March 6, 2025

Recent job cuts at the federal office responsible for enforcing the No Surprises Act could weaken protections against surprise medical bills. With the independent dispute resolution system already overwhelmed, experts warn that these staffing reductions may slow efforts to streamline the process and safeguard consumers from unexpected healthcare costs.

As enhanced Affordable Care Act (ACA) subsidies come to an end in 2025, individuals earning more than four times the federal poverty level—such as a 60-year-old couple making $85,000 annually—could lose subsidy eligibility and face significant premium increases. Those affected are disproportionately early retirees, self-employed individuals, and residents of rural areas, underscoring the broader implications for these demographics.

The federal government currently covers between 50% and approximately 74% of each state’s Medicaid costs, while funding 90% of expenses for newly eligible enrollees in the 41 states that expanded coverage. If these funds are reduced, states will face a difficult choice: impose significant tax increases to sustain the program or risk leaving millions without coverage.

The administration's efforts to reduce FDA headcount have caused delays in medical device approvals, potentially driving mergers and acquisitions as companies face expiring patents. Additionally, major trade policy changes with Europe under the Trump administration could further impact the healthcare industry.

The rollback of health equity guidance under Medicaid and CHIP could significantly limit states' ability to address social determinants of health, potentially worsening disparities in healthcare access and outcomes for vulnerable populations.