President Donald Trump’s administration has taken decisive action to overhaul ObamaCare, issuing a final rule that shortens enrollment periods, ends benefits for illegal immigrants, and cracks down on abuse in the federal health system.
This major rollback comes after years of rising costs and lax oversight under Joe Biden, who expanded the Affordable Care Act (ACA) and allowed record numbers to enroll—many of whom, critics say, were not eligible and cost taxpayers dearly.
Shorter Enrollment Window Saves Billions
Beginning this year, the federal ACA open enrollment period will be cut nearly in half. Instead of running through January 15, it will now end on December 31. This move alone is expected to save billions by reducing unnecessary or fraudulent signups.
States with their own health exchanges can still manage their timelines—but must stay within a nine-week window from November through December.
Illegal Immigrants Lose Coverage Under New Rule
In a long-awaited reversal of Biden’s open-border policies, the Trump administration is canceling ObamaCare coverage for illegal immigrants who arrived in the U.S. as minors—often referred to as “Dreamers.”
Biden’s rule would have allowed over 147,000 undocumented immigrants to enroll in taxpayer-subsidized healthcare. Trump officials say this is unfair to American citizens who are already struggling with rising premiums and limited provider networks.
Protecting American Families from Fraud and Abuse
The new rule implements tougher income verification for enrollees and closes loopholes that allowed bad actors to manipulate “special enrollment” periods—often signing people up without their knowledge.
Anyone automatically re-enrolled in a subsidized plan will now face a $5 monthly premium unless they verify or update their income information—another step to prevent wasteful spending.
CMS estimates these measures will save taxpayers up to $12 billion in 2026, by restoring accountability and ensuring only those who truly qualify receive benefits.
Gender Procedures No Longer Covered
Starting in 2026, the rule also bans taxpayer-funded plans from covering gender-altering procedures, a controversial Biden-era inclusion. This rollback will affect states that either mandated or allowed “gender-affirming care” as part of ACA coverage.
The Trump administration says essential health benefits should focus on real medical needs—not politically driven treatments.
One-Year Rule Designed to Let Congress Act
Some of the changes are set to expire in a year, giving Republicans in Congress time to pass permanent reforms and use the projected savings to support Trump’s America First tax and budget plan.
A spokesperson from CMS said the new policy “protects hardworking families, reins in out-of-control spending, and puts Americans—not illegal immigrants—first.”