The landscape of healthcare coverage for over 24 million people under the Affordable Care Act (ACA) is on the verge of significant changes. These changes are driven by the “One Big Beautiful Bill,” a piece of legislation aimed at advancing President Donald Trump’s policy agenda. The bill has already passed the House and is now awaiting Senate approval.
Additionally, the Trump administration has proposed regulations in March that could further impact ACA coverage. There is also the potential expiration of larger premium subsidies that were put in place during the COVID-19 pandemic. These changes could result in millions of people dropping or losing their coverage by 2034, according to the Congressional Budget Office.
The combined efforts of Trump and his allies are expected to have a detrimental effect on access to ACA plans, as noted by Katie Keith from the O’Neill Institute. States running their own Obamacare marketplaces and the National Association of Insurance Commissioners have expressed concerns about increased costs and reduced access.
The House Republicans and conservative think tanks argue that the ACA needs to be revamped to combat fraud, which they attribute to certain Biden administration changes that the new measures aim to undo. Senate Republicans are now tasked with deciding whether to incorporate the House’s proposals into their bill, with the goal of passing it by July 4.
Here are four key ways in which Trump’s policies could impact Obamacare enrollment and coverage:
1. More Enrollment Hoops: The One Big Beautiful Bill Act introduces paperwork requirements that could delay access to tax credits for some enrollees, potentially increasing the cost of their insurance. The bill would eliminate automatic reenrollment for most ACA policyholders, requiring them to provide detailed information each year to qualify for premium tax credits.
2. Coverage Delays for Life Changes: The House bill would require documentation before receiving tax credits for life changes such as having a baby or getting married. This could create delays in coverage, particularly for new parents waiting for Social Security numbers for their newborns.
3. Less Time To Sign Up: The bill proposes to shorten the ACA open enrollment period, ending it on December 15. This would eliminate a special enrollment period created by the Biden administration, which allowed lower-income individuals to sign up anytime during the year.
4. Premium Increases: The expiration of enhanced tax credits created during the pandemic could lead to higher premiums and out-of-pocket costs for ACA enrollees. The House bill does not extend these subsidies, potentially causing a national average premium increase of 75% and leaving millions more uninsured by 2034.
Overall, the changes proposed by Trump and his allies could have far-reaching consequences for ACA enrollees, affecting their access to coverage, premiums, and enrollment processes. It remains to be seen how these proposals will be received and implemented in the coming months.
