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The Brief

The most important stories for you to know today
  • Corrections officers are leaving in droves for ICE
    A two-story building with bars on the windows is visible beyond a barbed wire and chainlink fence.
    The Federal Correctional Institution (FCI) Terminal Island photographed in September.

    Topline:

    After years of struggling to find enough workers for some of the nation’s toughest lockups, the Federal Bureau of Prisons is facing a new challenge: Corrections officers are jumping ship for more lucrative jobs at Immigration and Customs Enforcement.

    Why now: This is one of the unintended consequences of the Trump administration’s focus on mass deportations. For months, ICE has been on a recruiting blitz, offering $50,000 starting bonuses and tuition reimbursement at an agency that has long offered better pay than the federal prison system. For many corrections officers, it’s been an easy sell.

    Why it matters: The exodus — at detention centers and maximum-security prisons from Florida to Minnesota to California — comes amid shortages of critical supplies, from food to personal hygiene items, and threatens to make the already grim conditions in federal prisons even worse.

    After years of struggling to find enough workers for some of the nation’s toughest lockups, the Federal Bureau of Prisons is facing a new challenge: Corrections officers are jumping ship for more lucrative jobs at Immigration and Customs Enforcement.

    This is one of the unintended consequences of the Trump administration’s focus on mass deportations. For months, ICE has been on a recruiting blitz, offering $50,000 starting bonuses and tuition reimbursement at an agency that has long offered better pay than the federal prison system. For many corrections officers, it’s been an easy sell.

    Workers at detention centers and maximum-security prisons from Florida to Minnesota to California counted off the number of co-workers who’d left for ICE or were in the process of doing so. Six at one lockup in Texas, eight at another. More than a dozen at one California facility, and over four dozen at a larger one. After retirements and other attrition, by the start of November the agency had lost at least 1,400 more staff this year than it had hired, according to internal prison data shared with ProPublica.

    “We’re broken and we’re being poached by ICE,” one official with the prison workers union told ProPublica. “It’s unbelievable. People are leaving in droves.”

    The exodus comes amid shortages of critical supplies, from food to personal hygiene items, and threatens to make the already grim conditions in federal prisons even worse. Fewer corrections officers means more lockdowns, less programming and fewer health care services for inmates, along with more risks to staff and more grueling hours of mandatory overtime. Prison teachers and medical staff are being forced to step in as corrections officers on a regular basis.

    And at some facilities, staff said the agency had even stopped providing basic hygiene items for officers, such as paper towels, soap and toilet paper.

    “I have never seen it like this in all my 25 years,” an officer in Texas told ProPublica. “You have to literally go around carrying your own roll of toilet paper. No paper towels, you have to bring your own stuff. No soap. I even ordered little sheets that you put in an envelope and it turns to soap because there wasn’t any soap.”

    The prisons bureau did not answer a series of emailed questions. In a video posted Wednesday afternoon, Deputy Director Josh Smith said that the agency was “left in shambles by the previous administration” and would take years to repair. Staffing levels, he said, were “catastrophic,” which, along with crumbling infrastructure and corruption, had made the prisons less safe.

    Smith said that he and Director William Marshall III had been empowered by the Trump administration to “confront these challenges head-on,” adding, “Transparency and accountability are the cornerstones of our mission to make the BOP great again, and we’re going to expose the truth and hold those responsible accountable.”

    ICE, meanwhile, responded to a request for comment by forwarding a press release that failed to answer specific questions but noted that the agency had made more than 18,000 total tentative job offers as of mid-September.


    The BOP has long faced challenges, from sex abuse scandals and contraband problems to crumbling infrastructure and poor medical care. It has repeatedly been deemed the worst federal workplace by one analysis of annual employee surveys, and in 2023 union officials said that some 40% of corrections officer jobs sat vacant.

    That dearth of officers helped land the prison system on a government list of high-risk agencies with serious vulnerabilities and attracted the eye of oversight officials, who blamed chronic understaffing for contributing to at least 30 prisoner deaths.

    The bureau tried tackling the problem with a long-term hiring push that included signing bonuses, retention pay and a fast-tracked hiring process. By the start of the year, that effort seemed to be working.

    Kathleen Toomey, then the bureau’s associate deputy director, told members of Congress in February that the agency had just enjoyed its most successful hiring spree in a decade, increasing its ranks by more than 1,200 in 2024.

    “Higher staffing levels make institutions safer,” she told a House appropriations subcommittee.

    But the costly efforts to reel in more staff strained a stagnant budget that was already stretched thin. Toomey told Congress the bureau had not seen a funding increase since 2023, even as it absorbed millions in pay raises and retention incentives. As inflation and personnel costs rose, the bureau was forced to cut its operating budgets by 20%, Toomey said.

    And despite some improvement, the staffing problems persisted. In her February testimony, Toomey acknowledged there were still at least 4,000 vacant positions, leaving the agency with so few officers that prison teachers, nurses and electricians were regularly being ordered to abandon their normal duties and fill in as corrections officers.

    Then ICE rolled out its recruiting drive.

    “At first it seemed like it was going to be no big deal, and then over the last week or so we already lost five, and then we have another 10 to 15 in various stages of waiting for a start date,” an employee at one low-security facility told ProPublica in October. “For us that’s almost 20% of our custody staff.”

    He, like most of the prison workers and union officials who spoke to ProPublica, asked to remain anonymous for fear of retaliation — a concern that has grown since the agency canceled the union’s contract in September following an executive order. Now union leaders say they’ve been warned that without their union protections, they could be punished for speaking to the media.

    After the contract’s cancellation, many of the current staff who had originally spoken on the record asked to have their names withheld. Those who still agreed to be identified asked ProPublica to note that their interviews took place before the agency revoked the union agreement.

    Earlier this year, Brandy Moore White, national president of the prison workers union, said it’s not unprecedented to see a string of prison staffers leaving the agency, often in response to changes that significantly impact their working conditions. Prior government shutdowns, changes in leadership and the pandemic all drove away workers — but usually, she said, people leaving the agency en masse tended to be near the end of their careers. Now, that’s not the case.

    “This is, from what I can remember, the biggest exodus of younger staff, staff who are not retirement-eligible,” she said. “And that’s super concerning to me.”

    ICE’s expansion has even thrown a wrench into BOP’s usual training program for rookies. Normally, new officers have to take a three-week Introduction to Correctional Techniques course at the Federal Law Enforcement Training Centers in Georgia within their first 60 days on the job, according to the prisons bureau’s website. In August, FLETC announced that it would focus only on “surge-related training,” pausing programs for other law enforcement agencies until at least early 2026, according to an internal email obtained by ProPublica. Afterward, FLETC said in a press release that it was “exploring temporary solutions” to “meet the needs of all partner agencies,” though it’s not clear whether any of those solutions have since been implemented. The centers did not respond to emailed requests for comment.


    At the same time, the effects of the budget crunch were starting to show. In recent months, more than 40 staff and prisoners at facilities across the country have reported cutbacks even more severe than the usual prison scarcities.

    In September, Moore White told ProPublica some prisons had fallen behind on utility and trash bills. At one point, she said, the prison complex in Oakdale, Louisiana, was days away from running out of food for inmates before the union — worried that hungry prisoners would be more apt to riot — intervened, nudging agency higher-ups to address the problem, an account confirmed by two other prison workers. (Officials at the prison complex declined to comment.) Elsewhere, staff and prisoners reported shortages — no eggs in a California facility and no beef in a Texas lockup where staff said they were doling out smaller portions at mealtimes.

    Earlier this year, a defense lawyer complained that the Los Angeles detention center ran out of pens for prisoners in solitary confinement, where people without phone or e-messaging privileges rely on snail mail to contact the outside world. One of his clients was “rationing his ink to write letters to his family,” the attorney said. The center didn’t respond to requests for comment.

    Personal hygiene supplies have been running low, too. Several prisoners said their facilities had become stingier than usual with toilet paper, and women incarcerated in Carswell in Texas reported a shortage of tampons. “I was told to use my socks,” one said. The facility did not answer questions from ProPublica about conditions there.

    Fewer staff has meant in some cases that inmates have lost access to care. At the prison complex in Victorville, California, staff lodged written complaints accusing the warden of skimping on the number of officers assigned to inmate hospital visits in order to cut back on overtime. (The complex did not respond to a request for comment.) In some instances, the complaints alleged, that left so few officers at the hospital that ailing inmates missed the procedures that had landed them there in the first place.

    Chyann Bratcher, a prisoner at Carswell, a medical lockup in Texas, said she missed an appointment for rectal surgery — something she’d been waiting on for two years — because there weren’t enough staff to take her there. She was able to have the procedure almost two months later, after another cancellation.

    Staffers say several facilities have started scheduling recurring “blackout” days, when officers are banned from working overtime in an effort to save money. Instead, prison officials turn to a practice known as “augmentation,” where they direct teachers, plumbers and medical staff to fill in as corrections officers.

    “That’s why I left,” said Tom Kamm, who retired in September from the federal prison in Pekin, Illinois, after 29 years with the bureau. “My job was to try to settle EEO complaints, so if somebody alleged discrimination against the agency it was my job to look into it and try to resolve it.”

    When he found out earlier this year that he would soon be required to work two shifts per week as a corrections officer, he decided to retire instead.

    “I hadn’t been an officer in a housing unit since like 2001 — it had been like 24 years,” he said. “I had really no clue how to do that anymore.”

    Augmentation isn’t new, but staff and prisoners at some facilities say it’s being used more often than it once was. It also means fewer medical staff available to address inmates’ needs. “Today we had a Physical Therapist as a unit officer so all of his PT appointments would have been cancelled,” Brian Casper, an inmate at the federal medical prison in Missouri, wrote in an email earlier this year. “Yesterday one of the other units had the head of Radiology for the unit officer so there would have been one less person doing x-rays and CT scans.” The prison didn’t respond to emailed questions.

    When the government shutdown hit in October, it only made the situation worse, exacerbating the shortages and increasing the allure of leaving the bureau. While ICE agents and corrections officers continued bringing home paychecks, thousands of prison teachers, plumbers and nurses did not.

    The so-called One Big Beautiful Bill Act, the domestic policy megabill that Trump signed into law on July 4, could offer some financial support for the agency’s staffing woes, as it will route another $5 billion to the prisons bureau over four years — $3 billion of which is specifically earmarked to improve retention, hiring and training. Yet exactly what the effects of that cash infusion will look like remains to be seen: Though the funding bill passed more than four months ago, in November the bureau declined to answer questions about when it will receive the money or how it will be spent.

  • Work to begin Monday
    A peeling chemical tank is seen next to two other intact tanks at the GKN aerospace facility in Garden grove. An RV can be seen on the right hand side peeking into the picture. An even larger tank is behind the two other tanks.
    The chemical tank at the GKN Garden Grove aerospace facility.

    Topline:

    On Monday clean up begins for two tanks of neutralized methyl methacrylate at the center of last month’s chemical incident in Garden Grove.

    The backstory: About 50,000 Orange County residents were evacuated for several days after one of the tanks overheated on May 21, generating fears of an explosion or a leak through the Memorial Day weekend.

    What's next: The cleanup will be done in phases. This phase wraps Thursday, July 2.

    Go deeper: FBI executes search warrant at site of Garden Grove chemical meltdown scare

    A hazardous materials team will begin working Monday to remove neutralized methyl methacrylate from two of three tanks at the GKN aerospace facility in Garden Grove.

    Some 50,000 Orange County residents were evacuated for several days last month after one of the tanks overheated on May 21, causing fears of an explosion or a leak through the Memorial Day weekend.

    The clean-up will be done in phases, until Thursday, “with multiple layers of safety protocols and oversight measures in place,” according to a press release from the Orange County Health Care Agency.

    Garden Grove chemical cleanup

    Updates on the cleanup activities will be posted publicly here, including air monitoring data.

    Containers that support temperature control and secure transportation will be used in the operation.

    Cleanup was initially scheduled to begin June 4, but was postponed after officials said "needed resources" were unavailable.

    Orange County District Attorney Todd Spitzer launched an investigation into the incident last month. The FBI and Environmental Protection Agency also seized evidence at the facility earlier this month.

    Methyl methacrylate produces a fruit-like odor, Orange County Health Care Agency said residents may notice the scent during the operation. The agency said levels will remain below thresholds that could pose health risks.

    Officials say environmental protection will be in place throughout the week. Air will be continuously monitored through both mobile and fixed equipment at the fence line of the facility and in the community. Air and odor monitoring based on wind conditions will also be done. Work will occur only during the daylight hours until Thursday.

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  • Budget cuts limit education access
    a number of men in blue shirts sit at desks with papers and books in front of them, many of them holding pencils
    Incarcerated people study to take the G.E.D. exam at San Quentin State Prison on July 26, 2023.

    Topline:

    California prisons are limiting access to programs for incarcerated people as the system manages it overtime budget. The state spends about $18 billion a year on corrections.

    Why now: The rollback began earlier this month and will end June 30, according to documents obtained by CalMatters. Corrections spokesperson Terri Hardy described the limitations as a “cost-saving measure.” The department’s overall budget has remained about flat since 2022 around $18 billion a year despite recent cuts that include five prison closures.

    The backstory: Lawmakers at budget hearings earlier this year pressed Corrections Secretary Jeff Macomber to tighten spending as the department asked for additional $91 million in ongoing funding to cover unbudgeted personnel costs. The department last month also proposed an additional $100 million in workers compensation.

    Read on ... for more on how these cuts will affect programs in the prisons.

    The California Department of Corrections and Rehabilitation is restricting access to rehabilitative programming for incarcerated people as it clamps down on overtime spending before the end of its financial year.

    Hundreds of rehabilitative programs operate throughout California prisons, including restorative justice, violence prevention, higher education, creative arts expression and entrepreneurial training.

    The rollback began earlier this month and will end June 30, according to documents obtained by CalMatters. Corrections spokesperson Terri Hardy described the limitations as a “cost-saving measure.” The department did not respond to a detailed list of questions, including which prisons and programs have been affected.

    The department’s overall budget has remained about flat since 2022, around $18 billion a year despite recent cuts that include five prison closures.

    Lawmakers at budget hearings earlier this year pressed Corrections Secretary Jeff Macomber to tighten spending as the department asked for additional $91 million in ongoing funding to cover unbudgeted personnel costs. The department last month also proposed an additional $100 million in workers compensation.

    The California Correctional Peace Officers Association, the union that represents state prison guards, did not respond to CalMatters’ requests for an interview.

    Tony Tafoya, who’s been incarcerated since 2012, said he’s never seen anything like this happen before. Tafoya said the scale-back has had the biggest impact on college classes. He’s currently enrolled in Mount Tamalpais College at San Quentin but said his math class has missed out on 12 days of instruction.

    “I feel like I’m falling behind,” he said. “There’s a lot of healing that comes from going to school. It provides humanity. It makes me feel like I’m actually seen as a person. I feel like that’s what’s being missed out on.”

    Programs at Pleasant Valley State Prison in Coalinga have also been interrupted, including a civic education pilot program. The program, run by the organization Initiate Justice, includes just over a dozen incarcerated people who helped draft legislation to improve social emotional learning in the K-12 school system. Assembly Bill 1851, authored by Democratic Assemblymember Mike Gipson from Gardena, is sailing through the Legislature and scheduled for an upcoming education committee hearing Wednesday.

    Antoinette Ratcliffe, executive director of Initiate Justice, said the group “thrives off of active and live discussion, off of meaningful exploration.” The severing of that connection disrupts the learning experience and practical application of the programming, she said.

    “We have made it a goal across the Legislature to make rehabilitative programming a priority, so to continue to see disruptions like this feels counter to what we agreed upon as a state,” she said. “It feels like a let down.”

    Other advocates have echoed those sentiments. Danica Rodarmel, a criminal justice reform lobbyist, said any disruption in people’s ability to access programming impacts their mental health and well being. The completion of a program or certificate, she said, is often a determining factor in people’s ability to be granted parole.

    “Limiting people’s ability to engage in pro-social activities is contradictory to the goals of maintaining safe prisons both for the people who are incarcerated but also for the people who work there,” she said.

  • Would those most at risk trust potential vaccine?
    a person in an american flag t-shirt holds up a piece of paper with red targets printed on it and which has been shot full of holes
    Matthew Mealer holds up his targets at the Busch Shooting Range in Weldon Spring, Mo., in May. Mealer said he's generally skeptical of new vaccines but might consider one for Lyme disease if it proves safe and effective.
    Topline:
    Pharmaceutical companies Pfizer and Valneva announced this spring that they plan to seek regulatory approval for a vaccine to protect against Lyme disease. But it's unclear whether this latest stab at a Lyme disease vaccine will get a warmer reception if it's approved, especially in the post-COVID era of vaccine skepticism.

    Why it matters: About 476,000 people in the U.S. may be diagnosed and treated for Lyme disease each year, the CDC says. Left untreated, Lyme disease can cause a variety of symptoms, from fevers, chills and headaches to arthritis, shooting pains and inflammation of the brain and spinal cord.

    Read on ... to see what rural hunters in Missouri think about the possibility of a vaccine and for their stories of how the disease has affected them personally.

    It's tick season, possibly the worst in a decade.

    More and more Americans are being exposed to these parasites as climate change expands the range where they can survive. That means more people are also exposed to the bevy of health conditions they can cause, such as Rocky Mountain spotted fever, the alpha-gal-triggered red meat allergy and, most common of all, Lyme disease.

    For Lyme disease, there may be some additional protection on the horizon. Pharmaceutical companies Pfizer and Valneva announced this spring that they plan to seek regulatory approval for a vaccine to protect against Lyme disease. A previous vaccine for Lyme became available in the late 1990s but was pulled only three years later due to lawsuits, public fear of side effects and a lack of interest.

    It's unclear whether this latest stab at a Lyme disease vaccine will get a warmer reception if it's approved, especially in the post-COVID era of vaccine skepticism.

    For a sense of how it might go over with rural populations at high risk of Lyme, KFF Health News spoke with a group of hunters.

    Few people spend more time in the woods exposed to ticks. At the same time, as a collective, hunters  skew conservative, rural and male, according to a survey from the Theodore Roosevelt Conservation Partnership. And these are identities associated with increased hesitancy about or resistance to vaccines, according to Ashley Kirzinger, associate director for Public Opinion and Survey Research at KFF, a health information nonprofit that includes KFF Health News.

    Targets for ticks

    Left untreated, Lyme can cause a variety of symptoms, from fevers, chills and headaches to arthritis, shooting pains and inflammation of the brain and spinal cord, according to the Centers for Disease Control and Prevention.

    About 476,000 people in the U.S. may be diagnosed and treated for Lyme disease each year, the CDC says. That's at least in part because the range of places where cases have been reported has "expanded significantly" since 1995.

    So would hunters get the Lyme vaccine if it became available?

    "Given my proclivity for the outdoors, absolutely," said Jess Manganelli, one of seven hunters (and one hiker) who spoke with KFF Health News on a recent Saturday at the Busch Shooting Range in Weldon Spring, Mo., just outside of St. Louis.

    Of the eight, Manganelli, who had been hunting turkeys the weekend before, was the most positive about the vaccine. Six others said they would consider it but would want more information about its safety and effectiveness, as well as their risk for contracting the disease.

    But Manganelli was the only one who believed she may have previously contracted Lyme disease, although she was never formally diagnosed with it. Two years ago, she experienced muscle weakness, tiredness, fatigue, swelling and headaches after a tick bite, but when she went to urgent care, she was told they didn't test for Lyme.

    Nearly all the hunters knew someone who had had Lyme disease — an old roommate, a family member, friends, a former student. Lyme can be difficult to diagnose and to treat and is often misdiagnosed at first. Many of the hunters witnessed their acquaintances navigating those challenges and struggling with sometimes debilitating symptoms.

    An illness with lingering effects

    That familiarity among the hunters in Missouri was unsurprising to author and conservationist Steven Rinella, host of the hunting show MeatEater.

    "I'm a turkey hunter. In talking about turkey hunting, you talk about ticks as much as you talk about turkeys," Rinella said. "Just the nature of turkey hunting puts you into exposure. You're sitting for long periods of time, trying to use vegetation for concealment."

    In fact, both Rinella and his older son contracted Lyme disease 13 years ago during a bluegill fishing trip in the Hudson Valley in New York. His son developed Bell's palsy, a sudden paralysis on one side of the face, but recovered quickly after a course of oral antibiotics. Steven Rinella's symptoms, on the other hand, lingered for months, leaving him unable to walk down stairs without a handrail or to ride a bike. He ended up receiving intravenous antibiotic treatments for a month.

    "I thought my life had changed," Rinella said, "but I recovered, as far as I know."

    That experience is one reason Rinella said he would absolutely consider getting a Lyme vaccine if it proved safe and provided considerable protection against the disease. Unlike with some other diseases, prior infection does not provide permanent immunity, so a person who has had Lyme could still benefit from a vaccine.

    Knowledge of similar challenges influenced the thinking of the hunters in Missouri as well.

    Jeremy Hollingshead said he may be less inclined to take a vaccine owing to his former roommate's experience with Lyme disease, which is not to say the experience was pleasant. In fact, Hollingshead said he thinks his old pal is still dealing with lingering effects of it 10 years later. But Hollingshead has spent his whole life in the woods, and of hundreds of people he knows who have done the same, he knows of only one of them contracting Lyme.

    "I know it was a bad outcome for him," Hollingshead said, but he thinks the odds of getting Lyme himself seem pretty slim.

    Meanwhile, Julian Barnes said seeing a relative struggle with Lyme makes him more open to a potential vaccine. It took a long time for doctors to come to that diagnosis, and finding a good treatment has been equally difficult.

    "I would say I am vaccine-hesitant, generally speaking," Barnes said. "But Lyme, I've seen the way it affects people in my life. ... I would definitely have to really understand the vaccine, how it works."

    An unclear path for a new vaccine

    The new, four-dose vaccine candidate technically missed one of the bars set out in trials because not enough participants contracted Lyme. Still, the companies say it's about 75% effective in reducing cases, and they plan to submit it to regulators for approval. A Pfizer spokesperson said there were no updates on their regulatory efforts when contacted by KFF Health News in June.

    Health and Human Services Secretary Robert F. Kennedy Jr. was a noted anti-vaccine activist before taking over as head the agency that oversees vaccine approvals, and he's remade it in ways that have prompted some vaccine makers to pull back on development.

    But he's also been an advocate on Lyme disease. In May, he announced an initiative to combat Lyme disease. And during his Senate confirmation hearings, he said his family had been deeply affected by Lyme disease and that nobody would work harder than he would to find a vaccine or treatment.

    If the vaccine is ultimately approved by the FDA, an endorsement from Kennedy would go a long way, according to KFF's Kirzinger, particularly among supporters of his Make America Healthy Again movement, who tend to be more vaccine-skeptical.

    "They trust him as much as they trust their own doctors to tell them what to do with their health and for health information," Kirzinger said. "If he comes out as a strong proponent of this vaccine and says, 'Look what my administration did, and we made this available,' I would imagine there would be less vaccine resistance among that group."

    Only one of the hunters who spoke with KFF Health News said they definitely would not be interested in a Lyme vaccine if it became available.

    "I kind of hand it off to God and the body he gave me. I'm pretty durable," JP Cummings said. But even though he's not interested in it for himself, he's curious to see what his fellow hunters do as more information comes out.

    "Hunters care about the wildlife; hunters care about health," Cummings said. "They love the wildlife, they love their deer, and they love their fellow hunters."

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF.

  • Steep price increase likely to blame
    The federal government released data on how many people dropped coverage in the 29 states that use the HealthCare.gov marketplace for ACA insurance.

    Topline:

    Five million fewer people are currently enrolled in ACA marketplace plans compared to the record high reached last year. More than 1 million fewer people picked a plan for 2026, and then 4 million more either disenrolled or failed to pay their premiums and, therefore, dropped coverage.

    Why now: Prices in the market skyrocketed after President Donald Trump and Republicans in Congress failed to extend extra financial help for enrollees last year. The Department of Health and Human Services published a report about the data on its website Friday.

    What's next: People dropping their coverage tend to be healthier people. If too many healthy people drop out of the markets, there's a danger that the markets could enter a "death spiral."

    Read on ... for more on the latest insurance market trends.

    Far more people than previously known have dropped Affordable Care Act health insurance for 2026, according to data released Friday.

    Five million fewer people are currently enrolled in ACA marketplace plans compared to the record high reached last year. More than 1 million fewer people picked a plan for 2026, and then 4 million more either disenrolled or failed to pay their premiums and, therefore, dropped coverage.

    Prices in the market skyrocketed after President Donald Trump and Republicans in Congress failed to extend extra financial help for enrollees last year. The Department of Health and Human Services published a report about the data on its website Friday.

    The report says 19.2 million people are currently enrolled in ACA insurance now.

    At its high, 24.2 million people were in the ACA marketplace in 2025, according to government figures.

    The steep drop in enrollment reflects what insurers, administrators and other health policy experts expected earlier this year. After initial sign ups were lower than last year, they predicted the picture would get worse as time went on and people found they could not afford to pay their premiums.

    "The main takeaway is that enrollment is down 13% from last year," explains Cynthia Cox, director of KFF's Program on the ACA. "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced double- or even triple-digit increases in their premium payments with the expiration of enhanced tax credits."

    The idea that the growth in enrollment was due to massive fraud is a theory advanced by the Paragon Health Institute, a conservative think tank influential in the Trump administration.

    Many health policy experts are skeptical. They say the increase in enrollment during the pandemic is not suspicious. It was a predictable consequence of Congress's investment of billions of federal dollars in making premiums more affordable — the enhanced premium tax credits.

    "The marketplace doubled in size during the period when there were enhanced subsidies because the coverage was much more affordable and much more appealing to people," Cox says.

    This year's drop in enrollment is also predictable, given that premium costs doubled, on average, from 2025 to 2026. The costs went up after Republican lawmakers let the enhanced premium tax credits expire; Democrats shut down the government in October 2025 trying to negotiate an extension of the credits that would have kept prices low.

    "When their costs went up, many of them dropped their coverage," Cox says.

    She adds that while fraud is a real problem in the ACA marketplaces, as it is in all insurance markets, she thinks it does not account for all of the drop in enrollment.

    Stacey Pogue, senior research fellow at the Georgetown Center on Health Insurance Reforms, agrees.

    "I don't see data that point to that conclusion that a 5 million-person drop can be explained by allegations of fraud," she says. "There's lots of evidence pointing to people making decisions based on what they can pay each month."

    The higher health insurance costs are tough for consumers in an economy still plagued by overall inflation. As congress let the prices go up, people made tough decisions about family budgets, where to work, whom to marry and more.

    It's also a problem for insurance companies, several of which have announced they will not be participating in ACA markets next year, including Cigna.

    "If there are fewer customers, then that makes the market less appealing to insurance companies," Cox says.

    That's especially true because the people dropping their coverage tend to be healthier people. If too many healthy people drop out of the markets, there's a danger that the markets could enter a "death spiral."

    Cox says she's not worried about a death spiral at this point.

    "I think there are still enough people buying ACA marketplace coverage and that's going to keep these markets working," she says. "At this point, we don't see any parts of the country that are at risk of having no insurance company. If that were to happen, that would be what a death spiral might look like."

    Even so, the premiums for these plans are on track to keep rising, which could continue to pummel consumers navigating high health care costs. Enrollment in the marketplaces may continue to shrink too. According to a recent analysis from Pogue at Georgetown, early insurance rate filings for 2027 show that rates will be going up again next year.