On Friday, June 20, the Centers for Medicare & Medicaid Services (CMS) announced the finalization of a rule that CMS claims will lower individual health insurance premiums by approximately 5 percent on average. In a press release, CMS stated that it also projected saving taxpayers up to $12 billion in 2026 by addressing the surge of improper enrollments in the Affordable Care Act (ACA) Exchanges, reducing wasteful federal spending, and refocusing on making health insurance markets more affordable and sustainable.
According to CMS, the 2025 Marketplace Integrity and Affordability Final Rule aims to restore oversight, strengthen accountability, and ensure taxpayer dollars are used only for those who are eligible. Meanwhile, an estimated 750,000 to 2 million consumers could lose their coverage, including Deferred Action for Childhood Arrivals (DACA) recipients.
Actions CMS is taking:
Furthermore, CMS is taking steps to ensure that federal subsidies for coverage through ACA Exchanges only support the statutory requirements and goals of the ACA. This includes prohibiting federal subsidies from being used to help cover the cost of specified sex-trait modification procedures and reinstating HHS’ 2012 interpretation of “lawfully present” to exclude Deferred DACA recipients from eligibility and enrollment in ACA Exchange coverage and Basic Health Program (BHP) coverage in states that choose to operate a BHP (Basic Health Program), including APTC (Advance Premium Tax Credit), premium tax credits, and cost-sharing reductions.
The final rule would undo a rule that was estimated to allow 147,000 immigrants to obtain healthcare coverage. In March, Healthcare Innovation spoke with Sydelle Baretto, the policy manager of the National Asian Pacific American Women’s Forum (NAPAWF), about the barriers immigrants face in accessing healthcare. At that time, Baretto predicted that DACA access would likely be revoked. “If folks don’t have access to healthcare, that means they’re probably not going to seek preventative care. If something comes up, they’re having symptoms, they’ll let things get worse. Then they’re going to need to go to the emergency room….Overburdening our emergency care system is definitely not a good thing, and it’s always better for both patients and providers when people are able to access preventative and routine care.”
The American Hospital Association (AHA) voiced concerns to CMS as well, in April, after the rule was proposed. “Coverage loss of this magnitude would have substantial consequences for patient access to care, as well as the financial stability of hospitals, health systems, and other providers,” Ashley Thompson, SVP Public Policy Analysis and Development with AHA, wrote in a letter addressed to CMS Administrator Dr. Mehmet Oz. “CMS had estimated that 750,000 to 2 million consumers could lose their coverage due to the provisions,” AHA expressed in a statement on Friday.
“We are strengthening health insurance markets for American families and protecting taxpayer dollars from waste, fraud, and abuse,” said U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., in a statement. “With this rule, we’re lowering marketplace premiums, expanding coverage for families, and ensuring that illegal aliens do not receive taxpayer-funded health insurance.”
“A number of the policies CMS is finalizing are temporary measures to immediately tamp down on improper enrollments and the improper flow of federal funds. These policies will sunset at the end of the 2026 plan year,” CMS stated. Nathaniel Weixel reported on June 20 for The Hill that “The one-year sunset is a change from when the rule was proposed in March. It’s designed to give Republicans on Capitol Hill an opportunity to codify the provisions into law for the long-term and use the savings to fund their massive party-line tax and spending bill.”

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As temperatures soar in Milwaukee, health officials urge residents to take precautions against heat-related illnesses, emphasizing hydration and limited outdoor exposure.
As temperatures soar in Milwaukee, health officials urge residents to take precautions against heat-related illnesses, emphasizing hydration and limited outdoor exposure.
As temperatures soar in Milwaukee, health officials urge residents to take precautions against heat-related illnesses, emphasizing hydration and limited outdoor exposure.
Southeast Wisconsin residents are facing a heat wave this weekend, with temperatures expected to feel like over 100 degrees, prompting health officials to advise limiting outdoor activities and taking precautions to prevent heat-related illnesses.
Milwaukee, Racine and Kenosha Counties are all under extreme heat warnings, while other counties are experiencing lesser advisories, but will still be uncomfortably hot.
There are numerous cooling centers available across all counties, including public libraries, senior centers, and indoor malls. To find a cooling center near you in Milwaukee County, click here.
Health experts recommend staying hydrated by drinking plenty of water or electrolyte drinks, even before feeling thirsty. Alcohol consumption should be monitored closely, as it can lead to faster dehydration. Loose, light-colored clothing is advised for outdoor activities, and while fans can provide some relief, they should not be relied upon as the primary cooling method.
“Because this is really the first heat event within Milwaukee County this year, we want people to be aware that our bodies aren’t used to it. And so they need to take precautions, make sure that they’re drinking plenty of fluids, staying hydrated, and taking frequent breaks in cooling centers or, going into the house that has air conditioning,” said Jackie Ove, public health administrator for the City of South Milwaukee and Saint Francis Health Department.
“Our older adults, especially if you have neighbors that you know are living alone, just check in on to make sure that they’re doing OK, that maybe they’re turning their air conditioning on because, some older adults don’t turn their air conditioning on and their houses can get extremely warm. So definitely check on the older adults, as well as anybody who has chronic medical conditions that take medications that may make them more sensitive to the heat,” Ove said.
Never leave young children or pets in unattended vehicles. Car interiors will reach lethal temperatures in a matter of minutes.
A cooling scarf, which is available in stores, can also provide instant relief when dipped in water and worn around the neck.
Many public cooling sites are located along Milwaukee County Transit System (MCTS) routes. For more information about how to use public transit in Milwaukee County, visit www.ridemcts.com
Hearst Television participates in various affiliate marketing programs, which means we may get paid commissions on editorially chosen products purchased through our links to retailer sites.

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Interview: NMHS administrator explains United Healthcare Medicare Advantage termination  WTVA
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Well-being Might Be Important To Memory  Index-Journal
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Sign up for Chalkbeat Indiana’s free daily newsletter to keep up with Indianapolis Public Schools, Marion County’s township districts, and statewide education news.
Emojis are an important part of morning check-ins for students at some Marion County schools.
After they pick a smiling, neutral, or sad face, they also write a few words to explain their choice. If they skipped breakfast or didn’t get a good night’s sleep, that signals to school staff that they may need a snack or a talk with a trusted adult.
Students in a southern Indiana district learn that not getting basic needs met can cause someone to “flip their lid,” and lose control of their behavior. But they also learn how to reset from that state, and come back fresh the next day.
These are examples of social-emotional learning programs in Indiana schools. Educators say they provide a common language for students, teachers, administrators, and parents to understand a student’s well-being, and in turn improve academic performance, attendance, and school culture.
“You can’t teach a child anything if they don’t feel safe and cared for,” said Tricia Hudson, director of K-8 curriculum at North Lawrence Community Schools.
But putting these programs in place and maintaining them in the current political climate is increasingly challenging for Indiana schools despite persistent needs: Indiana schools saw a 41% increase in bullying incidents from 2023 to 2024, according to the Indiana Youth Institute. And feelings of hopelessness remain higher among Hoosier girls than boys despite an overall decline in self-reported rates of depression.
Indiana legislators this year left several bills on the table that sought to address student mental health, bullying, and counselor shortages, and dropped some requirements related to social emotional learning in teacher training. In April, the Trump administration announced an end to federal grants that supported mental health professionals. And conservative state and national politicians and groups have criticized social-emotional learning as inappropriate in a school environment.
Uncertainty about state and local funding is also an ongoing concern, said Brandie Oliver, a professor in the graduate counseling program at Butler University, because it affects schools’ ability to offer proactive rather than reactive resources.
While most schools offer some mental health support, a much smaller portion effectively address the needs of all students, she said. Without that kind of help, growing anxiety and school refusal can affect students’ attendance and academics.
“The capacity to be able to adequately resource the needs of our students is just not there,” Oliver said. “We’re trying to triage what we see rather than get to the root causes.”
The legislative session was “devastating” for student mental health initiatives, said Rachel Van Alstine, a parent and advocate for anti-bullying legislation.
Three bills about the issue championed by her group, the Parent Coalition for Child Safety and Wellness, failed to advance this year. One of them would have changed the definition of bullying to include isolated incidents, and also would have required more tracking and reporting of bullying.
Another bill would have compelled parents and the state Department of Child Services to address bullying behavior by seeking resources for the perpetrator, and the the final bill would have specified that officials must assume students’ mental health is endangered if they learn that their parent or guardian uses illegal substances.
Van Alstine said her group was told by legislators that these initiatives were scrapped due to a tight state budget. But addressing bullying early could save the state money it spends on mental health issues, she said.
“We have the money — but where are we choosing to put it?” Van Alstine said.
Other bills that failed this year would have created ways for victims or perpetrators of bullying to transfer schools.
Proposals that sought to increase the time that counselors can spend with students, or relieve them of other non-counseling duties, also failed to pass despite years of advocacy from counseling groups. Indiana already has much higher ratios of students to counselors than recommended.
When those counselors spend their time overseeing testing or making attendance calls, they’re not able to “help a student change their behavior, or find a reason to wake up and be there,” said Jan Desmarais-Morse, executive director of the Indiana School Counselor Association.
“They may struggle emotionally, have discipline issues, or not meet their full potential because of all the other things getting in their way,” Desmarais-Morse said. “That’s our job, to help remove barriers.”
Indiana lawmakers again tried to allow chaplains to serve as public school counselors, but the bill failed.
One of the few proposals related to mental health that passed the state legislature focuses on how quickly schools must report bullying to parents. The new rule going into effect July 1 says schools must make a “reasonable attempt” to notify parents that the school is investigating a bullying incident “before the end of the next school day after the school becomes aware of the possible incident.”
The school must also report the conclusion of the investigation to parents before the end of the next school day. Current law gives schools five days to report a bullying incident to parents and does not address investigations.
Lawmakers also increased the Secured School Safety Grant Program by $2.6 million in each of the next two years. The program can fund mental health programs, along with school resource officers and other safety initiatives.
In a last-minute move, Republican legislators removed teacher training requirements related to social-emotional learning, cultural competency, and restorative justice, arguing that they were not relevant to schools’ core purpose.
“Teachers should focus on academic rigor, math, science, reading, and writing, technical skills, instead of this emotional regulation, empathy, and etcetera,” said Republican Sen. Gary Byrne.
But the move drew significant pushback — even in one instance from a fellow conservative legislator, Sen. Ron Alting, who said that “the best counseling I’ve had in my whole life was from my teachers and my coaches.”
Despite the hostile political environment, some schools are proceeding with mental health programs, often through community partnerships, although these are easier to form in urban districts than rural ones, Desmarais-Morse noted.
Districts may also turn to discretionary grants, but these don’t offer the same reliable funding for counselors and mental health initiatives as consistent state aid.
Offering these services in schools removes transportation, scheduling, and access barriers for families, said Oliver, the Butler professor, and students are more likely to complete a series of counseling sessions.
But on the flip side, fully implementing these programs can take years — much longer than the life of a typical grant.
North Lawrence Community Schools in Bedford, Indiana was among five districts to receive funding and support from Butler University to sustain in-school social emotional and mental health programs. Providing mental health services in every school was a promise the district made to the community made in 2020 when it underwent school consolidation, said Hudson, the curriculum director.
The district tries to funnel grant funding into support for several longstanding programs: The district has since 2018 trained all staff — certified and not — in Trust-Based Relational Intervention, or TBRI, a framework to address student behavior. TBRI provides a common language for educators and students to understand their emotional state, said Megan Shipley, the district’s school health coordinator.
Teachers also practice the principles of TBRI, like recognizing when they’re “flipping their lids,” a term for becoming overwhelmed.
The district also uses grant funding to place specialists in schools from Centerstone, a community mental health system. These specialists can help identify students who need more comprehensive interventions, and offer it at school.
But now the district may need to seek alternative funding sources to sustain a family engagement specialist position. It’s currently funded by the federal Bipartisan Safer Communities Act, but the grants associated with that law were recently discontinued by the Trump administration.
“Our job is to make such a strong case that these roles are essential that you can’t say, ‘oh we’ll be fine without that,’” said Hudson.
In Indianapolis, 13 schools use the Building Dreams platform from the Fight for Life Foundation, which allows educators and parents to communicate about student behavior, both positive and negative. The program has been provided for free to some schools via fundraising and grants. But at least one of those schools will need to find new funding to sustain the program beginning next year.
The system allows students to report both their own mood — via the morning check-ins — as well as concerns or conflicts with peers that trigger a series of interventions from school personnel, said Fight for Life founder Marlin Jackson.
“We want to create an environment where students feel, ‘they’re paying attention to me. They support me. I feel understood so I want to be here,’” said Jackson, a former Indianapolis Colts player.
At a recent panel discussion about Building Dreams, educators observed that regular check-ins had reduced negative behavior and helped students learn to articulate and cope with their feelings.
“It gives you a chance to express your emotions,” said Joshua Lopez-Martinez, a fifth grade student recognized at the panel for his consistent use of the platform. This in turn builds trust with teachers, he added: “Everyone should be able to do that.”
The practice of giving their classmates compliments made students kinder and more self-aware over the course of the year, said Daria Parham, executive director of schools at IPS who used to be the principal of Frederick Douglass School 19, which uses Building Dreams.
“It creates a sense of belonging, and that sets the tone for learning,” Parham said.
Aleksandra Appleton covers Indiana education policy and writes about K-12 schools across the state. Contact her at aappleton@chalkbeat.org.
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