FOR IMMEDIATE RELEASE: April 11, 2025 

Contact: Jack Cardinal | jcardinal@communitycatalyst.org

From Repeal to Rollback: The Trump Administration’s New Strategy to Gut the ACA

BOSTON, MA—Today, Community Catalyst organized hundreds of local, state and national partners to submit comments to the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) opposing a new proposed rule from the Trump administration that would make it harder and more expensive for people to buy their own insurance on Affordable Care Act (ACA) Marketplaces and increase their medical debt. These harmful changes would disproportionately impact communities of color, immigrants, and families with low incomes—people who have long been excluded from our health system. If the rule goes into effect, people will be forced to pay approximately 4.5% more for the same health care plans they already have, and out-of-pocket maximum spending limits will increase by more than $1,000 per person. The administration’s own estimates suggest that as many as 2 million people will lose their coverage under this proposal, which may well be an underestimate.

You can read Community Catalyst’s comments here.

“The Trump administration knows that trying to repeal the ACA is a non-starter. They have touched that third rail before and been burned. So now they are trying to quietly gut the ACA – making it increasingly harder and more expensive for people to buy their own insurance on Marketplaces. In doing so, they are trying to make the ACA collapse on itself. And they are attempting to do it all under the radar. It is shameful and wrong,” said Mona Shah, Senior Director of Policy and Strategy at Community Catalyst.

As a national leader in advancing health justice and improving enrollment in health care for people, Community Catalyst has worked with partners across the country to help millions of people—especially those historically shut out of the system—gain coverage, get care, and avoid crushing medical debt. The organization recently laid out how rules like this are part of a new strategy focused on undermining the ACA. Out are the days when Congress pursued high profile votes to repeal the whole law; the new strategy is to quietly gut the law.

“At a time when the administration is creating tremendous economic instability, we should be making health care more accessible and affordable. Marketplace coverage has helped shrink racial disparities in access to care, and any attempt to undermine it is an attack on health and economic justice. The actions by the administration, along with this rule and its support for cutting Medicaid and other health care programs in Congress, do the exact opposite,” continued Shah.

While the administration claims these actions would benefit people who buy their insurance on the Marketplace, it would actually do the exact opposite—making it harder for people to buy insurance, leaving people underinsured and uninsured and at risk of incurring life-upending medical debt simply because they get sick.  The administration also claims to want to maintain program integrity, but these actions do not include evidence-based policies to reduce fraud, instead they are shifting burdens to individuals—especially those with low incomes, self-employment, and immigrants. The proposed rule would:

  • Shorten the open enrollment period limiting the time people have to sign up for coverage—especially harmful to people juggling multiple jobs, those with limited internet access, people who are learning English, and rural communities;
  • Create unnecessary paperwork hurdles for special enrollment periods – unique times when people can buy insurance outside of open enrollment due to a life event like giving birth, moving, getting divorced or losing a job;
  • Take away automatic enrollment options for people who like, and want to keep, their insurance;
  • Decrease the value of plans on the marketplaces and drive up the cost of purchasing health insurance;
  • Exclude DACA recipients from buying health insurance on Marketplaces; and more.

Community Catalyst and its partners have helped thousands of individuals navigate open enrollment, prioritize community-centered outreach, and advocate for policy solutions that people want and need. These efforts have contributed to a record 24.2 million enrollments on the ACA Marketplace last year–thanks to efforts that make plans more affordable, including premium tax credits. 

Jason, a freelance illustrator in Philadelphia, credits the ACA’s premium tax credits with saving his life after a cancer diagnosis. “I’m very grateful that I’ve been able to afford coverage—and it’s only because of the premium tax credits,” he said. “Not only did this plan save my life, but I don’t know what I’ll do if it’s taken away.”

Research shows that early cancer detection through ACA coverage has saved lives and improved outcomes—especially among Black and Latinx communities, who often face systemic barriers to timely care. Providing plenty of opportunities for people to buy, and keep, the coverage they want is at risk for people like Jason under the administration’s proposal. 

Community Catalyst remains committed to fighting for a health system where affordability, equity, and justice are not optional—but guaranteed. We will continue building power with communities most harmed by the health system today to ensure coverage is not only protected, but expanded.

To learn more about Community Catalyst work to protect the ACA, please visit: https://communitycatalyst.org/issues/affordability/affordable-care-act/.

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About Community Catalyst:   

Community Catalyst is a national organization dedicated to building the power of people to create a health system rooted in race equity and health justice, and a society where health is a right for all. We’re an experienced, trusted partner to organizations across the country, a change agent to policymakers at the local, state, and national level, and both an adversary and a collaborator to health systems in our efforts to advance health justice. We partner with local, state and national organizations and leaders to leverage and build power so that people are at the center of important decisions about health and health care, whether they are made by health care executives, in state houses, or on Capitol Hill. Together with partners, we’re building a powerful, united movement with a shared vision of and strategy for a health system accountable to all people. Learn more at www.communitycatalyst.org.