Millions of Americans appear to be dropping Obamacare coverage in the months since Congress failed to extend the generous subsidies that had become a defining feature of the Affordable Care Act.
Initial sign-ups had already fallen by about 1.2 million people. But insurance companies, state officials and industry analysts are reporting that many more have lost Obamacare coverage now that people are facing long-term higher costs. The federal government has yet to report current enrollment data.
Many insurers and analysts are estimating overall declines of about 20 percent, dropping to around 19 million from the 24 million who were covered under the A.C.A. last year. Other indications suggest there could be even larger potential losses by the end of the year, a deep retrenchment for Obamacare coverage and a reversal of significant gains in the last several years.
The rising cost of health care has shown up as a top concern among Americans in several public opinion polls. Premiums are rising for Americans who get insurance through work, too, as health care costs have been increasing nationwide. Out-of-pocket costs are growing too, as plans with high deductibles have become popular.
When President Donald Trump attempted to overturn the 2020 election, the institutional guardrails of American democracy held — but just barely.
If faced with the same tests today, those guardrails and the people who held the line would largely be missing, a ProPublica examination found.
At least 75 career officials who once held roles at federal agencies related to election integrity and safety are gone. Two dozen appointees — including many who either actively worked to reverse the 2020 vote or are associates of such people — have been hired to replace them. And once-fringe actors now have access to vast powers.
As the midterms approach, current and former government officials and election security experts expressed concerns that Trump appointees who’ve espoused debunked conspiracy theories about balloting are now in positions to control the narrative around the vote’s soundness.
It’s hard to debunk false claims “coming with the seal of the federal government,” said Derek Tisler, counsel and manager with the Brennan Center for Justice’s elections and government program. “I certainly worry what damage that could do to voters’ confidence.”
Here are some of the key things you should know about the Trump administration’s efforts to, as the president said, “take over” the midterms. Read the full investigation here.
1. In 2020, institutional guardrails helped to prevent Trump from overturning the election.
Following his defeat in the 2020 election, Trump pushed for federal officials to uncover proof that he had, in fact, beaten Joe Biden at the polls. Election cybersecurity experts with the Department of Homeland Security relayed to Attorney General William Barr that the election fraud claims that they looked into were false. Barr then told the president what he didn’t want to hear: The election had not been hacked.
Barr was one of many federal officials — most of them Trump appointees — who refused to bend to the president’s demands, which only intensified in the weeks leading up to Jan. 6, 2021. Despite the violent uprising at the Capitol on that day, the election results held firm.
2. Less than 18 months into his second term, Trump has dismantled many of those same guardrails.
Since the start of his second term, Trump and his appointees have made significant changes at federal agencies tasked with helping to safeguard elections. In all, at least 75 career officials who’d played important roles in elections work at DHS, the Department of Justice and other agencies have left, been fired or been reassigned, ProPublica found.
In their place are roughly two dozen people Trump has installed in positions that could affect elections. Ten of them actively worked to reverse the 2020 vote, and the rest are associates of those people. In some cases, ProPublica found, officials have been hired from activist groups that are pillars of the election-denial movement.
3. Among the first agencies Trump gutted after returning to office was one that had repeatedly disproved his stolen-election claims.
Officials at DHS’ Cybersecurity and Infrastructure Security Agency had provided research to the first Trump White House that disproved many theories claiming that the 2020 election had been hacked. CISA also played a crucial part in publicly countering these claims by producing a “Rumor Control” website to rebut them.
Then, only weeks into Trump’s second term, DHS leadership put employees focused on countering disinformation and helping safeguard elections on leave. They also froze CISA’s other election security work, which included assessing local election offices for physical and cybersecurity risks. Eventually, all CISA employees specializing in elections were fired or transferred.
A DHS spokesperson told ProPublica that the changes at CISA were in response to “a ballooning budget concealing a dangerous departure from its statutory mission,” which included “electioneering instead of defending America’s critical infrastructure.”
4. Trump and his appointees have gutted election-related teams at federal law enforcement agencies.
FBI Director Kash Patel dismantled the agency’s public corruption team, which had previously been deployed to help monitor possible criminal activity on Election Day. The Foreign Influence Task Force, which aimed to combat foreign influence in U.S. politics, was also disbanded.
(An FBI spokesperson said the bureau “remains committed to detecting and countering foreign influence efforts by adversarial nations.”)
The voting section of the DOJ’s Civil Rights Division had enforced federal laws that protect voting rights, particularly those that combat racial discrimination. But now, nearly all of the section’s roughly 30 career lawyers have resigned or been moved. Trump then filled the section with conservative lawyers, including at least four who participated in challenging the 2020 vote or have worked with people who helped Trump try to overturn the 2020 election.
That's an excerpt, read it in full.
Washington, D.C. — Today, U.S. Senators Patty Murray (D-WA), Vice Chair of the Senate Appropriations Committee, and Lisa Murkowski (R-AK), a senior member of the Senate Appropriations Committee, reintroduced comprehensive bipartisan legislation that would be the most expansive effort so far to boost federal research on menopause and would—for the first time—coordinate the federal government’s existing programs related to menopause and mid-life women’s health. The Advancing Menopause Care and Mid-Life Women’s Health Act, authorized at $275 million over five years, would better address menopause and mid-life women’s health issues by strengthening and expanding federal research, health care workforce training, awareness and education efforts, and public health promotion and prevention activities.
75 million women are in perimenopause, menopause, or post-menopause right now in the U.S.—with 6,000 more women reaching menopause each day. But despite the fact that half the population in the U.S. will eventually experience menopause, menopause research has long been underinvested in and overlooked. To date, there are few federally funded clinical trials on menopause and menopausal hormone therapy and very little menopause education for doctors—only 30 percent of U.S. residency programs offer a formal menopause curriculum, and 80 percent of OB-GYN residents admit to being ill-prepared to discuss menopause.
“For too long, menopause has been something women are expected to deal with by themselves and like many areas of women’s health, it hasn’t received the attention or investment it deserves—that needs to change,” said Senator Murray. “This legislation takes important steps by increasing funding for menopause research and providing federal agencies with additional tools to better study and support mid-life women’s health. While this administration continues to dismantle programs and research that support women’s health, I’ll keep fighting to make sure we make it a federal priority.”
“Menopause is something half of the global population will experience, and it is imperative that we better understand it—as women, as healthcare professionals, as partners and support systems,” said Senator Murkowski. “This legislation makes it possible to invest time and energy into doing just that. I am honored to join this bipartisan group of determined women and strong leaders to advocate for women’s health.”
“ACOG is pleased to endorse the Advancing Menopause Care and Mid-Life Women’s Health Act. As ob-gyns, we see firsthand the urgent need for improved public health awareness and access to trusted, evidence-based information on menopause and mid-life women’s health—especially at a time when health misinformation is rapidly increasing,” said Steven J. Fleischman, MD, MBA, FACOG, President of the American College of OB-GYNs (ACOG). “We’re encouraged that this bill would expand long overdue investments in federal research into menopause and evidence-based approaches to better support patients through the menopausal transition. We thank Senator Patty Murray and Senator Lisa Murkowski for their continued leadership and dedication to advancing menopause care.”
“The Society for Women’s Health Research (SWHR) is pleased to endorse the Advancing Menopause Care and Mid-Life Women’s Health Act once again, and we thank Senator Murray and Senator Murkowski for reintroducing the bill,” said Kathryn Schubert, President & CEO of the Society for Women’s Health Research. “By boosting research, strengthening clinician training, and raising awareness, this legislation will transform how our health system serves women in midlife and menopause — a population that has for too long been overlooked.”
“Menopause is not just a moment in time — it marks a major inflection point in a woman’s life and long-term health,” said Halle Berry, Academy-Award winning actor, advocate, and founder of women’s health company Respin. “I found out I was in menopause at 54 and spent years being misdiagnosed and in search of answers. The Advancing Menopause Care and Mid-Life Women’s Health Act is a profound step toward addressing the harmful gaps in research, education, and healthcare and I’m excited to see this bill reintroduced. Thank you to Senators Murray and Murkowski, and to all the fierce Members of Congress who have supported and continue to support this effort.”
The Advancing Menopause Care and Mid-Life Women’s Health Act would:
- Expand federal research on menopause and mid-life women’s health:
- Authorize $25 million per year over five fiscal years for NIH to award grants to support biomedical, public health, clinical, and translational research and innovation related to menopause and mid-life women’s health.
- Establish new Research, Condition, and Disease Categorization (RCDC) categories for chronic or debilitating conditions among women related to perimenopause, menopause, post-menopause, and mid-life women’s health.
- Strengthen coordination within the NIH and across HHS to expand federal research into menopause and mid-life women’s health, including new pharmacological or non-pharmacological treatments, and prevent adverse health outcomes among women experiencing menopausal symptoms.
- Support translational research activities to speed the translation and implementation of federal research to support evidence-based health care delivery of perimenopause, menopause, post-menopause care, and related women’s health services.
- Require HHS to expand public health research, health care quality research, data collection and reporting, and occupational health research related to menopause and mid-life women’s health.
- Support public health promotion activities to address chronic conditions affecting mid-life women’s health, strengthen early detection, diagnosis, and treatment of menopausal symptoms; improve health care delivery; and support the development of recommendations and best practices to expand access to mental health and substance use services for women experiencing perimenopausal, menopausal, or postmenopausal symptoms. Authorized at $10 million per year over five fiscal years.
- Establish a national public health awareness, education, and outreach program on menopause and mid-life women’s health. Authorized at $10 million per year over five fiscal years.
- Improve professional training resources for health care providers on menopause and mid-life women’s health through a new grant program. Authorized at $10 million per year over five fiscal years.
- Direct the designation of Centers of Excellence in Menopause and Mid-Life Women’s Health, and authorize grants to support the improvement of professional training resources for health care providers on menopause and mid-life women’s health.
- Require HHS to report to Congress on federal research activities related to menopause and mid-life women’s health, related barriers to care for patients in rural and underserved areas; barriers to training for health care providers, and recommendations to expand access to care and increase public awareness.
- Support coordination between HHS and other federal departments and agencies—including Veteran’s Affairs (VA) and the Department of Defense (DoD)—related to menopausal symptoms, mid-life women’s health, aging, and public health promotion activities.
This legislation is cosponsored by Senators Angela Alsobrooks (D-MD), Tammy Baldwin (D-WI), Lisa Blunt Rochester (D-DE), Cory Booker (D-NJ), Maria Cantwell (D-WA), Catherine Cortez Masto (D-NV), Tammy Duckworth (D-IL), Kirsten Gillibrand (D-NY), Maggie Hassan (D-NH), John Hickenlooper (D-CO), Amy Klobuchar (D-MN), Jack Reed (D-RI), Jacky Rosen (D-NV), Jeanne Shaheen (D-NH), and Tina Smith (D-MN).
The legislation is endorsed by the American College of Obstetricians and Gynecologists, American Society for Reproductive Medicine, American Urogynecologic Society, Endocrine Society, National Association of Nurse Practitioners in Women’s Health, Society for Reproductive Investigation, Society for Women’s Health Research, and Women’s First Research Coalition.
In the FY26 appropriations bills, Senator Murray championed women’s health research at and across NIH, as well as $5 million for a new Menopause Research to Action initiative at the Agency for Healthcare Research and Quality (AHRQ), which will focus on scaling up and deploying research and care delivery models into routine clinical practice, as well as supporting efforts to share best practices. Senator Murray also secured language to encourage the Food and Drug Administration (FDA) to continue outreach and engagement activities with health care providers on perimenopause, menopause, post-menopause, and mid-life women’s health, and to facilitate the development and testing of new pharmacological treatments for menopausal symptoms. Murray also supported language to explore the creation of Centers of Excellence in Menopause at VA.
Senator Murray, a senior member and former Chair of the Senate Health, Education, Labor and Pensions (HELP) Committee, has always championed and fought to boost investments in women’s health care and research. When she was the top Democrat on the HELP Committee, Murray led negotiations and passage of the 21st Century Cures Act in 2016, bipartisan legislation that provided $4.8 billion over the next 10 years to invests in a wide range of health priorities—including women’s health care. Murray leads and has repeatedly introduced the Jeanette Acosta Invest in Women’s Health Act, which would increase women’s access to preventive and lifesaving cancer screenings. Murray has also been a strong advocate for women veterans’ health care—transforming the VA over decades to meet the needs of women veterans, whether by authoring and passing the Women Veterans Health Care Improvement Act in 2010 or by delivering annual funding as an appropriator to help VA provide the necessary care for women veterans. In 2024, as Appropriations Chair, Murray delivered a record $900 million investment in women veterans’ health care, as well as a $300 million funding boost for the National Institutes of Health (NIH).
The full text of the legislation is HERE.
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BlackCommentator.com April 30, 2026 Issue 1085 |
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