ACA navigators are trained to help consumers and small businesses find coverage options. CMS said Feb. 14 that despite receiving $98 million in 2024, the navigator program enrolled just 92,000 people. The funding cut is expected to save $360 million over the next four years, with the savings directed toward lowering user fees and premiums for those paying full premiums without subsidies. Under the Biden administration, CMS had committed $500 million over five years to improve marketplace efficiency and target underserved populations, with $100 million awarded in August.
On Feb. 11, CMS submitted a proposed rule, titled “Patient Protection and Affordable Care Act; Individual Health Insurance Market and Exchange Program Integrity,” to the White House Office of Management and Budget for review.
CMS has not released details about the specifics of the rule, but it comes amid rising concerns among Republicans, who have pointed to potential fraud in the marketplace, particularly with premium subsidies. On Feb. 12, House Republicans unveiled a budget proposal that orders the Energy and Commerce Committee, which oversees Medicare and Medicaid, to find $880 billion in savings from fiscal years 2025 through 2034.
This push follows a broader scrutiny of government health spending. In early February, Elon Musk’s Department of Government Efficiency gained access to CMS systems to analyze spending for potential fraud or waste.
ACA enrollment reached a record 23.6 million in 2025, in part due to the expansion of premium tax credits set to expire at the end of the year. The growth has also raised concerns about the integrity of the marketplace, prompting CMS to implement stronger enforcement measures this year against fraud, including cracking down on unauthorized plan changes and broadening the scope for which brokers can be suspended from the marketplace.
On January 20, President Trump rescinded President Biden’s 2021 executive order that established a special enrollment period for ACA plans in most states, as well as a 2022 executive order that directed federal agencies to develop new ways to lower costs, simplify Medicaid and ACA enrollment, and increase coverage access.
