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The Brief

The most important stories for you to know today
  • Newsom signs law walking back on data sharing
    A low angle view of a sign that reads "Double your CalFresh Dollars. Duplique su dolares de CalFresh. Get More Fruits & Vegetables." In the background, people are looking at items at a table in a stall.
    A sign advertising “Market Match,” a program that matches CalFresh benefits up to $10 for purchasing fruits and vegetables, at the Ecology Center farmers market in North Berkeley on July 11, 2019.

    Topline:

    The governor has signed a law that will walk back data sharing meant to increase CalFresh recipients. The new limitations are in response to the federal government’s attempts to collect private data.

    More details: On Monday, Gov. Gavin Newsom signed Assembly Bill 593 by Assemblymember Buffy Wicks, a Democrat from Oakland, that forbids state and local departments from sharing sensitive personal data to increase food stamp enrollment.

    Some background: But only a year ago, it was Wicks who introduced that same data sharing initiative, to get more people enrolled in CalFresh, the state’s federally funded food assistance program. Her bill from last year, Assembly Bill 518, granted state and local public entities involved in education, crime, employment, and other areas the authority to override all state privacy laws to share data about people who could potentially get CalFresh.

    Read on... more about the new law.

    A law that allowed the sharing of limitless amounts of personal data across the state to find people eligible for CalFresh was rescinded this week.

    On Monday, Gov. Gavin Newsom signed Assembly Bill 593 by Assemblymember Buffy Wicks, a Democrat from Oakland, that forbids state and local departments from sharing sensitive personal data to increase food stamp enrollment.

    But only a year ago, it was Wicks who introduced that same data sharing initiative, to get more people enrolled in CalFresh, the state's federally funded food assistance program. Her bill from last year, Assembly Bill 518, granted state and local public entities involved in education, crime, employment, and other areas the authority to override all state privacy laws to share data about people who could potentially get CalFresh.

    CalFresh is funded by the federal government, run by the state Department of Social Services and administered locally. Over 1 in 5 Californians are food insecure. About 5 million Californians are CalFresh recipients, and the state estimates almost 2 million more are eligible and haven’t signed up.

    Around 200,000 college students in California receive CalFresh, according to the California Department of Social Services. All recipients must complete an application process many consider time-consuming and confusing.

    In May, 20,000 college students applied for CalFresh, and over half of the applications were denied, often because the student couldn’t prove they were eligible, according to the social services department. CalFresh coordinators say students are unaware of their own eligibility, making outreach important. Through data sharing, Wicks intended to identify demographic groups as well as individuals who are eligible for CalFresh, and develop marketing that would appeal to them.

    Reversing course on data sharing

    In July, Wicks told a Senate committee she had changed her strategy to ensure data could not be shared beyond what is necessary for CalFresh outreach.

    She said limitations on data sharing were increasingly important as the “federal government is attempting to weaponize state data to actively prosecute a subset of Californians.” In June, the federal government shared Medicaid data with the Department of Homeland Security for the stated purpose of monitoring alleged Medicaid fraud. In September, Newsom signed Senate Bill 81, which protects medical data from immigration authorities, effective immediately.

    The feds have also asked for CalFresh data. In May, the U.S. Department of Agriculture requested all state agencies send names, addresses and Social Security numbers of people who either received or applied for food assistance, as well as the calculated value of all the benefits allotted over time. The department cited an executive order by President Donald Trump as the basis for the request.

    California’s Attorney General Rob Bonta and others representing Democratic states sued the Trump administration in July to prevent this data collection. On Oct. 15, a Northern California court issued a preliminary injunction temporarily blocking the transfer of CalFresh recipient data to the agriculture department.

    Using data to help food stamp access

    The previous law that allowed data sharing was originally written to expand paid family leave, but the bill was deactivated in September 2023. Wicks and co-author Assemblymember Corey Jackson, a Democrat from Riverside, reintroduced the bill in late August 2024, with an entirely new focus on CalFresh. Within one month, it passed both the Assembly and the Senate and was approved by the governor.

    The law granted state and local entities the authority to flag Californians eligible for CalFresh, allowing them to bypass all existing state laws to do so. The law authorized departments overseeing justice, veteran services, employment, financial aid, and homelessness, as well as all three public higher education systems, to share data. Types of data included utility bills, criminal records, immigration and tax records, and health information.

    There was no limit on what kinds of information could be shared, which Bill Essayli, acting U.S. Central District Attorney and former Republican assemblymember representing the 63rd Assembly District, criticized.

    End Child Poverty California, an advocacy network fighting to eradicate poverty, supported the previous law, saying data sharing could streamline CalFresh enrollment. If the state were provided data, they argued, households wouldn’t have to submit their own verification proving their food stamp eligibility, which could speed up the process.

    Though the original law was entered late in the 2024 session, it garnered several opponents, including the ACLU, the Electronic Frontier Foundation, and Oakland Privacy. The latter group argued to the Senate that the “preposterously broad” bill didn’t let Californians opt in or out of data sharing.

    Assemblymember Alex Lee, a Democrat from San Jose, concurred with Oakland Privacy that the bill was “far too broad.”

    “I'm deeply concerned how this will impact low-income individuals,” Lee had said on the Assembly floor. “This population deserves the same privacy as everyone in this room.”

    Lee as well as Essayli took issue with the gut-and-amend process that allowed the legislators to completely change the bill without approval from any Assembly policy committees. When bills are rushed in this way, Essayli said, they “can have unintended consequences.”

    However, Wicks promised to add clauses limiting the bill’s scope during the following year. Four assemblymembers voted no on the bill, three of them Republicans and the last one being Lee. Newsom signed the bill into law on Sept. 28, 2024.

    Clean-up leads to limitations

    Wicks proposed initial drafts of the clean-up bill in early 2025. Early drafts set some limits on the scope of shareable data, but were “pretty weak,” according to Tracy Rosenberg, advocacy director for Oakland Privacy.

    Another draft of the bill removed the sharing of public data related to income and health. It also required the data only be used for CalFresh outreach, facilitating enrollment, and measuring impact. To Rosenberg, this “catch-all” language was still too broad, and still would have “justified… using the data for all kinds of things.”

    Oakland Privacy collaborated with Wicks to draft this year’s bill, and Rosenberg noted Wicks was very open to protecting people’s privacy. “We think the changing political environment probably played a role,” she said.

    As proven by federal probes into Medi-Cal data, Rosenberg said, California’s social services department couldn’t guarantee their data was safe from federal interference. “That was certainly a concern in 2024, but it’s a much bigger concern in 2025,” she said.

    Finally, after facing Senate amendments, the last bill draft removed authorization for the data sharing entirely. The bill passed the Senate and Assembly with only two dissenting votes in total, and was signed by Newsom and chaptered into law on Oct. 13.

    CalFresh data is crucial for colleges

    Not all aspects of the data sharing law were rescinded this week. For example, the state social services department is still tasked with developing a methodology for estimating the rate of CalFresh participation, to be released to the public each year.

    The department will also determine the typical characteristics of people who are CalFresh-eligible, including but not limited to “race, ethnicity, preferred language, age, and location.” The department is required to develop marketing schemes that correspond to these demographics. Promoting CalFresh in underserved communities could make for more “equitable” SNAP access, Jackson said.

    The department is also required to identify all public data sets that could name potential CalFresh participants.

    State social services will not receive county data under this new law. But according to the people who run CalFresh programs at colleges and universities, analyzing participation is critical at the local level.

    At Cal Poly San Luis Obispo, almost 30% of all students are on CalFresh, according to Olivia Watts, program manager of CalFresh outreach at the university. She largely attributes the program’s success to their close relationship with the San Luis Obispo Department of Social Services.

    Through the data provided by that department, the university learned that half of all CalFresh applicants in the county are its students.

    The data they receive is scrubbed of personal information, Watts said. It’s just numbers, which she said are integral to CalFresh functionality. “Without knowing how many students are enrolled, it makes it difficult for us to do our job, to really see, are we making progress?”

    Other university programs strive for that kind of open information. Amy Gonzales, Cal Fresh director at Chico State, has repeatedly requested CalFresh participation data from her local social services department in Butte County. They rejected the requests.

    But according to Tiffany Rowe, director of Butte County’s Department of Employment and Social Services, the department doesn’t have direct access to that data, and would have to request it from the state. If they had that data, she said, they wouldn’t deny Chico State’s access.

    With access to data, Gonzales said, the CalFresh program at Chico State could improve its outreach initiatives. They could attempt to target student groups that are eligible but under-enrolled.

    Gonzales would be “all about” data sharing, even across the state, as long as the information is shared with “trusted” agencies. “I think it can be very beneficial to share that eligibility data,” she said, and flag people for different social service programs based on their characteristics.

    Still, Gonzales manages to conduct outreach without countywide data. At Chico State, she partners with some of the college’s academic programs and workplaces to find students eligible for CalFresh.

    College students are eligible for food assistance based on their participation in employment training programs. Certain majors count toward this criteria. Students are often unaware of their eligibility, which is why targeted outreach is important, Gonzales said.

    But though she’d appreciate data on eligible people, “I do have concerns with data sharing, given the current administration’s priorities and what they have requested,” she said.

    Watts and Gonzales both help students at their universities with CalFresh applications. They both said they wish that all college students were automatically eligible for the program.

    Under the new law, counties can continue to harvest data about the efficacy of their own CalFresh programs. They’re just prevented from sharing data on eligible individuals with the state. But interagency relationships at local levels, Watts said, need to be protected.

    “We’ve had a lot of success… because of our ability to share data, and communicate in these ways, and problem-solve together,” Watts said.

    Phoebe Huss is a contributor with the College Journalism Network, a collaboration between CalMatters and student journalists from across California. CalMatters higher education coverage is supported by a grant from the College Futures Foundation.

    This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

  • 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.