The Washington Report

August 06, 2025

Note to Subscribers

While we do our best to provide timely updates, it is possible that the information shared in the newsletter may change after our publication deadline.

Health

 

IRS Announces Increases for 2026 ACA Employer Shared Responsibility Penalties
In Revenue Procedure 2025-26, released on July 22, 2025, the Internal Revenue Service (IRS) announced 2026 indexing adjustments to the applicable dollar amount used to calculate employer mandate payments under the Affordable Care Act (ACA). As background, applicable large employers (ALEs) may be liable for an ACA employer mandate penalty if they fail to offer minimum essential coverage (MEC) to 95 percent of full-time employees (and their dependents, excluding spouses), if the employee receives subsidized coverage through the public Exchange (the “a” penalty). Alternatively, ALEs may be subject to a penalty if they offer MEC to full-time employees (and their dependents, excluding spouses) who receive subsidized coverage through a public Exchange, but the offered coverage is not affordable and minimum value (the “b” penalty). The adjusted penalty amount for failures occurring in the 2026 calendar year for the “a” penalty will be $3,340 per full-time employee (less the 30-employee reduction) (a $440 increase from 2025), and $5,010 per full-time employee that receives subsidized coverage through a public Exchange (a $660 increase from 2025) for the “b” penalty.

IRS Revenue Procedure 2025-26 is available here.

Aon Publications

 

Departments Issue FAQs Addressing No Surprises Act and ACA Cost-Sharing Limit
On July 31, 2025, the Departments of Labor, Health and Human Services, and Treasury (the Departments) issued Frequently Asked Question (FAQ) guidance for further implementation of the No Surprises Act (NSA) as enacted in the Consolidated Appropriations Act, 2021. 

The NSA FAQs provide guidance regarding patient payments for nonparticipating (out-of-network) providers after ongoing lawsuits regarding the Independent Dispute Resolution process and timing.

The FAQs also confirm the Affordable Care Act (ACA) cost-sharing limits for 2026.

The Aon bulletin is available here.