Medicaid

As I and many others have been warning about for the past year or so, the upcoming so-called "work requirements" (aka "paperwork hell" requirements) of last year's Big Ugly Bill are ramping up in January...and in fact have already begun in Nebraska. A few days ago the Centers for Medicare & Medicaid Services (CMS) published their "final rule" with the reporting and exemption regulations which every state which has expanded Medicaid under the Affordable Care Act will be required to follow...and, as expected, it's likely to be a disaster.

Via Selena Simmons-Duffin of NPR:

Advocates for people with serious illnesses, like cancer and HIV, say the strict Medicaid work rules that the Trump administration released this week are likely to put ongoing treatments in jeopardy.

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

February 2026 Key Findings

Medicaid and CHIP Enrollment

• In February 2026, 74.9 million individuals were enrolled in Medicaid and CHIP.
• 67.7 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
• 39.2 million adults were enrolled in Medicaid, and there were 35.7 million Medicaid child and CHIP enrollees.

Total Medicaid/CHIP enrollment in December 2025 dropped about 1.2% from January 2026, or by around 918,000 people.

via NPR:

In 2020, Oklahoma voters passed Medicaid expansion, adding more people to Soonercare. Republican lawmakers are advancing proposed constitutional changes to reverse that vote: House Bill 4440 and House Joint Resolution 1067.

If approved, both state questions would give lawmakers the ability to adjust or reverse Oklahoma’s expanded Medicaid eligibility without a majority vote of approval by Oklahomans, with one acting as a failsafe in case the other is unsuccessful during the Aug. 15 primary runoff.

...Both measures passed the Senate Rules Committee along party lines on Monday.

Democrats say the process to approve the measures in the Senate feels ‘intentionally chaotic.’

Expanded Medicaid eligibility extends government-subsidized health coverage to adults aged 19-64 with incomes up to 138% of the federal poverty level. Today, adults made eligible by the expansion vote account for just over a fifth of all Oklahomans enrolled.

As of June 2025, around 70,000 Nebraska residents were enrolled in Medicaid via the ACA's expansion of the program.

Last summer, after Congressional Republicans passed their Big Ugly Bill, I warned people against assuming that the gutting of Medicaid wouldn't hit until after the 2026 midterms:

Over at The New Republic, Greg Sargent has taken this thinking one step further, noting that by delaying so much of the ugliness of the new law until 2027 or beyond...

Republicans know how unpopular all this will be. So they’ve structured the bill so the tax cuts land immediately, while many of the Medicaid cuts get going in 2027 and 2028. That’s meant to spare them in the midterms.

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

January 2026 Key Findings

Medicaid and CHIP Enrollment

• In January 2026, 75.3 million individuals were enrolled in Medicaid and CHIP.
• 68.0 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
• 39.4 million adults were enrolled in Medicaid, and there were 35.9 million Medicaid child and CHIP enrollees.

Total Medicaid/CHIP enrollment in December 2025 dropped about 1.3% from December 2025, or by around 943,000 people.

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

December 2025 Key Findings

Medicaid and CHIP Enrollment

• In December 2025, 75.7 million individuals were enrolled in Medicaid and CHIP.
• 68.5 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
• 39.7 million adults were enrolled in Medicaid, and there were 36.0 million Medicaid child and CHIP enrollees.

Total Medicaid/CHIP enrollment in December 2025 dropped about 1.0% from November 2025, or by around 727,000 people.

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

November 2025 Key Findings

Medicaid and CHIP Enrollment

• In November 2025, 76.0 million individuals were enrolled in Medicaid and CHIP.
• 68.8 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
• 39.8 million adults were enrolled in Medicaid, and there were 36.2 million Medicaid child and CHIP enrollees.

Total Medicaid/CHIP enrollment in November 2025 dropped about 1.5% from October 2025, or by around 1.17 million people.

The Centers for Medicare & Medicaid Services (CMS) has posted an official update to the enrollment data for ACA Medicaid expansion through June 2025.

According to the new report, total enrollment from December 2024 through June 2025 dropped by 517,000 people, or roughly 2.5%, standing at 20.4 million nationally as of last June, so it doesn't look like the Trump Admin has started cooking these particular books, at least not yet.

This will likely change radically with the draconian provisions of the GOP's Big Ugly Bill starting to kick in soon, however.

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

October 2025 Key Findings

Medicaid and CHIP Enrollment

• In October 2025, 76.8 million individuals were enrolled in Medicaid and CHIP.
• 69.5 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
• 40.2 million adults were enrolled in Medicaid, and there were 36.6 million Medicaid child and CHIP enrollees.

Total Medicaid/CHIP enrollment in October 2025 of ~76.8 million dropped about 0.9% from September 2025, or by around 690,000 people.

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

September 2025 Key Findings

Medicaid and CHIP Enrollment

• In September 2025, 77.1 million individuals were enrolled in Medicaid and CHIP.
• 69.8 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
• 40.3 million adults were enrolled in Medicaid, and there were 36.7 million Medicaid child and CHIP enrollees.

Total Medicaid/CHIP enrollment in September 2025 of ~77.1 million dropped about 0.9% from July 2025, or by around 700,000 people.