The Trump administration will make sweeping changes to Affordable Care Act (ACA) coverage that could kick more than a million people off the rolls.
The Centers for Medicare and Medicaid Services (CMS), a subsidiary of the Department of Health and Human Services (HHS), will cut the annual open enrollment period from 11 weeks to nine, rescind Biden-era monthly opportunities for low-income people to receive coverage, limit gender-affirming care, and exclude Deferred Action for Childhood Arrivals (DACA) recipients from obtaining overage, among other changes, according to Axios.
CMS said the new policies will lower marketplace premiums by an average of 5 percent, saving $12 billion a year. However, between 725,000 and 1.8 million people are expected to lose coverage, CMS projections show.
“We are strengthening health insurance markets for American families and protecting taxpayer dollars from waste, fraud, and abuse,” HHS Secretary Robert F. Kennedy, Jr. said in a statement Friday. “With this rule, we’re lowering marketplace premiums, expanding coverage for families, and ensuring that illegal aliens do not receive taxpayer-funded health insurance.”
The Trump administration claims that changes made under the Biden administration, during which Obamacare enrollment reached record highs, opened the floodgates to fraudulent claims. Five million people may have been improperly enrolled, the CMS claimed, costing taxpayers as much as $20 billion.
Some of the changes would be temporary. The CMS will charge $5 monthly premiums to users who are automatically enrolled in an ACA plan from one year to the next in 2026 only. New rules around heightened income verification for applicants will also end after 2026.
Many of the changes could be codified in the GOP budget bill currently before the Senate, making them difficult for subsequent administrations to reverse.
“This is about putting patients first,” said CMS Administrator Dr. Mehmet Oz. “CMS is restoring integrity to ACA Exchanges by cracking down on fraud, protecting American taxpayer dollars, and ensuring coverage is there for those who truly need it.”
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