Health program cuts hit home, fueling blame game

Sweeping changes that congressional Republicans made to the Affordable Care Act and Medicaid are starting to take effect, fueling an election-year blame game over coverage losses. Why it matters: A rise in the uninsured rate will put more stress on the health system and ratchet up concerns about health costs in an election year where affordability is voters' biggest concern. Driving the news: The changes are hitting home, with about 1.2 million fewer people signed up for ACA coverage compared with a year ago, following Congress' refusal to extend enhanced subsidies. Nebraska this month also became the first state to impose new work requirements on Medicaid recipients who enrolled under the ACA expansion. By the numbers: Wakely Consulting Group found that 14% of enrollees did not pay their first ACA premium in January. It estimated that 2026 enrollment will end up being 17% to 26% lower than last year. Insurers in some states are reporting drops in enrollment as high as 20% to 30%, while other states are stepping in to offer additional financial help to limit the losses, according to an insurance industry source. What they're saying: "We don't have full data yet but all signs point to a substantial drop in enrollment with the expiration of the enhanced premium subsidies," said Larry Levitt, executive vice president for health policy at KFF, estimating "several million" fewer enrollees. The coverage losses already are seeping into campaign messaging ahead of the midterm elections as Democrats try to flip control of the House. The Democratic Congressional Campaign Committee took aim at Rep. Nick Begich (R-Alaska) last week for voting against extending the enhanced ACA tax credits, saying premiums have risen 58% on average. It similarly targeted Colorado GOP Reps. Jeff Crank and Gabe Evans for their votes to cut Medicaid in last year's Republican tax-and-spending bill and refusal to extend ACA subsidies. Other ads in competitive Ho...

Original source: Axios