The federal government has significantly reduced the number of caseworkers who help resolve Affordable Care Act (ACA) coverage issues, leaving millions of enrollees with fewer resources for critical support. These specialized workers, based within the Centers for Medicare & Medicaid Services (CMS), typically step in when consumers face complex problems like a newborn left off a policy or an unauthorized broker switching someone’s health plan.
Under a broader reduction-in-force initiative by the Trump administration, two out of six divisions of ACA caseworkers have been cut. This move comes at a time when ACA enrollment has reached a record high of 24 million people. Critics argue the cuts will increase delays for consumers seeking help with urgent coverage issues that, if unresolved, could result in large medical bills or disrupted care.
Many of the dismissed workers were let go abruptly, some losing computer access before receiving official notice. The cuts have also impacted morale among remaining staff, who already managed demanding caseloads involving complex health insurance regulations.
Advocates like Jackie Kiger of Pisgah Legal Services warn the staffing loss will make it harder for consumers to get assistance through ACA call centers and marketplaces, potentially leaving them stuck in bureaucratic limbo. Compounding the problem, future proposed changes to the ACA, including new eligibility requirements and enrollment rules, could create additional confusion for consumers.
The workforce reduction affects not just CMS but other agencies within the Department of Health and Human Services, including the CDC and FDA, with an estimated 20,000 federal positions to be eliminated. The administration says the cuts will save taxpayers $1.8 billion a year. However, former CMS officials and health policy advocates worry the downsizing will weaken essential services for millions relying on ACA coverage.
