Trump Plans ACA Changes, Dreamer Coverage Block

The Trump administration has announced a proposal to shorten the Affordable Care Act (ACA) open enrollment period from January 15 to December 15, aiming to align it with employer-based health plans and reduce consumer confusion. This proposal also seeks to end ACA coverage for 'Dreamers'—immigrants who arrived in the U.S. illegally as children—overturning a Biden-era rule, although enforcement is currently blocked in 19 states. The Centers for Medicare and Medicaid Services (CMS) claims these changes will streamline enrollment and reduce adverse selection. Critics argue that these moves might restrict access to healthcare, especially for low-income individuals, as additional requirements for eligibility and subsidies are introduced. Moreover, CMS proposes that 'sex-trait modification' may not be covered as an essential health benefit starting in 2026. Previously, record ACA enrollment was achieved under the Biden administration due to expanded subsidies that lowered premiums for many enrollees.