If this happens, it would mean the ACA exchange market would drop by more than 1/3 from the ~24.2 million currently enrolled (myself & my own family included).
However, I've repeatedly stated that even this is likely a low estimate--the remaining ~16 million exchange enrollees would still be hit with MASSIVE (and in some cases eye-poppingly huge) premium hikes which would force them to drop to far worse plans (meaning much higher deductibles & co-pays; worse provider networks and so on).
Back in March, the Health & Human Services (HHS) Dept. and the Centers for Medicare & Medicaid Services (CMS) proposed a so-called "Marketplace Integrity & Affordability Rule" which would include sweeping changes to how the ACA exchanges (both the federal one (HealthCare.Gov) and the 20-odd state-based ones (Covered California, MNsure, etc) operate, as well as who is or isn't eligible to enroll in ACA exchange coverage, restrictions on subsidy eligibility and so forth.
Many of these changes are simply repeals/reversals of improvements put into place during the Biden Administration; others are completely new ones being put into place by the Trump Regime under RFK Jr. & Dr. Oz.
However, until today, these were still technically only proposed changes. Now they're official. The final version isn't quite as bad as it could have been, and there's one or two items on the list which I'm not that upset about, but overall...yeah, it's pretty ugly.
In December 2024, 78.8 million individuals were enrolled in Medicaid and CHIP.
71.5 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
41.4 million adults were enrolled in Medicaid, and there were 37.4 million Medicaid child and CHIP enrollees.
Medicaid and CHIP Applications Received
In December 2024, Medicaid, CHIP, Human Services agencies, and State-based Marketplaces received 3.0 million applications, or 11 percent more applications, as compared to November 2024.
The number of applications received has increased by 30 percent since December 2023 and increased by 84 percent since December 2022.
Total Medicaid/CHIP enrollment in December 2024 dropped slightly from November, by 171,000 people or 0.2%.
This was actually announced a few weeks ago, but I was knee-deep in my Congressional District-level Enrollment Breakout Pie Chart project so I didn't get around to posting about it until now.
Today, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to address the troubling amount of improper enrollments impacting Affordable Care Act (ACA) Health Insurance Marketplaces across the country. CMS’ 2025 Marketplace Integrity and Affordability Proposed Rule includes proposals that take critical and necessary steps to protect people from being enrolled in Marketplace coverage without their knowledge or consent, promote stable and affordable health insurance markets, and ensure taxpayer dollars fund financial assistance only for the people the ACA set out to support.
Washington, D.C. — March 27, 2025 — Today, the U.S. Department of Health and Human Services (HHS) announced a dramatic restructuring in accordance with President Trump's Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.”
The restructuring will address this and serve multiple goals without impacting critical services. First, it will save taxpayers $1.8 billion per year through a reduction in workforce of about 10,000 full-time employees who are part of this most recent transformation. When combined with HHS’ other efforts, including early retirement and Fork in the Road, the restructuring results in a total downsizing from 82,000 to 62,000 full-time employees.
That's 20,000 people, or 24% of the HHS Dept's total workforce who are losing their jobs, many of whom are in departments which are currently understaffed.
Since my Internet Archive indexes of both CDC.gov and FDA.gov seem to have gotten a lot of positive responses, I'm following up by tackling a much larger federal healthcare department website: The Centers for Medicare & Medicaid Services (CMS).
Unlike the FDA's website, which has around ~5,800 public-facing pages, or the CDC's site which has ~7,200, CMS.gov has a whopping ~75,000 pages.
Needless to say, it's going to take some time to index them all, so bear with me.
No, I don't plan on posting every press release issued by the Centers for Medicare & Medicaid Services during the Musk/Trump Regime any more than I did under previous adminstrations, but this one attempts to directly address the single biggest Constitutional crisis going on at this very moment.
CMS has two senior Agency veterans – one focused on policy and one focused on operations – who are leading the collaboration with DOGE, including ensuring appropriate access to CMS systems and technology. We are taking a thoughtful approach to see where there may be opportunities for more effective and efficient use of resources in line with meeting the goals of President Trump.
The White House is working on an executive order to fire thousands of U.S. Department of Health and Human Services workers, according to people familiar with the matter.
Under the order, the Food and Drug Administration,Centers for Disease Control and Prevention and other health agencies would have to cut a certain percentage of employees.
...The agencies are responsible for a range of functions, from approving new drugs to tracing bird-flu outbreaks and researching cancer. A loss of staff could affect the efforts depending on which workers are cut and whether they are concentrated in particular areas.
...Agency officials have been told to prepare lists of probationary workers who have essential roles and must be retained, and of employees who don’t, according to people familiar with the instructions.
Federal employees must decide today whether to take the administration’s buyout offer. More than 40,000 federal workers to date have said they would resign under the deal.
