Edwin Park

November 1: All Saints' Day, Day of the Dead, and the start of ACA open enrollment, when people start realizing that their out-of-pocket premiums are increasing an average of 114% due to expiration of enhanced tax credits.

Today’s rulings confirm what’s been clear all along: the Administration has been sitting on billions of available dollars that it is legally required to use to fund November benefits for the 1 in 8 Americans who need SNAP to afford their groceries.

New @urbaninstitute.bsky.social analysis on the increasing importance of ACA Marketplace coverage for families. About 40% of current Marketplace enrollees are parents and children: www.urban.org/research/pub...

CMS’s Georgia Waiver Extension Underscores the Failure of Medicaid Work Requirements As regular readers of SayAhhh! know, on January 1, 2027, 42 states and DC will be required by HR 1 to impose work reporting requirements on many adults covered by Medicaid. The only state in the co…

My colleague @joanalker1.bsky.social explains how Georgia's #Medicaid work reporting requirements waiver (recently extended by Trump Admin) underscores the severe harm and waste that will result from imposing such requirements on all expansion states under H.R. 1: ccf.georgetown.edu/2025/10/30/c...

Trump pushes an end to medical care for transgender youth nationally The White House plans to bar hospitals that treat transgender children and youth from getting any Medicare and Medicaid payments. The move would affect trans youth who have private insurance, too.

The White House plans to bar hospitals that treat transgender children and youth from getting any Medicare and Medicaid payments. The move would affect trans youth who have private insurance, too. n.pr/4qFa1mY

Many Unanswered Questions: Will the Trump Administration’s Drug Pricing Deals Result in Any Cost Savings for State Medicaid Programs? Over the last month, the White House has widely touted pricing agreements from two drug manufacturers — Pfizer and AstraZeneca — which it claims will result in substantial prescription drug cost sa…

My new blog on the many unanswered questions about the Trump Admin’s Most Favored Nation drug pricing agreements especially how MFN prices would interact with existing #Medicaid rebates & whether MFN prices will save any $ (and may even increase Medicaid Rx costs). ccf.georgetown.edu/2025/10/29/m...

Many Unanswered Questions: Will the Trump Administration’s Drug Pricing Deals Result in Any Cost Savings for State Medicaid Programs? Over the last month, the White House has widely touted pricing agreements from two drug manufacturers — Pfizer and AstraZeneca — which it claims will result in substantial prescription drug cost sa…

My new blog on the many unanswered questions about the Trump Admin’s Most Favored Nation drug pricing agreements especially how MFN prices would interact with existing #Medicaid rebates & whether MFN prices will save any $ (and may even increase Medicaid Rx costs). ccf.georgetown.edu/2025/10/29/m...

The contrast with SNAP is deafening.

The White House is stretching well beyond what anyone could claim is legal in order to pay the troops — while simultaneously stretching beyond what’s legal to NOT pay SNAP benefits.

There are two different KFF numbers about the ACA out there. Both are accurate, but mean different things.

114%: The average increase in out-of-pocket premiums if enhanced tax credits expire.

26%: The average increase in what insurers are charging for benchmark ACA plans.

Evergreen: there has never been and never will be a credible Trump/GOP Congress plan to repeal & replace the ACA. The only plan has always been repealing/deeply cutting the ACA coverage expansions & cutting rest of #Medicaid to help pay for tax cuts for the wealthy. That’s what HR 1 did this summer.

Lots of reporting on SNAP getting the details wrong.

SNAP is not set to run out of money on November 1. There’s money in the contingency fund to pay benefits.

The Trump admin is illegally refusing to deliver benefits on November 1, despite having funding to pay benefits.

Some new detail from CBO about the draconian #Medicaid cuts in the budget reconciliation law: 800,000 fewer low-income seniors & people with disabilities on Medicare will be enrolled in the Medicare Savings Programs that help pay for Medicare premiums & cost-sharing: www.cbo.gov/publication/...

SNAP’s Contingency Reserve Is Available for Regular SNAP Benefits, as USDA and OMB Have Ruled in Past The Administration must use all available options to fund November benefits for the 1 in 8 people in the U.S. who need SNAP to afford their grocery bill.

The Trump Administration’s assertion that it can't use SNAP’s contingency reserves for SNAP benefits is contrary to:
▪️The plain language of the law
▪️Their own (now deleted) shutdown plan
▪️Guidance from prior Administrations

We have the receipts:

LAO report: big Medi-Cal challenges ahead LAO: "The state does not have fiscal capacity to backfill all of the lost federal revenue..."

LAO report notes big Medi-Cal challenges ahead. "The state does not have fiscal capacity to backfill all of the lost federal revenue." #CABudget jasonsisney.substack.com/p/lao-report...

USDA is legally required to use the contingency funds on SNAP benefits for November.

In July, President Trump and Congressional Republicans enacted the largest cuts to SNAP in history.

The reason they aren't planning on providing SNAP benefits is that they don't want to.

Evergreen: there has never been and never will be a credible Trump/GOP Congress plan to repeal & replace the ACA. The only plan has always been repealing/deeply cutting the ACA coverage expansions & cutting rest of #Medicaid to help pay for tax cuts for the wealthy. That’s what HR 1 did this summer.

How Trump Played ‘Budgetary Twister’ to Pay Some Workers During the Shutdown

NEW: The White House is reprogramming billions in congressionally approved spending during the shutdown, aiming to pay troops, ICE agents and others who work on programs that fulfill the president's political agenda. Some of the money comes from Trump's tax cuts. www.nytimes.com/2025/10/21/u...

Mike Johnson shamelessly lies: "We strengthened Medicaid. We improved healthcare access and we lowered premiums with our legislation."

The Trump Administration Can and Should Take Available Steps to Ensure SNAP Participants Get November Food Benefits Agriculture Secretary Brooke Rollins has indicated, and media have reported, that the U.S. Department of Agriculture (USDA) will run out of funding for SNAP food assistance for November as a result...

USDA has warned that #SNAP funding could run out in Nov, leaving 40M people without food assistance. Nearly two-thirds of needed funds are available in the contingency reserve; the Administration needs to release them now so families can eat next month: www.cbpp.org/blog/the-tru...

Trump Administration Severely Limits Rural Health Transformation Funds for Rural Hospitals and Clinics – Capped at 15% Passage of the budget reconciliation law signed into law by President Trump (HR1) will result in a gross reduction of $990 billion in federal Medicaid and CHIP spending over 10 years and an increas…

My colleague @adamsearing.bsky.social notes how Trump Admin will allow only 15% of the $50B in rural health funds in H.R. 1 to be used to reimburse rural hospitals despite being framed as a way to mitigate the draconian #Medicaid cuts harming rural hospitals: ccf.georgetown.edu/2025/10/21/t...

States Jostle Over $50B Rural Health Fund as Trump’s Medicaid Cuts Trigger Scramble - KFF Health News States are battling for their piece of $50 billion in federal rural health funding, but it’s not just hospitals vying for the money. Tech startups and policy demands are raising the stakes as Medicaid...

Trump's "Big Beautiful" Law included a $50B rural health fund, added at last minute to win votes from Rs who worried Medicaid cuts would hurt rural hospitals
Much of this "rural health fund" $ is instead being awarded on things like whether states cut food aid and add the Presidential Fitness Test

KFF graphic summarizing key facts about ACA Enhanced Premium Tax Credits. Highlights include a 114% increase in enrollments due to expanded tax credits. More than 90% of individual market ACA enrollees receive a tax credit; 24 million enrollees in 2025, and coverage details for middle-income families and farmers. Also notes an average $35 billion annual cost to extend these credits. Source: KFF Affordable Care Act analyses.

Get the key facts about the ACA’s enhanced premium tax credits at the center of the ongoing government shutdown.

Trump Administration Plans Deep Cuts to Social Security Disability Insurance, Particularly for Older Workers Despite repeatedly promising not to cut Social Security, the Trump Administration is reportedly preparing a proposed rule that could reduce the share of applicants who qualify for Social Security...

Despite repeatedly promising not to cut Social Security, the Trump Admin is reportedly preparing a proposed rule that could reduce the share of applicants who qualify for Social Security Disability Insurance by up to 20%--which would be the largest cut ever. 🧵

www.cbpp.org/blog/trump-a...

CMS seems to be reversing itself after earlier announcing it was going to delay all Medicare physician payments despite no basis to do so.

This seems troubling. It’s not a situation like when the physician payment formula was in flux in 2015 & all Medicare physician claims were temporarily held (or paid at lower rates and then later reprocessed). Most payments should flow normally with only certain telemedicine/other claims held.

Exclusive | Trump Team Plans IRS Overhaul to Enable Pursuit of Left-Leaning Groups The effort would install a Trump ally at the IRS’s criminal unit who has drawn up a list of investigative targets.

Seems bad. www.wsj.com/politics/pol...

https://www.whitehouse.gov/presidential-actions/2025/10/national-security-presidential-memorandum-nspm-8/

Trump's mechanism to pay the troops during the shutdown is by far the most illegal budgetary action he's taken as POTUS, potentially setting the stage to break everything.

It's also needless because Congress would easily pass a troop pay bill if Johnson were willing to gavel in.

Long thread.

Important @hamiltonproject.org analysis on how harsh SNAP cuts undermine its vital countercyclical role. Also true of budget reconciliation law’s #Medicaid cuts especially those targeting expansion & restricting state provider tax financing. Medicaid is largest source of federal funding for states.

More than 43,000 children dropped from KidCare program for nonpayment, report shows A state agency may have underestimated the number of children removed from subsidized health insurance in Florida, according to a report by the Florida Phoenix.

Florida is violating federal law for children covered by CHIP and thousands are losing coverage. The Trump Adminstrarion is not enforcing the law.

www.wusf.org/health-news-...

Hospital Medicaid pay cuts spread as state budget gaps widen

States are ratcheting down Medicaid reimbursement rates, squeezing providers already bracing for short- and long-term cuts from state and federal governments.