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This November, Vote Like Your Well-Being Depends on It
We are all hurting, but together we can start to fix this. Voting lets us hold elected officials to account—and choose representatives who will fight for our housing, healthcare, and food assistance.
Oct 29, 2026
It’s really cold living in a home with no heat or running water in December. That was a hard lesson I had to learn as a kid when my family was struggling.
Now, as a healthcare case manager, I’ve seen firsthand even more unnecessary human suffering caused by bad policy choices. We need change, and voting is part of how we make it.
I grew up in a large family. My dad was a convoy driver during the Iraq War and was gone from us for nearly a decade. During that time, we struggled to afford the medication to manage my sister’s Type 1 diabetes. My mother stayed home so often to care for her that she lost her job.
Even as prices rise, they’ve also chosen to take help away from those who need it the most—and give it to those who need it least.
My family filed for bankruptcy, hoping for a clean slate. Instead, with no credit, we couldn’t find a stable place to live. We lost our home and spent time bouncing around trying to find housing.
Those hard years inspired me to serve people struggling in circumstances like ours, which are all too common. And as prices rise and safety net programs get cut, they’re becoming more common every day.
When my family experienced homelessness in the early 2000s, the Urban Institute estimated that between 500,000 and 600,000 Americans experienced homelessness on any given night. Now the Department of Housing and Urban Development reports that number is over 745,000.
Today, between 50-60% of Americans live paycheck to paycheck or report being financially strained. This has worsened in recent years as pandemic-era financial help has expired.
Part of the pain comes from the Trump administration’s sweeping tariffs and war of choice in Iran, which have increased inflation and spiked the cost of gas and groceries. But even as prices rise, they’ve also chosen to take help away from those who need it the most—and give it to those who need it least.
The so-called “One Big Beautiful Bill,” which this Congress passed last year, slashed Medicaid and the Supplemental Nutrition Assistance Program (SNAP) and shifted those investments to tax cuts for the ultra rich. So far, over 5 million people nationwide have lost SNAP, and at least 10 million people nationwide are expected to lose Medicaid coverage by 2034.
These changes will affect you even if you aren’t on Medicaid. Rural hospitals rely heavily on Medicaid patients. As these patients lose coverage, rural hospitals are at risk of closing, which could deprive entire communities of access to care. Nationwide, estimates suggest 400 to 700 rural hospitals are now vulnerable to closure, with nearly 300 at immediate risk.
These Medicaid cuts have also significantly compromised care coordination in rural areas. Care coordination lets case managers like me help families find wraparound care for intersecting hardships, from housing to food to healthcare. Since the Medicaid cuts, several providers have withdrawn services that help my clients with daily needs, like laundry or transportation.
My wife and I experienced firsthand how critical care coordination can be when our beautiful baby boy was born with terminal brain damage. Our care coordinator was invaluable in helping us determine his care and its costs. She was compassionate with our anguish.
Even though I’m a case manager and my wife works in human services, we struggled to navigate the system while grieving. How can a family less familiar with the system possibly cope?
Meanwhile, vulnerable people are losing help left and right. I’ve had clients like a woman with a sight disability get denied Medicaid renewal because she could “still walk and talk.” I’ve had clients with missing limbs denied disability benefits outright and then have to go through a lengthy appeals process.
We are all hurting, but together we can start to fix this. Voting lets us hold elected officials to account—and choose representatives who will fight for our housing, healthcare, and food assistance. Our lives depend on it.
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The Bait and Switch Trump's GOP Uses to Distract Voters From Massive Healthcare Cuts
Let's be clear: a one-time check doesn’t undo a permanent cut, and a press release doesn’t replace lost coverage. These payouts are designed to paper over much bigger cuts to exactly the same people hurt by this administration’s policies.
Oct 23, 2026
The Trump administration’s health care policy has a clear pattern: Distract attention from massive, permanent cuts to health coverage and care by handing a small sliver back to a fraction of the people harmed with a letter, a press release, and the president’s name attached. American families are struggling every day and every month to pay their health care bills. Whether they get coverage through Medicaid, Medicare, or the Affordable Care Act marketplaces, Americans are demanding more than one-time checks that don’t cover the massive increases they’ve been experiencing.
Premiums Jumped by Over $1,000. One in 20 Enrollees Got a One-Time $500 Back.
People who buy coverage through marketplaces like Healthcare.gov saw their premiums more than double, an increase of over $1,000 in 2026. That was a direct result of the deliberate decisions of this Republican Congress and the Trump administration to let the enhanced tax credits that help Americans afford coverage expire. Even people who never received that help saw premiums jump 24% on average this year, and will see another 17% in 2027, often adding up to thousands of dollars. These jumps were the direct results of policy decisions, after years of stability, when annual increases stayed in the single digits for the previous five years.
Now, one month before the election, the administration has mailed one-time $500 checks, paired with what amounts to a campaign letter, to about 1 million of the nearly 20 million people in the marketplaces. That’s one in 20. For the fraction who got the check, $500 doesn’t cover this year’s higher premiums, which are now baked in for years to come, let alone the increases in future years. The other 19 million people just got a higher bill. And some 3-4 million people couldn’t afford a higher bill and didn’t enroll at all for 2026. Many of these individuals are now likely uninsured.
To be clear, this rebate was money available in part from the sudden defunding of navigator assistance that helps consumers get on and stay on coverage. In previous years under past administrations, extra dollars like these would have lowered next year’s fees. Instead, they paid for an election-season mailer. For more on the administration’s actions to make marketplace coverage more expensive, and harder to get and keep, see this recent blog posting, One Battle After Another Heading into Marketplace Open Enrollment for 2027.
The Biggest Cuts in Medicaid History, and a One-Time Fund with Strings Attached
Millions of people are losing Medicaid coverage and services because of the budget cuts made by the current Congress and Trump Administration. The biggest cut to Medicaid in history, over $900 billion dollars, is projected to leave over 10 million more Americans uninsured, and strip key health care services and providers from communities, including over $130 billion in cuts in rural areas.
In contrast to those permanent cuts, the same law created a one-time $50 billion rural health fund—with strings that bar those dollars from backfilling the cuts. The Trump administration has rolled out a steady stream of press releases and announcements distributing these funds before the election, while many of the much bigger, permanent cuts are set to hit right after it. Rural communities face very real health care challenges, but this program was never designed to solve them. And no amount of spin can make $50 billion fill a $900 billion dollar hole. To learn more about how states are navigating these massive cuts and implementing rural health fund dollars, please read, Don’t be Fooled by the Rural Health Transformation Grants.
$90 for Some Seniors with Medicare While Other Costs Spike
This month, about 20 million people with traditional Medicare began receiving a $90 “premium rebate” from Social Security, announced by the White House on October 2, just one month before Election Day.
That’s less than half of a single month’s standard Part B premium, which is about $202 this year. The money comes from the Medicare Improvement Fund, which Congress created to strengthen Medicare, not to bankroll a one-time payment timed to an election. And many seniors are left out entirely. Everyone in the Medicare Advantage program is excluded, a group with higher shares of Black, Hispanic, and Asian enrollees compared to traditional Medicare. So are the lowest income seniors who get help paying their premiums through Medicaid, the same program facing more than $900 trillion in cuts. The seniors most likely to need help with health care costs are the least likely to see a check.
The Bait and Switch Context — Cuts to Care and Coverage for All, Smaller Checks for a Few
Consumer and patient advocates support funding for rural health care, and financial help for families. Every dollar helps. But a one-time check doesn’t undo a permanent cut, and a press release doesn’t replace lost coverage. These payouts are designed to paper over much bigger cuts to exactly the same people hurt by this administration’s policies. We expect most Americans will see them for what they are: a small check meant to distract from a much bigger bill.
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From Bad to Catastrophic: Report Details How Trump's GOP 'Taking This Country Backward' on Healthcare
A new report warns that President Donald Trump and the GOP's assault on key healthcare programs is set to push up the number of uninsured people to 37 million—a level not seen in more than a decade.
Oct 22, 2026
A comprehensive report on the state of the for-profit US healthcare system published Thursday shows that President Donald Trump and the Republican Party's assault on Medicaid and the Affordable Care Act is on track to reverse more than a decade of progress on expanding insurance coverage, fueling a worsening medical debt crisis and forcing millions to delay or forgo treatment.
The Commonwealth Fund's annual status report on the American health insurance system notes that the uninsured rate for working-age US adults rose from 8.9% in 2024 to 11.2% this year, as the Trump-GOP cuts to Medicaid and their refusal to extend enhanced ACA subsidies pushed millions off their coverage. The report emphasizes that the worst is yet to come, given that many of the Medicaid cuts included in the 2025 Trump-GOP budget law—including punitive new work reporting requirements—have not taken effect nationwide.
"The combined effects of these changes are expected to drive the number of uninsured people to 37 million by 2036—about the same as in 2014, when most of the ACA’s changes took effect," the report observes. "At the same time, rapid growth in health costs is making both insurance and care even less affordable—and contributing to medical debt—for Americans across the country."
Looking beyond just the uninsured rate, the Commonwealth Fund report shows that nearly half of working-age adults were "inadequately insured" this year due to a coverage gap or unaffordable plans. Around 30% of US adults reported having medical debt, according to the new report.
"Unlike peer countries, the US does not guarantee adequate health insurance for all its residents," the report states. "Our survey findings show just how detrimental a lack of continuous coverage and high out-of-pocket costs are to people’s ability to afford care and maintain their health—without going into debt."
The report comes as Americans casting their ballots in the November 3 midterm elections identify healthcare as a key issue amid a broader affordability crisis that Trump has repeatedly dismissed as a "hoax" perpetrated by his political opponents.
According to the Commonwealth Fund's survey, 73% of US adults "believe the federal government has a responsibility to ensure all Americans have coverage, including 45% of Republicans, 93% of Democrats, and 76% of independents." That finding is consistent with an earlier poll from the health policy group KFF showing that two-thirds of the American public has a favorable view of Medicare for All.
Trump has publicly and misleadingly attacked Medicare for All while insisting—without providing any specifics—that he intends to pass "a truly great healthcare plan" if the GOP retains control of Congress next month.
Trump has also touted small, one-time healthcare rebate checks that his administration has sent out to some Americans ahead of the midterms. The checks pale in comparison to the healthcare cost increases facing tens of millions of Americans.
Leslie Dach, chair of the advocacy group Protect Our Care, said in response to the Commonwealth Fund report that "Trump and Republicans are taking this country backward."
"Families are facing skyrocketing premiums, mounting medical bills, and going without coverage altogether," said Dach. "They’re being forced to put off seeing a doctor, skip prescriptions, or gamble with their health because they can’t afford care. And it’s only going to get worse as millions more Americans are expected to lose their health insurance as the full force of Republican cuts takes hold."
"This is a damning report on Donald Trump and Republicans’ healthcare agenda, which is making it harder to afford and access care for working families across the country," Dach added. "The only way to fix this is through the choices that Americans make in November.”
The Commonwealth Fund report came as KFF found that American workers now pay around $7,470 per year on average for employer-sponsored family health coverage—an increase of 9% compared to 2025.
“We have been hearing a lot about Affordable Care Act and Medicaid cuts," said KFF president and CEO Drew Altman. "Now add a 9% increase in what workers with employer coverage paid toward family premiums in 2026 to the reasons voters are so concerned about their healthcare costs."
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'Bald-Faced Lies': GOP Called Out for Running on Saving the Rural Health System They're Destroying
"Republicans across the country are desperately trying to pull the wool over voters’ eyes."
Oct 21, 2026
With the US midterm elections less than two weeks away, Republicans across the country are posturing as defenders of the country's ailing rural healthcare system even as hospitals and providers nationwide buckle under the financial strain imposed by President Donald Trump and the GOP's unprecedented cuts to Medicaid.
The advocacy group Protect Our Care said Wednesday that Republicans in key congressional races "are touting bald-faced lies" by highlighting their support for a $50 billion rural health fund that pales in comparison to the roughly $900 billion in Medicaid cuts that Trump signed into law last summer. The health policy organization KFF estimates that the Republican law will cut $137 billion in Medicaid spending for rural areas over the next decade.
Protect Our Care calls out multiple Republicans by name for misleadingly promoting their support for rural health funds, including Sens. Roger Marshall of Kansas, Jon Husted of Ohio, Susan Collins of Maine, and Ted Cruz of Texas, as well as Reps. Juan Ciscomani of Arizona, Jeff Crank of Colorado, Mariannette Miller-Meeks of Iowa, Jason Smith of Missouri, and Derrick Van Orden of Wisconsin.
"Republicans across the country are desperately trying to pull the wool over voters’ eyes, touting their so-called 'rural health investments' as if they make up for the $1 trillion they ripped away from Medicaid and the Affordable Care Act. It doesn’t come close," said Protect Our Care. "Rural Americans are rapidly losing the care they need, and over 1,250 hospitals, clinics, and essential service providers are closing, cutting services, or are at risk of doing so."
"These investments," the group said of the $50 billion rural health fund, "will do nothing to stop the gushing wound Republicans hacked in the American healthcare system."
As Common Dreams reported over the summer, Collins—who is running for a sixth term against former Maine Senate President Troy Jackson—has played up her role in securing the Rural Health Transformation Program as part of the sprawling One Big Beautiful Bill Act. Collins voted against final passage of the bill, citing its cuts to Medicaid, but she provided her party with critical support to advance the measure through the Senate.
"Senator Collins is like an arsonist who helped set the fire, and then she wants credit for bringing a cup of water to put it out," Jackson said during a debate earlier this month.
Maine has so far received $190 million from the rural health fund—a fraction of the roughly $3 billion in Medicaid cuts facing the state over the next decade.
Several of Maine’s rural hospitals are at risk of closure thanks to Trump's disastrous One Big Beautiful Bill.Our healthcare system cannot survive another Susan Collins term.https://t.co/cE1Z3ujjfp
— Troy Jackson (@TroyJackson207) August 25, 2026
Sen. Jon Ossoff (D-Ga.), who is running for reelection against Rep. Mike Collins (R-Ga.), similarly homed in on his GOP opponent's support for Medicaid cuts that are wreaking havoc across the country and forcing healthcare facilities to cut back on services—or close entirely.
"Mike Collins and Donald Trump passed the biggest Medicaid cut in history," said Ossoff during an October 8 debate. "A hospital in Mike Collins' own district had to shut down its labor-and-delivery unit, citing those Medicaid cuts. How can a sitting congressman vote to shut down a labor-and-delivery unit in his own district?"
While Republicans have characterized the $50 billion in funding as a key lifeline for rural hospitals, KFF noted in a recent analysis that the money "could mitigate but will not fully offset estimated cuts to federal Medicaid spending in rural areas." The policy group observed that, "unlike most of the federal Medicaid spending cuts, the fund is also time limited." States must spend the funds they receive by the end of fiscal year 2032.
"While the fund was established in part to address concerns about the impact of the reconciliation law on rural hospitals, the funding is being used for a much broader set of purposes, and there are restrictions on how hospitals can benefit," the group said, pointing out that the money cannot be put toward "propping up struggling hospitals with temporary relief."
In a fact sheet released on Wednesday, Protect Our Care pointed to comments made earlier this year by Jed Hansen, the executive director of the Nebraska Rural Health Association, who said in March that the GOP's rural health funding wouldn't go to "rural hospitals, rural clinics, and rural providers in a meaningful way.”
“Rural Health Transformation will not save a single hospital in our state,” said Hansen. “I don’t think it will save a hospital nationally.”
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Private Medicaid Contractors Set to Cash In as Trump-GOP Cuts Take Care From Millions
"It’s plain wrong for these companies to boost their profits by kicking people off their healthcare."
Oct 20, 2026
As millions of Americans lose Medicaid coverage due to the unparalleled cuts that President Donald Trump signed into law last year, large private contractors are poised to make a financial killing as states move to implement draconian new work reporting requirements that are already wreaking havoc in several states.
A report published Tuesday by Democrats on the Senate Finance Committee warns that "a small handful of companies—some whose technology has a history of grievous errors—will be in charge of implementing historically harsh Medicaid work reporting requirements that never should have been enacted in the first place." The report spotlights five firms that hold contracts with states for Medicaid eligibility and enrollment work: Maximus, Gainwell, General Dynamics Information Technology, Conduent, and Deloitte.
"This investigation began by asking contractors a series of questions to determine whether they are up to the task of implementing Medicaid work reporting requirements on behalf of states, and the committee’s interim findings show that we cannot conclude they are," the report states. "The companies who stand to profit from new Medicaid work reporting requirements evaded hard questions about past performance, current process, and the potential for errors that cause widespread harm."
The Democrats' report comes as states are rushing to implement the new Medicaid work reporting requirements ahead of the January 1, 2027 deadline. The mandates require certain Medicaid recipients to document at least 80 hours per month of work or other qualifying activities—or lose coverage.
As KFF Health News reported earlier this year, state governments rely on private firms to "design and operate computer systems that assess whether low-income people qualify for Medicaid."
"Those state systems have a history of errors that can cut off benefits to eligible people," the outlet added, pointing to its 2024 investigation of Deloitte, which holds Medicaid-related contracts in at least 25 states.
States are paying Deloitte and other for-profit firms millions of dollars in taxpayer funds to help their governments comply with the new federal Medicaid rules, which could strip coverage from more than 10 million people by 2028.
None of the five vendors that Senate Democrats are investigating agreed to provide data on how many people their systems have reported to state Medicaid offices as potentially ineligible for coverage—though all of them denied having contract provisions that incentivize kicking people off the program. The companies also declined to disclose the compensation of their CEOs.
Nebraska, Montana, and Arkansas are so far the only US states that have begun implementing work requirements included in the Trump-GOP budget law. Preliminary data out of Nebraska indicates that red tape stemming from the work reporting mandates accounts for most of the coverage loss and denials so far.
Across the country, around 4 million people have lost Medicaid and Children's Health Insurance Program coverage since Trump signed the Republican budget package into law last July.
"The nation is just weeks away from Republicans rolling out the red tape on unsuspecting Americans who have life-or-death healthcare needs. This rushed rollout is going to be a disaster," Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee, said in a statement on Tuesday. "It is essential to hold these contractors to a higher standard and implement commonsense accountability measures that make fast, simple, and durable enrollment in healthcare coverage the bar for earning taxpayer dollars."
Sen. Elizabeth Warren (D-Mass.) added that "as President Trump and Republicans gut healthcare for millions of Americans, big corporations are cashing in by running systems that snarl Americans in red tape and strip them of their Medicaid coverage."
"It’s plain wrong for these companies to boost their profits by kicking people off their healthcare," the senator added, "and I’ll keep fighting to end this corporate greed."
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'Blatant Hypocrisy': Trump Signs Executive Order on Women’s Health—While Attacking Women's Health
"This is an attempt to change the headlines, not women’s lives.”
Oct 19, 2026
President Donald Trump signed an executive order on Monday to promote women's health. But advocates say it's an example of "blatant hypocrisy" after his administration slashed healthcare access and medical research funding.
The initiative, promoted by First Lady Melania Trump, establishes a new Women's Health Division within the US National Institutes of Health (NIH) and a White House task force to advance research into conditions disproportionately affecting women, like heart disease, Alzheimer's disease, cancer, and endometriosis.
During a speech on Monday, Trump said the task force "will mobilize the entire federal government to coordinate action focused on improving women's health." He added that it would be led by Health and Human Services Secretary Robert F. Kennedy Jr., whom he said "has been fantastic" even though he’s "a little different."
Critics were quick to point out that the order doesn’t provide any new research funding and that the Trump administration has canceled nearly half a billion dollars in NIH research funding, some of which supported research into the very diseases the order mentions.
Following years of growth in women's health research, a Washington Post analysis found that under Kennedy, the number of competitively funded NIH research projects mentioning women fell by 31% in 2025, amid the administration's crusade against so-called diversity, equity, and inclusion programs.
In April, Sen. Susan Collins (R-Maine)—who faces a tough reelection campaign—criticized these cuts, saying that "the administration's emphasis on canceling diversity-related grants has resulted in less research aimed at women's health."
The new order also revokes two Biden-era directives on women's health research, which had helped secure nearly $1 billion in funding. Trump's order provides no additional research funding. It also does not specify what will happen to the existing funds.
"Women’s health has long been ignored as a federal priority, and while we agree that steps must be taken to close disparities in women’s healthcare, it’s hard not to point out the blatant hypocrisy of this unfunded order coming from an administration that is actively decimating healthcare access for women," said Dorianne Mason, senior director of health equity and contraceptive access at the National Women's Law Center (NWLC).
"From the One Big Beautiful Bill Act’s cuts to Medicaid and the defunding of Planned Parenthood, to gutting the federal Office of Minority Health and slashing funding for women’s health research, this administration has made it clear that it doesn’t actually care about women’s healthcare needs, despite what this weak executive order attempts to convey," she added.
Last year, Trump signed a GOP budget law that cut hundreds of billions of dollars from Medicaid—a program that finances maternity care, reproductive healthcare, as well as routine health services for around 39 million low-income women.
Under Kennedy, the Department of Health and Human Services (HHS) has rescinded federal guidance protecting emergency abortion access and launched a medical review that could restrict access to abortion pills.
“With RFK Jr. at the HHS helm, millions of women are paying more for healthcare and have less access to services they need,” said Brad Woodhouse, president of Protect Our Care. “Secretary Kennedy has tried to scrap any research grant or program that dares to fix women’s health disparities—and disproportionately fired women doctors and career scientists en masse. He’s fought tooth and nail to restrict access to abortion medication even when the lives and health of women depend on it, including patients dealing with a horrific ectopic pregnancy."
Polls show that Trump and Republicans are performing dismally among women. According to a Washington Post/ABC News/Ipsos poll released Sunday, just 30% of women said they approved of Trump’s job performance, and 61% wanted Democrats to control Congress.
Noting that the midterm elections were just weeks away, Mason said Trump's announcement of a women's health initiative "is an attempt to change the headlines, not women’s lives.”
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MAGA Supporters Clap 'Like Seals' as Trump Yet Again Promises Secret Healthcare Fix
"He’s so completely full of shit, and voters across the country know it," said one patient advocate.
Oct 14, 2026
US President Donald Trump, who signed into law the largest Medicaid cuts in history last year and allowed private insurance premiums to skyrocket, assured supporters gathered at a rally in Wasilla, Alaska on Tuesday that he intends to enact "a truly great healthcare plan" if Republicans retain control of Congress in next month's midterm elections.
As with his earlier empty promises of a forthcoming overhaul of the US healthcare system, Trump offered virtually no detail on what his proposal would entail, saying vaguely that he wants to "stop all payments to big insurance companies" and "give the money directly to you, the people," to "go out and buy better healthcare."
While Trump's supporters in Wasilla applauded his promise—"clapping like seals," as one critic put it—patient advocates noted that Republicans have done nothing but make the country's healthcare system even more brutal and expensive over the past two years.
"All they did was cut Medicaid by $1 trillion to give tax cuts to billionaires and kick 3 million off of [Affordable Care Act] insurance," Dr. Rob Davidson, executive director of the Committee to Protect Healthcare, wrote in a social media post late Tuesday.
"He’s so completely full of shit," said Davidson, "and voters across the country know it."
Watch Trump's comments:
The advocacy group Protect Our Care noted ahead of Tuesday's rally that more than 34,000 Alaskans have health insurance coverage during Trump's second White House term. Brad Woodhouse, the group's president, said in a statement that “Trump has miserably failed Alaskans on healthcare, and now, with Election Day closing in, he has the audacity to waltz back into the state and act like none of it ever happened?"
"Make no mistake, this is a healthcare election, and Republicans have a whole lot to answer for," said Woodhouse. "With just weeks left until voters head to the polls, Trump is pulling out all the stops, from flashy rallies to desperate bribes. But the fallout from his healthcare cuts isn’t going anywhere. Families across Alaska are stretching their medications, skipping checkups, and crossing their fingers that nobody in the family gets sick enough to send them spiraling into debt."
"So Trump can put on his little show all he wants," Woodhouse added, "but eventually the stage lights will go out, the cameras will leave, and Alaskans will still be stuck paying the price."
Trump's rally came a week after the health policy organization KFF released a survey showing that 66% of Americans strongly or somewhat favor Medicare for All—the highest rate of approval since the group began asking about Medicare for All in 2017.
Separate Axios polling published Tuesday showed that a plurality of Americans support Medicare for All—and that Medicare for All's supporters outnumber its opponents nearly two to one.
Despite widespread and growing support for the proposal—which would guarantee comprehensive health coverage to everyone in the US at a lower overall cost than the status quo—Trump has openly attacked Medicare for All, falsely claiming it would cost "the entire budget of the whole country."
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Up to 12 Million Americans Have Lost Health Coverage During Trump’s Second Term: Analysis
Republicans' cuts to Medicaid and their refusal to extend enhanced Affordable Care Act subsidies are key factors in the coverage drop.
Oct 09, 2026
Independent healthcare analyst Charles Gaba on Thursday published an updated analysis estimating that up to 12 million Americans have lost their insurance coverage since the start of President Donald Trump's second term.
Gaba based his new estimate on updated data he compiled from recent reports for Medicare, Medicaid, and the Children's Health Insurance Program (CHIP), as well as some state enrollment data for Affordable Care Act (ACA) insurance exchanges.
In total, Gaba found that enrollment in Medicaid and CHIP has dropped by 6.2 million people since the start of Trump's second term, while enrollment in ACA exchanges is down by anywhere from 4.6 million to 6.1 million people, and enrollment in Basic Health Plans (BHP) is down by nearly 275,000 people over the same period.
While there are around 1.8 million more people enrolled in Medicare now than there were at the start of Trump's term, Gaba noted that this isn't nearly enough to make up for the loss of enrollment in other programs.
Adding everything up, Gaba estimated that "between 10.88 million and 12.40 million fewer Americans enrolled in a public healthcare coverage program as of June 2026 than in were as of January 2025."
As in prior analyses, Gaba examined the possibility that some of the people who lost coverage through these programs transitioned to employer-sponsored insurance, but deemed it "extremely unlikely... since unemployment is higher than it was in January 2025."
Over the last two years, Trump and congressional Republicans have taken a number of actions that have made healthcare less affordable and pushed people off coverage.
First, they cut spending on Medicaid by an estimated $900 billion over a 10-year period when they enacted the One Big Beautiful Bill Act in 2025. The Congressional Budget Office projects these cuts will leave more than 10 million fewer people enrolled in the program by 2034.
GOP lawmakers last year also refused to extend enhanced subsidies for insurance plans purchased through the ACA, even as insurers raised premiums on those plans by an average of 26% this year, according to an analysis published by KFF.
In a Thursday article published by Time, scholars Neale Mahoney and Abigail Sanchez of the Stanford Institute for Economic Research warned that the costs of private health insurance are set to spike even further in 2027.
"Employer health plan costs are projected to rise 8 to 10% next year," Mahoney and Sanchez explained, "the largest increase in more than 20 years and double the average increase of the 2010s."
The two researchers said there are three major reasons for the surge in insurance costs: The expiration of the enhanced ACA subsidies, an increase in premiums and out-of-pocket costs for employer-based insurance plans, and the upcoming Medicaid work requirements projected to push millions of people off the program.
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'Nebraska Is the Canary in the Coal Mine': Trump-GOP Medicaid Cuts Spark Mass Chaos, Coverage Loss
"Medicaid work reporting requirements are a flawed policy if the goal really is to incentivize work, but they are very effective at taking Medicaid coverage away by tangling folks up in red tape," said one expert.
Oct 01, 2026
Human rights organizations said Thursday that Nebraska should be seen as a bright red warning sign of what's to come for states across the US as they implement the draconian Medicaid work requirements included in the budget legislation that President Donald Trump signed into law last year.
In early May, Nebraska became the first state to implement the new work reporting mandates, which require certain Medicaid recipients to document at least 80 hours of work or other qualifying activities per month to remain enrolled in the program. Republican Gov. Jim Pillen, announced the state's fast-tracked implementation of the requirements at a celebratory press conference late last year alongside Mehmet Oz, head of the Centers for Medicare and Medicaid Services.
Human Rights Watch (HRW), Oxfam America, and Nebraska Appleseed said in a joint report released Thursday that the rush to impose the mandates has had the predicted results of mass confusion and bureaucratic chaos, previewing what millions of Medicaid recipients across the country can expect in the months ahead.
“Nebraska is the canary in the coal mine for issues that most states will face when they begin implementing these work requirements,” said Matt McConnell, a US researcher on economic, social, and cultural rights at HRW. "As they do, they should make sure red tape doesn’t strip people of healthcare."
The trio of advocacy groups interviewed a dozen Nebraskans who have directly experienced or witnessed the unruly rollout of the expanded work requirements. One 64-year-old man "said he lost his Medicaid coverage while undergoing treatment for kidney cancer and multiple chronic health conditions," the groups noted.
"He said a representative of the health plan that managed his Medicaid coverage informed him he lost access because he was not working, even though he is unable to work due to his condition," the groups added. The man said the loss of Medicaid coverage disrupted his care, including an appointment with a cancer specialist.
The Trump administration has said even people with terminal cancer are not necessarily exempt from the new work reporting requirements.
One Medicaid eligibility worker from the Nebraska Department of Health and Human Services told HRW, Oxfam, and Nebraska Appleseed that "poor training, vague and inconsistent guidance, and technical issues, including unprepared software systems, had caused stress and uncertainty for applicants and for state employees."
“We just sometimes don’t know what we’re doing,” the worker said. "I wish the people who make policies knew what they were doing."
It's unclear exactly how many people have lost Medicaid in Nebraska as a result of the new requirements. Sarah Maresh, healthcare access program director at Nebraska Appleseed, said Thursday that obtaining data from the state has been "like pulling teeth."
"Nebraskans deserve access to this information," said Maresh. "You can’t fix problems you refuse to measure."
Earlier this week, following relentless pressure from advocates, Nebraska's health department released preliminary data showing that more than 1,000 Nebraskans have been deprived of Medicaid coverage due to the expanded work requirements—a figure that's believed to be a significant undercount.
"I have been saying for years that Medicaid work reporting requirements are a flawed policy if the goal really is to incentivize work, but they are very effective at taking Medicaid coverage away by tangling folks up in red tape," Joan Alker, executive director of Georgetown University's Center for Children and Families, wrote in a blog post earlier this week. "Unfortunately, Nebraska’s data only reinforces this point."
Nationwide, millions of people have lost Medicaid coverage since Trump signed the GOP budget package, which includes around $800 billion in cuts to Medicaid over the next decade.
States face a January 1, 2027 deadline to implement the expanded work requirements—though states are allowed to move more quickly. Montana and Arkansas have joined Nebraska in implementing the mandates ahead of the federal deadline, resulting in similar chaos and confusion.
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After 50 Years of Anti-Choice Hyde Amendment, Campaigners and Lawmakers Say 'Enough Is Enough'
"Everyone, no matter who they are, where they live, how much money they make, or how they get their insurance, deserves access to abortion care without barriers."
Sep 30, 2026
On Wednesday, reproductive rights groups marked half a century of abortion care being "baselessly set apart from all other healthcare," with coverage for abortions blocked in government-funded healthcare plans like Medicaid, which about 16 million women of reproductive age rely on.
"Our constituents have suffered the consequences," said the Congressional Reproductive Freedom Caucus, chaired by Reps. Diana DeGette (D-Colo.) and Ayanna Pressley (D-Mass.).
For 50 years, the Hyde Amendment—proposed by the late Rep. Henry Hyde (D-Ill.), who expressed his wish to prevent "anybody having an abortion" and said blocking federal funds within the Medicaid program from being used for care was the best way to do so—has stopped hundreds of thousands of people from obtaining abortion care, and has been called by anti-abortion groups "one of the greatest achievements of the pro-life movement to date."
The Reproductive Freedom Caucus denounced the budget rider that has been reeimplemented in appropriations bills every year since 1976 as "a dangerous, racist, and classist abortion ban. An abortion ban for the working class and people of color, who disproportionately receive health insurance through the federal government."
The caucus noted that more than 200 House Democrats have supported efforts to repeal the amendment, and advocacy groups on Wednesday called on Congress to pass the Equal Access to Abortion Coverage in Health Insurance (EACH) Act, which would permanently repeal the Hyde Amendment.
"Without solutions like the EACH Act, the Hyde Amendment will continue to force people with low incomes to struggle for the care they need or carry a pregnancy against their will," said the National Women's Law Center (NWLC). "Everyone, no matter who they are, where they live, how much money they make, or how they get their insurance, deserves access to abortion care without barriers."
In addition to low-income people who rely on Medicaid, said the National Network of Abortion Funds (NNAF), the Hyde Amendment blocks abortion care for Indigenous people who use the Indian Health Service, people in federal prisons, disabled people, military service members and their families, and federal employees, among others.
Twenty-nine states follow Hyde Amendment restrictions, which include "exceptions" for pregnancies resulting from rape or incest or cases in which a pregnant person's life is at risk. Twenty-one states use state funds to cover abortion care, but nearly half of US women of reproductive age who use Medicaid live in states that either ban abortion care or bar them from getting abortions using the federally funded healthcare plan.
NNAF highlighted the network's decades of work to counter the Hyde Amendment by ensuring people who need abortions can access funding, which abortion funds across the country obtain through grassroots donations as they also advocate to end the Hyde Amendment.
"By the 1990s—less than two decades after Hyde first passed—28 abortion funds had formed across the country. Twenty-two of those funds started the National Network of Abortion Funds (NNAF) in 1993," said NNAF. "We joined together to build strategic power and end the Hyde Amendment. Today, our network has nearly 100 member abortion funds, and our fight against Hyde continues."
"The fierce abortion funds in our network have raised money, arranged travel, connected folks to clinics, provided practical support, and fought restrictions in their states and communities," the group added. "Despite endless challenges, their tireless work has built power for our collective goal: Make abortion accessible for all."
Abortion funds have helped people obtain care across the country, but the NWLC emphasized that the Hyde Amendment has still left hundreds of thousands of women with no choice but to pay for abortions out of pocket—often pushing them to delay care while they gather funds or to carry a pregnancy to term when they don't want to or can't afford to become a parent.
"While abortion costs vary by location, facility, and stage of pregnancy, the median out-of-pocket costs in 2023 were $563 for medication abortion, $650 for first-trimester procedural abortion, and $1,000 for second-trimester abortion care," said NWLC. "Those costs account for just the procedure itself, not additional expenses. And yet, nearly half of American families cannot afford the true cost of living... So, when the Hyde Amendment denies someone abortion care, the compounding costs can push people further into a struggle to survive and meet basic needs."
Dr. Jamila Perritt, president and CEO of Physicians for Reproductive Health, remembered Rosie Jimenez, a 27-year-old mother and aspiring teacher who died in 1977, almost exactly a year after the Hyde Amendment was passed, after being denied Medicaid coverage for an abortion.
“Hyde has harmed generations of people seeking abortion care," said Perritt. "Women like Rosie Jimenez, the first known person to die because of Hyde Amendment restrictions, should still be here. No one, no matter what insurance they have access to or who they are, should be denied abortion care, full stop."
Stateline reported Tuesday that with weeks to go until the midterm elections and President Donald Trump's approval rating plummeting to record lows, anti-abortion groups are increasingly concerned that a Democratic majority could repeal the amendment, which it came close to doing in 2022.
“If there becomes a pro-abortion majority in Congress, then Hyde is going to be one of the first things to go, probably, especially because it’s been in the spotlight more recently,” Gavin Oxley, spokesperson for Americans United for Life, told Stateline. Particularly since Trump told Republicans to be "a little flexible" on the Hyde Amendment when the party was pushing to end subsidies under the Affordable Care Act, Oxley said "there are some Republicans who may not be as committed to protecting Hyde.”
Perritt expressed hope that Congress could pass the EACH Act, which now "has the highest amount of support... ever seen with over 200 co-sponsors."
"As a DC-based OB-GYN and abortion provider, I see patients burdened with the cost of abortion care, forcing them to choose between basic living needs and lifesaving healthcare," she said. "The Hyde Amendment is a zero-sum constraint that is not about patients’ health and autonomy, but instead about punishing people for making informed decisions about their bodies, families, and futures. Enough is enough."
"We do not need another Hyde Amendment anniversary," said Perritt. "We need to repeal the Hyde Amendment for good.”
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