Tag: ACA

November Decisions and Daylight

In this post I review November’s events in the U.S. impacting health and well-being. Key changes include transitioning to standard time, updating health insurance plans, and participating in midterm elections.

Some notable events happen in November, at least in the United States, and they can directly affect our individual and collective health. Some happen within the first 3 days of November this year.

  • Time- from Daylight Saving to Standard
  • Healthcare-changing Medicare, ACA, or employer-sponsored health plans
  • Elections-Voters choose among candidates to fill multiple federal, state, and local offices

Daylight Saving Time ends on November 1

In most of the United States and Canada, we will resume standard time on Sunday, November 1 at 2 AM. Unless you’re awake at that time, you’ll probably want to change your clocks before going to bed Saturday night, which is Halloween October 31, 2026. (Although many clocks change automatically now.)

That means sunsets will come even earlier than they have been, and there will be fewer daylight hours until the first day of winter, December 21. If you live south of the equator, you welcome more sunshine instead.

Some people may not feel any different as far as sleep and sleepiness due to the change. For most people, “falling back” is less disruptive to sleep than “springing forward.”

Here are some tips to help you adjust to the new day-night schedule of light and dark.

Night before and morning of

  1. Keep your regular bedtime the night before — treat the clock change like a normal night of sleep so you preserve your circadian rhythm.
  2. Avoid a late bedtime because of the “extra” hour — going to bed much later undermines the benefit of the gained hour.
  3. Wake at your usual time on Monday even if you feel rested; consistent wake times anchor sleep timing and help adjust quickly.

Gradual schedule shift if you’re sensitive

  1. Shift sleep-wake by 15–30 minutes for 2–3 days before if you know you’re sensitive to schedule changes.
  2. Split the difference after the change by keeping the new clock time but nudging bedtime slightly earlier for a few nights.

Use light strategically

  1. Get bright morning light as soon as practical after waking to advance circadian timing and reduce morning grogginess.
  2. Dim evening light and avoid screens 60–90 minutes before bed to encourage melatonin production and earlier sleep onset.
A person with short blonde hair lying on a bed surrounded by a laptop, a notebook with writings, a pen, a coffee cup, and a pair of glasses.
Photo by Ketut Subiyanto on Pexels.com

Health Insurance Enrollment for 2027

Many people can change their health insurance in November.

Medicare is available to anyone at age 65 and certain other people. Enrollees can make changes from October 15 to December 7.

Medicare Advantage Plans (Part C), Medicare CostPlans,Demonstrations/Pilots, and Program of All-inclusive Care for the Elderly (PACE).

If you aren’t eligible for Medicare or an employer-sponsored insurance plan, you may get coverage through the Health Insurance Marketplace, with open enrollment starting November 1 through January 15.

If you are covered by an employer-sponsored health plan, you may be required to sign up for next year’s coverage, especially if you want to change coverage options. Otherwise, you may automatically be enrolled into the same plan.

Whatever plan you choose, you should carefully evaluate options, especially out-of-pocket costs. In a previous post, I reported on the problem of medical debt, due to unexpected expenses not covered by insurance.

Your out-of-pocket medical expenses may increase with a less expensive insurance plan if it requires higher deductibles and co-pays than a plan with higher premiums. You should consider the cost of anticipated health care as you choose coverage.

How to Pay for Medical Care: A Guide for Americans

In this post I review how people pay for their healthcare. In the U.S., medical care financing includes employer-provided insurance, Medicaid, Medicare, the Affordable Care Act, and COBRA. Eligibility for these programs varies based on income, age, and employment status. Additional financial assistance exists through Medicare Savings Programs and nonprofit organizations, helping manage medical bills…

Keep reading

Tuesday, November 4-United States Elections

Commonly referred to as the midterms, the United States holds elections for all federal, state, and local offices open due to an expiring term, death, or resignation. We will not elect another President and Vice President until 2028.

📌 Note: Election dates and contests can vary by locality. It’s always best to check with your local election office for the most accurate and up-to-date information.

How Voting Affects Your Health

State and local governments play a vital role in our communities by funding, organizing, and regulating essential health services. State health departments set public health policies, direct disease prevention programs, and manage emergency responses.

Some local governments operate health departments and clinics that provide direct care like vaccinations, maternal health services, and screenings. They also monitor water quality, food safety, and environmental hazards, keeping us safer. 

Since elected officials oversee these services, voting in local elections directly impacts the quality and availability of care. Local leaders decide budgets for hospitals, mental health programs, and emergency medical services, and they influence partnerships with schools, nonprofits, and first responders.

When we vote, we choose the decision-makers who determine how resources are allocated, which programs are prioritized, and how quickly communities can respond to crises. Thus, local elections shape the health systems that touch our lives every day—making participation vital for strong, resilient communities. 

Making Decisions

Most of us are confronted with important decisions this month. Who to vote for? What insurance program to use? How to spend the holidays?

  1. What decision is most important to you now?
  2. What resources will you use to help you make the best decision?
  3. What do you need to do now to be ready? How will you make sure you follow through?
A person holding a small American flag beside a lightbox sign that says 'KEEP CALM AND VOTE'.
Photo by cottonbro on Pexels.com

Exploring the HEART of Health

Thank you for reading this post. I strive to make them worth your time.

I share information and inspiration that sparks transformation in your body, mind, and spirit.

You can follow this blog two easy ways. One is to put your email address into the box below.

Another way is to follow me on Facebook where new posts appear, as well as other timely topics, photos, and an occasional cartoon.

Watercress Words by Dr. Aletha

Dr. Aletha

Expert Predictions about 2026 Health Policy

In this post I review some 2026 healthcare predictions for likely continuation of partisan gridlock, minimal congressional action, and increased focus on health care affordability amid midterm elections. Key issues to watch include ACA enrollment responses, Medicaid work requirements, rising insurance costs, and the impact of AI on consumer health care navigation.

This information is current as of the date of original publication or update but may have changed by the time you read this. Do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with a qualified healthcare professional.

As we anticipate 2026, here is a look at what the federal government may do with healthcare in the United States.

This is a reprint of an article first published on KFF and shared here by permission.

The author is Drew Altman, President and Chief Executive Officer of KFF, a position he has held for over 30 years, founding the KFF organization in the 1990s. He is a leading expert on national health policy issues and an innovator in health journalism and the nonprofit field.

(Note: I have edited this article for length and readability. I linked to the original content so you can read the full sections. The photos are for illustration and are not affiliated with the original article on KFF. AO)

Health Policy in 2026

from Drew Altman, December 8, 2025

Forecasting the year ahead in health policy is always treacherous because events intervene and screw up even the best predictions. But my working theory is that the sharp partisan divide in Congress, and even sharper disagreement on health care policy, can produce only small-ball actions on health next year.

So, what should you watch for that will really matter for people, policy, and politics?

Voter Reaction to the ACA in the Midterms

First and foremost is the role that health care affordability will play in the midterms. Assuming there is no deal on the enhanced ACA (Affordable Care Act) tax credits, spiking premium payments in the Marketplaces will become the national symbol for voters of concerns about their health care bills.

Democrats will prosecute the issue to the fullest, and Republicans will generally try to shift the subject and fight on other issues. Health care affordability will be in the spotlight, but how important it is as a vote-and-turnout driver remains to be determined.

Photo by Edmond Dantu00e8s on Pexels.com

How ACA Enrollment Might Change

Second, again assuming there’s no deal on the tax credits, we’ll see how enrollees actually respond in the Marketplaces. What share of the 24 million enrollees switch to cheaper high-deductible plans? What is the impact of doing that on their financial security and health-seeking behavior? What happens to older and sicker enrollees who need better, more comprehensive coverage? How many millions choose to be uninsured in 2026 and who are they?

Medicaid Work Requirements

Third, states that have expanded Medicaid will be gearing up for Medicaid work requirements, which kick in in 2027.

Red states may be looking for flexibility to implement the toughest possible requirements and reduce their Medicaid rolls and spending.

Blue states will be looking for nooks and crannies in the law and the rules to lessen the impact in the hopes that Democrats seize control again in 2028 and reverse the requirements.

Having implemented state welfare work requirements myself, I know there is always some ability to shade implementation depending on the goals of a state.

In our case in New Jersey, we had little interest in kicking people off welfare (and into homelessness or deep poverty, which we’d also have to address). We did have a big interest in providing job training, childcare, transportation, and a pathway to jobs.

More Expensive Health Insurance

Fourth, after years of moderate increases, health costs will increase more sharply again. Employer premium increases may not touch double digits but could come close.

The average cost of a family policy for employers could approach $30,000. Cost-sharing and deductibles will likely rise again after plateauing for several years.

Employers and public payers are increasingly skittish about the costs of GLP-1s for weight loss. It’s possible GLP-1s could turn from today’s dilemma to a technology-diffusion success story of sorts. (Glucagon-Like Peptide-1)

Costs are coming down, pills are on the horizon, and payers are developing more sensible guidelines for their initial and long-term use.

In a country where the dam breaks on every effective new medical technology and it’s rapidly disseminated at high costs, GLP-1s could emerge as a more balanced and sensible example of technology diffusion. Like most new medical technologies, it still increases costs.  

Drug and Hospital Costs Increase

Fifth, the Trump administration has put pressure on drug prices through a variety of initiatives. Probably the most important is Medicare drug price negotiations, which began in the Biden years, but together they are putting pressure on drug prices.

Still, retail drug spending is only 9% of overall health spending (16% for employers) and there is growing awareness that hospitals gobble up the single largest share of the health care dollar.

Proposals to cap hospital prices or put hospitals on a budget seem to be coming back into fashion again but are non-starters with Republicans in charge, as of course is single payer.

For 2026, we can look generally for greater attention being paid to hospital prices and possibly greater action at the state level, where several states have established hospital cost targets with varying degrees of teeth. 

Prior Authorization Review

Sixth, people (and providers) hate prior authorization review. Will the administration’s voluntary effort to work with industry to streamline and pare back prior authorization result in any concrete relief for patients when it kicks in this year?

MAHA and Vaccinations

Seventh, four in 10 Americans say they identify with the MAHA agenda. We’ll learn more in the coming year about which tenets of this loose movement have staying power. (Make America Healthy Again)

Everyone is for exercise and for healthier food for kids (although I do still miss those Hostess Cupcakes and Twinkies that I had as a kid).

But people who have serious illnesses may grow tired of the central MAHA notion that they are personally responsible for disease and may increasingly make the connection between their own need for medical care and cuts in Medicaid and ACA coverage.

President Trump and Secretary Kennedy at the MAHA commission meeting, public domain photo

There is some overlap between MAHA and the anti-vax movement. Another thing to watch: will vaccination rates continue to decline as the administration chips away at universal vaccination and trust in vaccines?

Patients Using AI for Health

Eighth, AI means a lot for physicians, researchers, hospitals, insurance companies, and investors, with profound implications in some areas of medicine, such as radiology. But when will AI start having real meaning for the things people care about most: their costs and their ability to navigate the health system? (AI-Artificial Intelligence)

The implications and practical applications for consumers receive far less attention, as generally does the relatively low level of trust in AI. Possibly, 2026 will be the year when attention shifts more seriously to the consumer side of AI in health. 

Conclusion

All told, it will be a big year ahead in health policy. And this list only just scratches the surface. (Others include the CDC, NIH, FDA, and Medicare.)

But there probably won’t be a lot of significant action in Congress. Still, every incremental change is a big fight in health care, and hard won, and in a hyper-partisan Congress, 2026 will be no different. 

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Subscribe to KFF Health News’ free Morning Briefing.

This article first appeared on KFF Health News and is republished here under a Creative Commons license.

How health policies may affect you.

Based on what you know now, how likely are these predictions correct?

Which of these issues are most important to your healthcare?

How will you respond to health policy changes that affect you? What information do you need?

How do you and your family contribute to “making America healthy again”?

Cover Photo

The cover image was created by the AI feature of Jetpack. (affiliate link)

Exploring the HEART of Health

Thank you for reading this post. I strive to make them worth your time.

I share information and inspiration that sparks transformation in your body, mind, and spirit.

You can follow this blog two easy ways. One is to put your email address into the box below.

Another way is to follow me on Facebook where new posts appear, as well as other timely topics, photos, and an occasional cartoon.

Watercress Words by Dr. Aletha

Use this link to search for other posts about

Medical stethoscope and heart on a textured background

Dr Aletha