Help for ACA health plans could be harder to come by since RFK axed teams of 'fixers'

Source: NPR

April 22, 2025 5:00 AM ET


They're the fixers, the ones who step in when Affordable Care Act enrollees have a problem with their coverage, like a newborn incorrectly left off a policy or discovering that a rogue broker had signed them up or switched their plan without consent. Specially trained caseworkers help resolve such issues, which might otherwise cause consumers to rack up large doctors' bills or prevent them or their family members from getting care.

Now, though, the broad federal reduction in force set in motion by the Trump administration has cut the ranks of those caseworkers, slashing two out of six divisions of caseworkers, according to one affected worker and a former Centers for Medicare & Medicaid Services official familiar with the situation, Jeffrey Grant.

Currently, the number of ACA enrollees is at an all-time high of 24 million. The ACA — known as Obamacare — has long drawn disfavor from Republicans and Trump himself. The health law faces additional changes next year that, if adopted, could sow confusion and more problems. Consumers would face a new learning curve with extra paperwork and rules. And the caseworker cuts might extend the time needed to resolve any difficulties.

"It impacts not only our jobs, but all these people we serve," said one New York City-based caseworker, who was let go in a Feb. 14 purge affecting federal employees in their probationary periods. "Usually, we would have on average 14 days to take care of a case that was very difficult, although the urgent cases would be solved within two to three business days. It will now be delayed so much more. Whole teams got wiped out completely."

Read more: https://www.npr.org/sections/shots-health-news/2025/04/22/nx-s1-5371672/cms-aca-hhs-federal-layoffs