The White House is working on an executive order to fire thousands of U.S. Department of Health and Human Services workers, according to people familiar with the matter.
Under the order, the Food and Drug Administration,Centers for Disease Control and Prevention and other health agencies would have to cut a certain percentage of employees.
...The agencies are responsible for a range of functions, from approving new drugs to tracing bird-flu outbreaks and researching cancer. A loss of staff could affect the efforts depending on which workers are cut and whether they are concentrated in particular areas.
...Agency officials have been told to prepare lists of probationary workers who have essential roles and must be retained, and of employees who don’t, according to people familiar with the instructions.
Federal employees must decide today whether to take the administration’s buyout offer. More than 40,000 federal workers to date have said they would resign under the deal.
(Yes, I'm aware Elon Musk is a naturalized citizen, but given the Musk/Trump Administration's obsession with demonizing immigrants it seems like an appropriate headline)
Representatives of Elon Musk’s Department of Government Efficiency have been working at the Centers for Medicare and Medicaid Services, where they have gotten access to key payment and contracting systems, according to people familiar with the matter.
The DOGE representatives have been on site at the agency’s offices this week, the people said, and they are looking at the systems’ technology as well as the spending that flows through them, with a focus on pinpointing what they consider fraud or waste. DOGE representatives are also examining the agency’s organizational design and how it is staffed, the people added.
However, for no particular reason, I included the methodology for Medicaid & CHIP data in with the ACA enrollment post, since it ACA Expansion Medicaid overlaps with that.
Early Monday evening I received a copy of a memo that will impact thousands of institutions supported by funding from the federal government.
A copy of the memo from the Office of Management and Budget (OMB) was provided to The Handbasket at approximately 5pm ET by a source whose anonymity is being protected for fear of professional retribution. The memo was sent to the heads of executive departments and agencies with the subject, “Temporary Pause of Agency Grant, Loan, and Other Financial Assistance Programs.” I shared the news on Bluesky at 6:04pm ET, and my reporting was confirmed by the Washington Post a few hours later.
It is a truly unhinged document that sounds like it was written by the world’s most petty 4Chan poster—but then again, that’s who’s currently running our federal government. Here’s the first paragraph to get a feel for it (emphasis mine):
Below I'm posting a similar breakout of total ACA Medicaid Expansion enrollment from January 2014 - June 2024, via the Centers for Medicare & Medicaid Services quarterly Medicaid Budget & Expenditure System reports (warning: That link could be broken or blank by the time you read this under the Trump Administration).
Unfortunately, the MBES reports currently only run through June of last year, so the last half of the year is missing.
No further analysis or comment here; I just think this is a pretty cool graphic...and keep in mind that most of the people represented here would have been utterly screwed from early 2020 - early 2023 without the Affordable Care Act being in place when the pandemic hit.
Click the image for a higher-resolution version. I'm not bothering to include the state labels since some would be too difficult to make out, but it starts with Alaska at the bottom and works its way up to West Virginia at the top (remember, neither Alabama nor Wisconsin or Wyoming have expanded Medicaid under the ACA). It also includes Guam, Puerto Rico and the U.S. Virgin Islands.
Vulnerable House Republicans warn leaders against cutting Obamacare
The group of centrists also said the party needed to be careful about deep cuts to social safety net programs.
House Republicans in competitive districts warned GOP leaders Thursday: We could lose our seats if you gut Obamacare to pay for a massive border, energy and tax bill.
A group of about a dozen centrist Republicans...worry GOP efforts to pare back the Affordable Care Act could pour fuel on the fire.
...Instead, they argued, Republicans needed to embrace the GOP’s role as the working class party. Leaders would counter that message by slashing programs working Americans rely on, they said. GOP lawmakers in the room included Rep. Brian Fitzpatrick (Pa.), Young Kim (Calif.), David Valadao (Calif.), Andrew Garbarino (N.Y.), Tom Barrett (Mich.) and Don Bacon (Neb.).
On his first day in office, Donald Trump issued dozens of Executive Orders. Some of these are mostly symbolic; some won't have any effect without legislative action; some are blatantly unconstitutional & are already being challenged in court. Many, however, are terrifying and will have horrific consequences for thousands or potentially millions of Americans and non-Americans alike.
Along with issuing his own new ones, Trump has also already rescinded over 60 XOs issued by President Biden. In this post I'm going to focus on three of them which pertain specifically to healthcare policy.
Again, all three of the following have now been RESCINDED BY DONALD TRUMP:
The biggest program on the hit list, however, is Medicaid, which would make up nearly half of the $5 TRILLION in budget cuts Republicans have in mind in order to pay for...massive tax cuts for corporations & the wealthy, of course.
In October 2024, 79.3 million individuals were enrolled in Medicaid and CHIP.
72.1 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
41.7 million adults were enrolled in Medicaid, and there were 37.6 million Medicaid child and CHIP enrollees.
Medicaid and CHIP Applications Received
In October 2024, Medicaid, CHIP, Human Services agencies, and State-based Marketplaces received 2.6 million applications, or 2 percent more applications, as compared to September 2024.
The number of applications received has increased by 20 percent since October 2023 and increased by 66 percent since October 2022.
Total Medicaid/CHIP enrollment in October 2024 still dropped very slightly from September...by just 55,000 people.
