The Affordable Care Act (ACA) currently supports a record high of 24 million enrollees, but upcoming changes in 2026 may complicate the enrollment process further.

As part of a significant workforce reduction, approximately 300 workers from the Centers for Medicare & Medicaid Services (CMS) will be laid off, including around 30 caseworkers, which is expected to impact consumer support.

This reduction is part of a federal initiative to decrease the Department of Health and Human Services workforce from 82,000 to 62,000, aiming to save taxpayers an estimated $1.8 billion annually.

The cuts to ACA caseworkers, often referred to as 'fixers', are particularly concerning as these individuals play a crucial role in resolving complex issues for enrollees.

Remaining caseworkers are already overwhelmed, with some managing over 45 cases a day, leading to increased workloads and longer delays in addressing consumer issues.

These staffing reductions are likely to increase wait times for enrollees facing problems, potentially delaying resolutions that were previously handled in a matter of days.

Consumer complaints regarding unauthorized enrollments and plan switches have surged, with at least 274,000 complaints filed against rogue brokers in the past year, further burdening the already strained caseworkers.

The morale of remaining staff has declined significantly, as they express concern over their ability to effectively assist consumers amidst rising case numbers.

These caseworkers, who handle intricate health insurance rules, often remain unseen by the public until issues arise, highlighting their critical role in the system.

Affected workers reported that the cuts were executed without proper notice, leaving some locked out of their systems without official communication.

These staffing changes are part of broader federal job losses across various agencies, including the CDC and FDA, reflecting a significant shift in government employment.

Former CMS officials have criticized the workforce cuts and the upcoming ACA changes, arguing they will exacerbate existing problems for consumers needing assistance.