Allison Orris

@aorris.bsky.social

Senior Fellow @centeronbudget focusing on Medicaid and the Affordable Care Act. Previously CMS and OMB/OIRA. She/her

1/ A court ruling this week allowed the federal Medicaid work requirement to proceed for now. That doesn’t change the fact that the Administration can take steps to prevent some people, including those with serious illnesses, from losing coverage under this harmful policy.

🧵No one should be forced to sleep outside in a nation as wealthy as ours. Yet, one year ago today, Pres. Trump issued an executive order (EO) calling on federal agencies to abandon effective homelessness solutions in favor of punishing people who have nowhere safe to sleep.

CMS just issued a proposed rule implementing some of H.R. 1's #Medicaid provider tax restrictions including those targeting expansion states. These taxes are a vital Medicaid funding source for states. I'll write up a CCF blog once I have had time to go through it: www.cms.gov/newsroom/fac...

Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes Proposed Rule (CMS-2452-P) | CMS

Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes Proposed Rule (CMS-2452-P)

cms.gov

The extra red tape required for the medical frailty exemption will greatly increase coverage loss from #Medicaid work requirements. Even before the rule, CBO estimated that 5.3 million people would lose their coverage and become uninsured. tinyurl.com/urbvk466

How sick is sick enough? New Medicaid work rule worries patient advocates, states.

Trump administration wants ill recipients to prove they can’t work every six months. Doctors, advocates and state officials wonder how.

tinyurl.com

Even if you take the ASPE report's lit review at face value — and you shouldn't, it skips critical recent + relevant work — the rosiest 1990s work requirements study in their technical appendix suggests an effect size less than 10% of what the report's "model" projects with @chloeneast.bsky.social:

The Trump Administration’s Dubious Case for Work Requirements

Cherry-picked studies and unrealistic assumptions define a new government report

donmoynihan.substack.com

Yesterday, @DrOzCMS falsely claimed that the ACA marketplace is full of “phantom” enrollees, referencing a number presumably pulled from Paragon paper that repeats the same flawed and thoroughly debunked analysis as its previous iterations. tinyurl.com/5n6cz7da

Setting the Record Straight on Premium Tax Credit Enhancements

Enhancements to premium tax credits (PTCs) cut out-of-pocket premiums by more than half, on average, for over 20 million Affordable Care Act (ACA) marketplace enrollees, making health care more...

tinyurl.com

The #Medicaid work requirement enacted by last year’s Republican reconciliation law was already bad enough – taking away coverage from millions who don’t show either that they’re working enough or are exempt. But the Trump administration’s final rule makes a bad policy worse.

We just moved a step closer to a Medicaid work requirement, a major cut made by last year’s Republican reconciliation law that will take away health coverage from millions of people. The Trump administration issued a rule that makes bad policy even worse. www.cms.gov/newsroom/fac...

Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC) | CMS

Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC)

cms.gov

Make no mistake: CBO continues to estimate huge cuts to #Medicaid from OBBBA, last year’s reconciliation bill, despite Trump Admin officials’ false claims otherwise. In fact, CBO projects that 7 million ppl will lose #ACA Medicaid expansion coverage from 2025 to 2032.

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Following the expiration of PTC enhancements, #ACA marketplace plan selections dropped by 1.2 million during the 2026 open enrollment period. A new analysis suggests that millions more will drop coverage over the year as enrollees confront higher monthly premiums. www.wakely.com/blog/who-pai...

Who Paid, and Who Stayed? Early 2026 Enrollment Trends in the Individual Market - Wakely

A new report from Wakely Consulting Group, an HMA Company, models changes to the 2026 ACA market enrollment due to the loss of federal subsidies. Findings

wakely.com

Happy #TaxDay! While millions of Americans file their returns today, statehouses across the country are making decisions that will shape who pays, who gains, & who gets left behind for years to come. And right now, states are headed in two VERY different directions. Some context:

The best evidence shows that SNAP's harsh work requirement doesn't increase employment or earnings. It just cuts people off SNAP. Yet Republicans dramatically expanded this ineffective policy in H.R. 1, putting millions more people at risk of losing SNAP.

SNAP work requirements don’t boost jobs, but drop participation, research finds

As states enact stricter work requirements for the federal food stamp program, a new analysis suggests those requirements won’t enhance employment and will push more people off of food assistance. The...

newsfromthestates.com

Last week, I outlined questions I would be looking to have answered when the President’s budget is released. Now that we have the full proposal, we can now answer them. Hint: It fails to offer affordability solutions to make life more affordable while raising the risk of hasty, harmful cuts. 🧵

Center on Budget and Policy Priorities@centeronbudget.bsky.social · 4mo ago

The Trump Administration is expected to release a budget proposal for 2027 in late March or early April. @brendanvduke.bsky.social lays out five key questions we will be looking to answer when the budget is released: www.cbpp.org/research/fed...

This week’s 16th anniversary of the #ACA marks an unfortunate turning point for ACA marketplaces: More people are likely to go uninsured because of affordability concerns and many will face higher health costs, as federal policy decisions that increase premiums and red tape take hold.

A horizontal bar graph from KFF showing that 80% of returning marketplace enrollees report higher health care costs and that many enrollees are not confident they can afford premiums all year.