Gideon Lukens

@gidlukens.bsky.social

Senior Fellow and Director of Research, Health Policy @centeronbudget. Former Dep. Director for Economic Policy at OMB. Music lover. Views expressed are my own.

Medicaid coverage losses will deepen as the work requirement comes into effect nationwide in 2027. The harder the rules are for people to navigate and states to implement, the more people will lose coverage – including many with serious illnesses. www.finance.senate.gov/ranking-memb...

Wyden, Warnock Lead Senate Democrats in Call to Stop Red Tape Requirements in Medicaid | The United States Senate Committee on Finance

Wyden, Warnock Lead Senate Democrats in Call to Stop Red Tape Requirements in Medicaid

finance.senate.gov

🧵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.

New CMS data confirms large enrollment drops after Congressional Republicans and President Trump let PTC enhancements expire last year. ~3 million people dropped coverage between 2025 and 2026. More will likely follow suit as premiums stack up throughout the year. www.cbpp.org/blog/nearly-...

Nearly 3 Million Fewer People Secured Marketplace Coverage After Republican Health Care Cuts, New Data Show

This is the largest drop in effectuated enrollment since the ACA marketplaces were established.

cbpp.org

New data show that #ACA marketplace enrollment fell by ~3 million people as premiums spiked following the failure of Congressional Republicans to extend PTC enhancements. This is Feb 2026 data - expect further coverage loss as the year goes on and monthly premiums pile up.

New USDA data confirm as many as 36 states will soon face massive new costs to continue SNAP – increasing the risk that even more struggling families could soon lose food assistance & some states could even end SNAP altogether. Congress must delay this cost shift for all states.

Directly funding cost-sharing reductions (CSRs), as Republicans are apparently considering, would INCREASE out-of-pocket premiums for millions of #ACA marketplace enrollees, cut funding by tens of billions of $, and leave hundreds of thousands of ppl uninsured.

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 as more people across our nation are struggling to afford gas, groceries, health care, and housing, Congressional Republicans are prioritizing the Administration's violent & callous detention and deportation machine over helping people across our nation afford basic needs.

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

NEW: In just the 12 states with available data, the number of children receiving SNAP has fallen by more than 700,000 since H.R. 1's unprecedented SNAP cuts were enacted last July — despite claims from Republican lawmakers that kids wouldn't lose benefits.

Sharp Drop in Number of Children Receiving SNAP Food Assistance Under New Federal Law

While cutting SNAP eligibility for children was not a stated target of H.R. 1’s proponents, the cost shift and access barriers are resulting in serious losses of food assistance for low-income childre...

cbpp.org

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

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.