Now we are back to attacking the American people...
For Your Consideration
Recent disclosures from the Centers for Medicare & Medicaid Services (CMS) show that the agency canceled roughly 315,000 Affordable Care Act plans last month, affecting an estimated 760,000 people.
The stated reasons include unverified citizenship or immigration documentation and suspected improper enrollments connected to certain brokers. CMS also announced a freeze on new broker registrations and barred more than 500 brokers whose application patterns were deemed “statistically implausible.”
These actions were implemented through an emergency rulemaking process — a mechanism that allows an agency to bypass the normal public notice and comment period when it declares “good cause.”
Under this pathway, the rule is top-down feed to and drafted inside CMS, reviewed by the Department of Health and Human Services (HHS), approved by the Secretary, cleared by the Office of Management and Budget, and published immediately in the Federal Register.
Congress is not involved.
The courts are not involved.
The public is not involved.
Emergency rulemaking is meant for situations where delay would cause imminent harm. It is not typically used for routine compliance issues or documentation mismatches. Under normal circumstances, CMS conducts targeted audits, requests missing information, gives individuals time to respond, and terminates coverage only after due diligence is complete.
The sudden use of emergency authority for mass disenrollment of this scale raises questions about process. When hundreds of thousands of people lose coverage without individualized review, the consequences are not abstract.
They include interruptions in cancer treatment, gaps in insulin access, disruptions in prenatal care, and exposure to catastrophic medical debt. Even if some portion of the affected enrollments were improper, the method used ensures that many people who did nothing wrong will bear the impact.
The broker sanctions also rely on statistical anomalies rather than demonstrated intent. While fraudulent behavior should be addressed, statistical deviation alone is not evidence of misconduct. It can reflect data entry errors, system issues, or unusual population patterns. Without investigation, it is difficult to know which is which.
It is important to note that actions of this scale do not originate at the career staff level inside CMS. The agency’s technical offices do not unilaterally cancel hundreds of thousands of health plans or invoke emergency rulemaking.
Those decisions require direction from higher levels of federal leadership. Without naming any individual or political party, it is clear that the intent behind this action was not neutral. It reflects a purposeful decision made outside the normal administrative process and one that carries consequences inconsistent with the welfare of the public the agency is meant to serve.
Bottom line: the decision to force this issue from the very top-down harms both the stability and the health of the public.
The question that remains, and the one worth serious consideration, is simple: who benefits from an act that places so many people at risk, and how do they benefit?
Recent disclosures from the Centers for Medicare & Medicaid Services (CMS) show that the agency canceled roughly 315,000 Affordable Care Act plans last month, affecting an estimated 760,000 people.
The stated reasons include unverified citizenship or immigration documentation and suspected improper enrollments connected to certain brokers. CMS also announced a freeze on new broker registrations and barred more than 500 brokers whose application patterns were deemed “statistically implausible.”
These actions were implemented through an emergency rulemaking process — a mechanism that allows an agency to bypass the normal public notice and comment period when it declares “good cause.”
Under this pathway, the rule is top-down feed to and drafted inside CMS, reviewed by the Department of Health and Human Services (HHS), approved by the Secretary, cleared by the Office of Management and Budget, and published immediately in the Federal Register.
Congress is not involved.
The courts are not involved.
The public is not involved.
Emergency rulemaking is meant for situations where delay would cause imminent harm. It is not typically used for routine compliance issues or documentation mismatches. Under normal circumstances, CMS conducts targeted audits, requests missing information, gives individuals time to respond, and terminates coverage only after due diligence is complete.
The sudden use of emergency authority for mass disenrollment of this scale raises questions about process. When hundreds of thousands of people lose coverage without individualized review, the consequences are not abstract.
They include interruptions in cancer treatment, gaps in insulin access, disruptions in prenatal care, and exposure to catastrophic medical debt. Even if some portion of the affected enrollments were improper, the method used ensures that many people who did nothing wrong will bear the impact.
The broker sanctions also rely on statistical anomalies rather than demonstrated intent. While fraudulent behavior should be addressed, statistical deviation alone is not evidence of misconduct. It can reflect data entry errors, system issues, or unusual population patterns. Without investigation, it is difficult to know which is which.
It is important to note that actions of this scale do not originate at the career staff level inside CMS. The agency’s technical offices do not unilaterally cancel hundreds of thousands of health plans or invoke emergency rulemaking.
Those decisions require direction from higher levels of federal leadership. Without naming any individual or political party, it is clear that the intent behind this action was not neutral. It reflects a purposeful decision made outside the normal administrative process and one that carries consequences inconsistent with the welfare of the public the agency is meant to serve.
Bottom line: the decision to force this issue from the very top-down harms both the stability and the health of the public.
The question that remains, and the one worth serious consideration, is simple: who benefits from an act that places so many people at risk, and how do they benefit?
