Trump Changes Health Care Enrollment for 24 Million People: Who’s Impacted

In a move that has significant implications for millions of Americans, President Donald Trump has issued a series of executive orders, some of which target the healthcare marketplace. These changes are expected to affect the enrollment process and medical insurance coverage for an estimated 24 million people.

Newsweek has reached out to the Trump transition team via email for comment.

Why It Matters

The Affordable Care Act (ACA), also known as Obamacare, has been a cornerstone of healthcare in the United States since its enactment in 2010. Roughly 24 million Americans have purchased health insurance via the ACA this year.

Trump’s recent changes will impact key provisions, including enrollment deadlines, eligibility criteria and federal subsidies. These shifts could result in reduced access to affordable healthcare for millions of Americans.

What To Know

On January 20, 2025, President Trump signed a series of executive orders. Two were aimed at reversing several key elements of the Affordable Care Act that were implemented during the Biden administration. This included rescinding President Biden’s 2021 executive order 14009, which expanded open enrollment periods for ACA plans, as well as 2022 executive order 14070, which aimed to lower ACA premiums.

Executive Order 14009, titled “Strengthening Medicaid and the Affordable Care Act,” includes several key components designed to increase access to affordable health care and reduce the number of uninsured Americans:

Reversal of Trump administration policies: The order sought to undo measures that limited ACA provisions or made healthcare less accessible.

Longer enrollment periods: The order encouraged states to lengthen enrollment periods and provided additional federal support. As a result, many states extended their enrollment windows to ensure broader access to affordable healthcare.

Restoration of pre-existing condition protections: Reaffirmed protections for individuals with pre-existing conditions and reinforced nondiscrimination policies in healthcare.

Immediate review of agency actions: The order directed various executive departments and agencies to review existing regulations, orders, and policies to ensure they align with the goal of strengthening Medicaid and the ACA.

Executive Order 14070, titled “Continuing To Strengthen Americans’ Access to Affordable, Quality Health Coverage,” aimed to maintain and enhance Medicaid and the ACA. Key components included:

Enhanced marketplace subsidies: The order highlights the positive impact of the American Rescue Plan Act on access to coverage, including enhanced marketplace subsidies.

Extended postpartum Medicaid coverage: It provides options for states to extend postpartum Medicaid coverage.

New incentives for Medicaid expansion: The order includes new incentives for states to expand their Medicaid programs.

What People Are Saying

President Donald Trump, in the executive order, said: “The previous administration has embedded deeply unpopular, inflationary, illegal and radical practices within every agency and office of the federal government.” He added: “…it is the policy of the United States to restore common sense to the Federal Government and unleash the potential of the American citizen. The revocations within this order will be the first of many steps the United States Federal Government will take to repair our institutions and our economy.”

Alex Beene, financial literacy instructor for the University of Tennessee at Martin, told Newsweek: “While we don’t yet know what the actual effects will be, it’s fair to say the reversal in trajectory from President Biden’s original executive order will lead to fewer Americans enrolling in insurance under the Affordable Care Act. That executive order extended enrollment periods for many states and excelled funding for outside entities to assist Americans in enrolling. The rescinding of it could return those enrollment time periods to their original length and cause assistance through third parties to decrease over time.”

“The extending of the ACA enrollment periods were important for Americans whose personal and professional life situations took an unexpected turn and immediately needed additional coverage. It could be someone losing healthcare coverage through losing a job, moving to another location, having a child, or a number of other situations that cause a sudden change in the needs of that individual. Now, if they’re outside of that enrollment period, the process of finding coverage just got more difficult.”

Kevin Thompson, founder and CEO of 9i Capital Group, told Newsweek: “Third-party funding played a significant role in boosting ACA participation. These funds, along with government subsidies, helped offset premiums for millions of Americans, driving the enrollment gains seen in recent years. A reduction in this funding will likely lead to lower enrollment numbers.”

“The most vulnerable populations will be the hardest hit. Non-expansion states—many of which are red states—tend to have higher percentages of their populations enrolled in the ACA Marketplace. These states will face significant challenges with shorter enrollment periods and reduced subsidies. What was once campaigned as “we won’t touch entitlements” is now coming dangerously close to contradicting that promise.”

What Happens Next

President Trump’s recent executive orders are just the first steps in his broader agenda to reshape federal policies and assert executive power. He announced plans to launch the “largest deportation program of criminals in the history of America” targeting undocumented immigrants. He also threatened to impose 25 perceent tariffs on Canada and Mexico unless they take stronger measures to stop unauthorized migrants and illicit drugs. Additionally, Trump declared a national energy emergency to boost domestic oil and gas production and end the electric vehicle mandate.