner, along with a note stating it was “Designed in DC by The National Design Studio,” a government web design hub created in August and led by Airbnb co-founder Joe Gebbia.

Analysts Say Broader Implications Still Unclear

Economists and public health experts say the AstraZeneca deal represents progress toward lowering drug costs, but its long-term impact will depend on enforcement and continued cooperation between the federal government and pharmaceutical firms.

“If these price guarantees are maintained beyond the current administration, it could mark a turning point in U.S. healthcare affordability,” said Sarah Bloom, a senior analyst at the Brookings Institution. “But sustained oversight will be critical to prevent prices from rebounding once political pressure subsides.”

Source: AP News – AstraZeneca agrees to lower drug prices for Medicaid under Trump administration deal

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New research reveals that abortion bans in the United States are worsening existing health disparities, leading to increased births in high-risk populations and a significant rise in infant mortality.

Increased Births Following Abortion Bans

Since the Supreme Court’s Dobbs decision revoked the federal right to abortion, 14 states have implemented complete or six-week abortion bans. A study published in the medical journal JAMA found that in these states, the fertility rate increased by 1.7%, resulting in one additional birth per 1,000 women of reproductive age.

However, the consequences extend beyond an increase in births.

Infant Mortality Spikes in Banned States

A parallel study from the same research team uncovered an alarming rise in infant mortality in states with abortion bans. The infant death rate surged by nearly 6%, with about 500 more deaths than expected among the 22,000 additional births.

For births directly linked to abortion bans, the infant mortality rate stood at 24 deaths per 1,000 births—four times higher than expected. Researchers analyzed birth and death rates from 2012 to 2023, comparing trends before the bans with states that did not impose restrictions.

“These additional births are occurring disproportionately among populations at greater risk of infant mortality and other poor pregnancy outcomes,” said Dr. Suzanne Bell, assistant professor at the Johns Hopkins Bloomberg School of Public Health and co-author of the studies.

Disproportionate Impact on Vulnerable Populations

The research highlights how abortion bans disproportionately impact marginalized communities.

• Black women and other minorities experienced the largest increases in fertility rates.
• Lower-income groups, including Medicaid beneficiaries and those with lower education levels, also saw a sharp rise in births.
• Infant mortality surged nearly 11% among Black babies—almost double the average increase—making them the most affected racial or ethnic group.

“Abortion bans are associated with excess births that shift the composition of births toward those at higher risk of infant death,” the researchers wrote.

Experts have long warned about the dangers of abortion bans, emphasizing their impact on the health and well-being of families.

“The argument in the Dobbs case was that removing abortion rights wouldn’t affect measurable outcomes,” said Caitlin Myers, a professor of economics at Middlebury College who studies abortion trends. “Well, here’s one: increased infant mortality.”

Rise in Deaths Due to Congenital Anomalies

The studies also found a significant increase in infant deaths from congenital anomalies in states with abortion bans. These conditions, which can range from heart defects to severe spinal issues, often result in infants surviving only a few months.

• Infant deaths due to congenital anomalies rose by 11%, equating to one additional death per 10,000 births.
• Infant deaths from other causes also increased by 4% in states with abortion bans.

This suggests that even allowing abortion exceptions for fetal anomalies would not fully mitigate the negative effects of abortion bans on infant health.

“Many pregnant people were unable to overcome barriers to abortion access and were forced to carry unwanted or unsafe pregnancies to term,” said Bell. “The largest impacts are among populations already facing structural disadvantages and poor maternal and child health outcomes.”

Broader Maternal Health Impacts

The crisis extends beyond infant mortality. A CDC report found that Black women were the only group to experience an increase in maternal mortality from 2022 to 2023. The maternal death rate for Black women in 2023 was 50 deaths per 100,000 live births—nearly three times higher than other racial groups.

“[Abortion restrictions] are compounding existing health disparities by limiting reproductive autonomy,” Bell noted. “And the rise in infant deaths is likely just the tip of the iceberg.”

Texas: A Major Contributor to the Crisis

Texas played a significant role in the findings, accounting for:

• 75% of additional births
• 80% of additional infant deaths

Experts suggest several factors contributed to this outsized impact, including:

• The state’s early adoption of Senate Bill 8, which restricted abortion before the Dobbs decision.
• Long travel distances required for Texans seeking out-of-state abortion care.

Calls for Policy Change

In a commentary accompanying the research, Dr. Alyssa Bilinski, an assistant professor of health policy at Brown University, stressed the need for increased support for affected families.

“Abortion restrictions that force people to continue unexpected and high-risk pregnancies make it even more critical to ensure strong support systems for children and families,” she wrote in JAMA.

“There should be no partisan divide over the idea that all children and families deserve the opportunity to thrive.”

Conclusion

The studies provide clear evidence that abortion bans are not only increasing births but also worsening health outcomes for mothers and infants—especially among vulnerable populations. Experts warn that without policy changes and expanded healthcare support, the crisis is likely to deepen.

Source

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