CMS

Just before shutting down for Christmas, Trump Regime CMS Administrator Dr. Oz announced that...

Quick ACA Update: More than 15.6 million Americans have enrolled in a plan on the federally run exchanges so far — compared to roughly 16 million Americans last year.

Notably, this small drop follows several important CMS actions over the past year to combat fraudulent and improper enrollments, which have already removed more than enough people from premium subsidies who are covered elsewhere to account for the modest enrollment change. That said, there is a politically motivated lawsuit that has paused critical actions to make sure Biden-era improper enrollments are fully knocked out.

IMPORTANT NOTE: For those who need insurance and have not already signed up — go to HealthCare.Gov to see if you qualify and what types of plans you can get. Most Americans can access a plan for $21 a month!

The Centers for Medicare & Medicaid Services (CMS) has posted an official update to the enrollment data for ACA Medicaid expansion through March 2025.

According to the new report, total enrollment from December 2024 through March 2025 only dropped slightly (just over 30,000 people, or just 0.14%), and remained at over 20.7 million nationally, so it doesn't look like the Trump Admin has started cooking these particular books, at least not yet.

I've been able to cobble together more recent ACA expansion enrollment for about half of the 40 states (+DC) which participate in the program; since March, expansion enrollment has dropped in some states but is actually up in some others. It remains remarkably stable so far, although this is going to change radically with the draconian provisions of the GOP's Big Ugly Bill starting to kick in soon.

Just before the close of business for the week, the Centers for Medicare & Medicaid Services (CMS) published the first official 2026 Open Enrollment Period snapshot report:

The Centers for Medicare & Medicaid Services (CMS) reports that nearly 950,000 consumers who do not currently have health care coverage through plans in the individual market Marketplace have signed up for coverage in 2026, since the start of the Marketplace Open Enrollment Period (OEP) on November 1, 2025. Existing consumers are also returning to the Marketplace to actively renew their coverage, and anyone who does not actively renew will be automatically re-enrolled for 2026. Over 4.8 million existing consumers have already returned to the Marketplace to select a plan for 2026.

Definitions and details on the data in this report are included in the glossary.

As usual, I'll start out with the top line numbers, compared to the same point last year:

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

August 2025 Key Findings

Medicaid and CHIP Enrollment

• In August 2025, 77.3 million individuals were enrolled in Medicaid and CHIP.
• 70.1 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
• 40.4 million adults were enrolled in Medicaid, and there were 36.9 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

July 2025 Key Findings

Medicaid and CHIP Enrollment

• In July 2025, 77.6 million individuals were enrolled in Medicaid and CHIP.
• 70.4 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
• 40.6 million adults were enrolled in Medicaid, and there were 36.9 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

June 2025 Key Findings

Medicaid and CHIP Enrollment

• In June 2025, 77.7 million individuals were enrolled in Medicaid and CHIP.
• 70.5 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
• 40.7 million adults were enrolled in Medicaid, and there were 37.0 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

Back in March I wrote about a proposed rule (really a set of rules) put out by the Trump Regime's Centers for Medicare & Medicaid Services (CMS) which, if implemented, would make major changes to how the Affordable Care Act is administered. This rule was finalized in June, with some provisions kicking in immediately, most starting January 1st and others over the next couple of eyars.

This set of regulatory changes is completely separate from the impending expiration of the improved premium tax credits which I've written so much about; these have to do with the specifics of how the ACA is actually implemented going forward.

A very simple example of this is the length of the annual Open Enrollment Period, which has ranged from as long as 6 months during the very first OEP in 2013-2014 to as short as just 75 days during most of the first Trump Administration.

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

April 2025 Key Findings - Medicaid and CHIP Enrollment

• In May 2025, 78.1 million individuals were enrolled in Medicaid and CHIP.
• 70.8 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
• 40.9 million adults were enrolled in Medicaid, and there were 37.2 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

The Centers for Medicare & Medicaid Services (CMS) has posted an official update to the enrollment data for ACA Medicaid expansion through December 2024.

According to the new report, total enrollment from September through December actually increased by just a hair (5,377) and still remained at over 20.7 million nationally, so it doesn't look like the Trump Admin has started cooking these particular books, at least not yet.

I've been able to cobble together more recent ACA expansion enrollment for about half of the 40 states (+DC) which participate in the program:

via the Washington Health Benefit Exchange:

Public comment at Washington Health Benefit Exchange Board  includes 10 testimonials, plus additional stories 

OLYMPIA, Wash. – Washingtonians shared stories of how access to more affordable health insurance has affected lives and communities all across the state, with Washington Health Benefit Exchange (Exchange) Board last week. The testimonials were particularly impactful in light of a myriad of recent federal changes to state-based marketplaces such as the Exchange, and the impending potential expiration of enhanced premium tax credits (ePTC) before Congress.