The Trump administration is creating a health-insurance crisis for working Americans, and its own data prove it.
A white paper released in late June by the Department of Health and Human Services shows that 19.2 million Americans were enrolled in ObamaCare plans as of February. That’s 2.9 million fewer than at the same time last year, but still 8.8 million more than in 2019 and 3.8 million more than in 2023, when the enhanced subsidies were in place.
HHS attributes this year’s 2.9-million decline to its “crackdown on fraud.” In practice, the administration stripped subsidies from people enrolled in Medicaid or who failed to file tax paperwork—not because they were ineligible for the underlying care, but because managing a paperwork problem mattered less than purging the rolls.
A lower court has blocked some of HHS’s most aggressive moves. The department nonetheless estimates that 2.6 million are still receiving the subsidies they were promised, including more than one million who enrolled without a Social Security number. The administration blames brokers for signing them up for zero-premium plans—the very zero-premium plans the law was designed to make accessible.
The report is being used to corroborate the conservative Paragon Health Institute, which has insisted that fraud, not unmet need, accounts for the program’s growth. But the report’s own numbers refute that: 3.8 million of the new enrollees previously had other forms of coverage. Some also moved from the law’s small-employer group market, which lacks the robust subsidies of the individual market.
That market fell to nine million enrollees in 2024 from 11.5 million in 2020, as employers dropped coverage or became self-insured to evade the law’s mandates. These include benefit requirements and restrictions on charging older workers more based on age—protections the law guarantees, and exactly what is being stripped away to deliver cheaper premiums to the healthy and higher bills to everyone else.
ObamaCare has been a slow-rolling success that Congress has only partially funded, and the resulting gaps are now being used as a pretext to dismantle the program entirely. The Trump administration and its Congressional allies have refused to extend the enhanced subsidies, even as their own data show that 19.2 million Americans depend on them.
