ACA exchanges require pre-enrollment verification as hydrogen credit ends

Health insurance exchanges must verify premium tax credit eligibility before enrollment (currently done retroactively) — expected to reduce enrollment significantly. Hydrogen production credit (45V) expires for projects commencing construction after December 31, 2027 — 6 years earlier than original IRA timeline. Medicare drug price negotiation restricted via expanded orphan drug exclusion. CBO projects 6.8 million more uninsured.