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Sarah Lueck

@sarahl202.bsky.social
1.5K followers 417 following 217 posts

VP for Health Policy at the Center on Budget and Policy Priorities. DSM native and @WSJ alumna. Views expressed here are mine. she/her

PostsRepliesMedia
Sarah Lueck @sarahl202.bsky.social · 22/09/2026
It’s surreal to see federal officials take a victory lap today for cancelling hundreds of thousands of marketplace enrollments, while massive health coverage losses are underway. www.nytimes.com/2026/09/22/h...
nytimes.com
Trump Officials Eject 750,000 From Obamacare Markets, Claiming Fraud
Vice President JD Vance said the measure would save the government $2.2 billion.
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Claire Heyison @claireheyison.bsky.social · 10/09/2026
Millions are losing health coverage or will soon because of the expiration of PTC enhancements, the Medicaid work requirement, and other harmful Republican policies. This proposal from President Trump for $500 cash payments would do nothing to help them. thehill.com/policy/healt...
thehill.com
Trump pledges $500 ObamaCare rebate checks
The Trump administration is pledging to send $500 rebate checks to nearly 1 million Americans who the White House says were overcharged for ObamaCare coverage.  In a recorded message post…
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Sarah Lueck @sarahl202.bsky.social · 08/09/2026
The 2025 Republican reconciliation law cut more than $900 billion from Medicaid, taking coverage away from millions of people and increasing pressure on state budgets. Now, a series of Trump Administration actions will worsen these harms. www.cbpp.org/blog/adminis...
cbpp.org
Administration Policies Go Beyond 2025 Republican Reconciliation Law, Deepening Its Harm
Recent policies from the Centers for Medicare & Medicaid Services (CMS) on the Medicaid work requirement and approaches states use to finance their Medicaid programs, pay their providers, and innovate...
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Sarah Lueck @sarahl202.bsky.social · 01/09/2026
More evidence of the harm of the 2025 Republican reconciliation law: The provision blocking people from Medicaid if they don't meet a work requirement will penalize some people who are hospitalized or looking for work. www.cbpp.org/blog/falling...
cbpp.org
Falling Through the Cracks: Major Gaps in Medicaid Work Requirement Policy
The work requirement could take away or block coverage from people who are looking for work, who are hospitalized, or who miss deadlines through no fault of their own. Conditioning medical care, a bas...
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Sarah Lueck @sarahl202.bsky.social · 31/07/2026
1/ A court ruling this week allowed the federal Medicaid work requirement to proceed for now. That doesn’t change the fact that the Administration can take steps to prevent some people, including those with serious illnesses, from losing coverage under this harmful policy.
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Claire Heyison @claireheyison.bsky.social · 01/07/2026
New CMS data confirms large enrollment drops after Congressional Republicans and President Trump let PTC enhancements expire last year. ~3 million people dropped coverage between 2025 and 2026. More will likely follow suit as premiums stack up throughout the year. www.cbpp.org/blog/nearly-...
cbpp.org
Nearly 3 Million Fewer People Secured Marketplace Coverage After Republican Health Care Cuts, New Data Show
This is the largest drop in effectuated enrollment since the ACA marketplaces were established.
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Sarah Lueck @sarahl202.bsky.social · 01/07/2026
Sadly, this is only the start. Republican health care cuts will take away coverage from millions. Nearly Three Million Fewer People Enrolled in Marketplace Coverage After Affordability Cuts www.cbpp.org/media/76680
cbpp.org
Nearly Three Million Fewer People Enrolled in Marketplace Coverage After Affordability Cuts
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Sarah Lueck @sarahl202.bsky.social · 27/06/2026
Another unfortunate data point: fewer people enrolled in marketplace plans.
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Nicole Rapfogel @nicolerapfogel.bsky.social · 25/06/2026
With millions struggling to afford health care and coverage, Trump and Republicans in Congress have once again pointed to expanding health savings accounts (HSAs) as a solution. But HSAs don’t solve affordability problem. Here are 5 reasons why: 🧵
cbpp.org
Five Reasons HSAs Aren’t the Answer to the Health Care Affordability Crisis
In the wake of their actions that have worsened health care affordability, President Trump and some in Congress have pushed expanding health savings accounts (HSAs). The problem is HSAs are not the an...
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Sarah Lueck @sarahl202.bsky.social · 25/06/2026
As some House Rs call for reconciliation 3.0, many want to expand health savings accounts. But HSAs mainly benefit higher-income people, and they do little to improve affordability for those struggling the most with health costs. read more by @nicolerapfogel.bsky.social www.cbpp.org/blog/five-re...
cbpp.org
Five Reasons HSAs Aren’t the Answer to the Health Care Affordability Crisis
In the wake of their actions that have worsened health care affordability, President Trump and some in Congress have pushed expanding health savings accounts (HSAs). The problem is HSAs are not the an...
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Sarah Lueck @sarahl202.bsky.social · 24/06/2026
The fed govt isn't supposed to issue a rule unless its benefits outweigh its costs.So what to do about the terrible policy that takes away health coverage from people not meeting a work requirement?Ignore key research, make unrealistic assumptions.@gidlukens.bsky.social www.cbpp.org/research/hea...
cbpp.org
Analysis Justifying Trump Administration’s Medicaid Work Requirement Rule Is Deeply Flawed
The 2025 reconciliation law instituted a harmful policy taking Medicaid coverage away from people not meeting a harsh work requirement, and the Trump Administration recently finalized a rule that...
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Gideon Lukens @gidlukens.bsky.social · 12/06/2026
Directly funding cost-sharing reductions (CSRs), as Republicans are apparently considering, would INCREASE out-of-pocket premiums for millions of #ACA marketplace enrollees, cut funding by tens of billions of $, and leave hundreds of thousands of ppl uninsured.
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Sarah Lueck @sarahl202.bsky.social · 01/06/2026
We just moved a step closer to a Medicaid work requirement, a major cut made by last year’s Republican reconciliation law that will take away health coverage from millions of people. The Trump administration issued a rule that makes bad policy even worse. www.cms.gov/newsroom/fac...
cms.gov
Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC) | CMS
Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC)
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Sarah Lueck @sarahl202.bsky.social · 29/05/2026
@centeronbudget.bsky.social is a proud partner of @onenationovercharged.com. People across the country are standing up and fighting to get healthcare right. Join the movement and sign up today ➡️ONENATIONOVERCHARGED.COM
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Gideon Lukens @gidlukens.bsky.social · 22/04/2026
Make no mistake: CBO continues to estimate huge cuts to #Medicaid from OBBBA, last year’s reconciliation bill, despite Trump Admin officials’ false claims otherwise. In fact, CBO projects that 7 million ppl will lose #ACA Medicaid expansion coverage from 2025 to 2032.
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Claire Heyison @claireheyison.bsky.social · 15/04/2026
Following the expiration of PTC enhancements, #ACA marketplace plan selections dropped by 1.2 million during the 2026 open enrollment period. A new analysis suggests that millions more will drop coverage over the year as enrollees confront higher monthly premiums. www.wakely.com/blog/who-pai...
wakely.com
Who Paid, and Who Stayed? Early 2026 Enrollment Trends in the Individual Market - Wakely
A new report from Wakely Consulting Group, an HMA Company, models changes to the 2026 ACA market enrollment due to the loss of federal subsidies. Findings
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Sarah Lueck @sarahl202.bsky.social · 27/03/2026
#ACA marketplace signups are down, and many people are paying higher costs and getting skimpier coverage, according to new federal data. A major reason: Republicans in Congress and the Trump Administration let premium tax credit enhancements expire. www.cms.gov/files/docume...
cms.gov
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Sarah Lueck @sarahl202.bsky.social · 25/03/2026
Don't forget that the harmful megabill has set big health coverage losses in motion. The new Medicaid work requirement and other red tape will take away coverage from millions. ⬇️
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Sarah Lueck @sarahl202.bsky.social · 23/03/2026
Today marks the 16th anniversary of the #ACA. The law covers record numbers of people in #Medicaid and the marketplaces, bans insurer discrimination against people with health conditions, and helps millions afford their health costs. Unfortunately this is all now at risk.
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Sarah Lueck @sarahl202.bsky.social · 25/02/2026
Even as President Trump talks up his health proposals, key decisions he has already made are making care unaffordable for millions. Federal policies he backed will leave some 15M uninsured. If they stood in a line, it would reach from Chicago to Buenos Aires. #CBPPSOTU
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Sharon Parrott @sharonparrott.bsky.social · 25/02/2026
Tonight, during the State of the Union address, we’ll hear President Trump’s priorities for the year ahead. It’s worth comparing what he says to the extreme actions his Administration took last year.
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Nicole Rapfogel @nicolerapfogel.bsky.social · 23/02/2026
Marketplace enrollees’ premiums have skyrocketed following the recent expiration of PTC enhancements. Some have suggested health savings accounts and less generous plans as a more affordable alternative to comprehensive coverage. Here’s why that line of reasoning is flawed: 🧵
cbpp.org
Health Savings Accounts Can Be a Bad Deal for Low-Income Marketplace Enrollees
In the wake of their actions that have worsened health care affordability, President Trump and Republicans in Congress have pushed to expand health savings accounts (HSAs). But this doubles down on an...
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Jennifer Sullivan @jenniferlsullivan.bsky.social · 06/01/2026
This week, the House is expected to vote on a bill to extend the Premium Tax Credit enhancements. This would reduce 2026 premiums for the average #ACA marketplace enrollee by more than half, improving affordability for millions of people struggling with health costs. www.cbpp.org/research/hea...
cbpp.org
Marketplace Enrollees In Every Congressional District Face Steep Premium Increases Unless Tax Credit Enhancements Are Extended
Annual premium increase, 60-year-old couple with income of $85,000 (401% FPL), by congressional district, 119th Congress Note: FPL = federal poverty level. Examples are based on 2026 average...
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Sarah Lueck @sarahl202.bsky.social · 12/12/2025
With marketplace premium spikes on the verge of hitting 20M+ people Jan. 1, House Speaker Johnson is reportedly considering a bill from Rep.Fitzpatrick with a 2-year extension of PTC enhancements. But the bill raises big concerns. www.politico.com/live-updates...
politico.com
House Republicans weigh vote on Obamacare extension
GOP moderates are exploring a last ditch attempt to get a vote to extend expiring subsidies.
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Sarah Lueck @sarahl202.bsky.social · 24/11/2025
Reports that the White House is working on a proposal to extend premium tax credit enhancements shows the Administration is acknowledging the urgent need to address premium spikes for millions of marketplace enrollees. But big questions remain.🧵
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Nicole Rapfogel @nicolerapfogel.bsky.social · 24/11/2025
The GAO released a report last week on health savings accounts (HSAs) reaffirming that HSAs do little to help people with low and moderate incomes – who would be hurt the most if Congress lets premium tax credit enhancements expire.
files.gao.gov
GAO-25-107480, HEALTH SAVINGS ACCOUNTS: Information on Features and Use, and Characteristics of Account Holders
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Jennifer Sullivan @jenniferlsullivan.bsky.social · 24/11/2025
Some recent Republican responses to the marketplace premium tax credit issue would shift more people to bronze plans with Health Savings Accounts as an alternative to silver plans with PTC enhancements and cost sharing reductions. So how do these plans stack up in real terms?
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Sarah Lueck @sarahl202.bsky.social · 20/11/2025
Here they go again: Republicans in Congress are reviving the ACA repeal debate. After enacting unprecedented cuts to Medicaid, they are looking for ways to eliminate federal premium tax credits that some help about 20M people afford marketplace plans.
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Sarah Lueck @sarahl202.bsky.social · 06/11/2025
Check out @centeronbudget.bsky.social's new graphics -- examples of the cost increases that marketplace enrollees in all 50 states and D.C. will face if Congress doesn't extend premium tax credit enhancements. h/t @gidlukens.bsky.social www.cbpp.org/research/res...
cbpp.org
Marketplace Enrollees Face Steep Premium Increases Unless Tax Credit Enhancements Are Extended
Click on a state to find it in the grid...
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Gideon Lukens @gidlukens.bsky.social · 04/11/2025
How concerned are people about rising health insurance premiums? With premium tax credit enhancements about to expire and ACA marketplace open enrollment underway, search volumes for terms like “health premium increase” are (almost) off the charts.
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Sarah Lueck @sarahl202.bsky.social · 14/10/2025
Republican leaders in Congress say they will address marketplace health care premium increases once the government is re-opened. But it’s hard to square that commitment with some of their recent comments.
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Sarah Lueck @sarahl202.bsky.social · 14/10/2025
If premium tax credit enhancements expire, millions of people with the lowest incomes would lose $0 premium plans and be at risk of becoming uninsured. Gains in coverage, especially in states that haven’t expanded #Medicaid, would be at risk. www.cbpp.org/blog/people-...
cbpp.org
People With Low Incomes May Lose $0 Premium Plans — a Lifeline — Unless Congress Acts | Center on Budget and Policy Priorities
Without congressional action, PTC enhancements will expire at the end of 2025. This will cause millions —many of these lowest-income enrollees especially — to become uninsured, or to face impossible c...
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Sarah Lueck @sarahl202.bsky.social · 08/10/2025
Attn: Idaho Marketplace enrollees in the Gem State are facing big premium increases if Congress does not act.
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Nicole Rapfogel @nicolerapfogel.bsky.social · 30/09/2025
NEW from @centeronbudget.bsky.social: Without Congressional action, premium tax credit enhancements will expire, raising costs for nearly all marketplace enrollees and putting millions of those with the lowest incomes at risk of becoming uninsured when they lose $0 premium plans.
cbpp.org
People With Low Incomes May Lose $0 Premium Plans — a Lifeline — Unless Congress Acts | Center on Budget and Policy Priorities
Everyone should be able to get the health care they need to thrive, and for that to happen, it must be affordable, high quality, and easily accessible for all. Premium tax credit (PTC) enhancements...
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Nicole Rapfogel @nicolerapfogel.bsky.social · 23/09/2025
NEW from @jenniferlsullivan.bsky.social and me for @centeronbudget.bsky.social: With Congress poised to take away premium tax credit enhancements soon, ~4M people will lose coverage and costs will rise for nearly all ACA marketplace enrollees unless Congress acts.🧵
cbpp.org
Five Key Changes to ACA Marketplaces Amid Uncertainty Over Premium Tax Credit Enhancements | Center on Budget and Policy Priorities
Recent policy changes, most notably enhancements to premium tax credits to reduce enrollees’ health insurance premiums, have driven record-breaking enrollment gains and delivered reduced costs, simpli...
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Sarah Lueck @sarahl202.bsky.social · 17/09/2025
Despite claims to the contrary, premium tax credits are well targeted to people with low & moderate incomes who need the most help with health costs. Three-quarters of people getting the credits have incomes below 300% FPL (~$47K for an individual). >90% have incomes below 400% FPL (~$63K)
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Sarah Lueck @sarahl202.bsky.social · 21/07/2025
The latest CBO estimates make clear that the so-called “Big Beautiful Bill” is anything but--it would cause widespread harm with more than $1T in cuts to Medicaid & ACA marketplaces and higher costs for families trying to afford health care and groceries.
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Sarah Lueck @sarahl202.bsky.social · 02/07/2025
Senate Republicans made a horrible bill even worse. Let's count the ways:
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Sarah Lueck @sarahl202.bsky.social · 30/06/2025
TSen. Scott amendment effectively repeals Medicaid expansion in only a few years. New analysis here: www.cbpp.org/research/med...
cbpp.org
Senate Reconciliation Amendment Would Cut Hundreds of Billions More From State Medicaid Funding, Putting Coverage at Risk for Millions | Center on Budget and Policy Priorities
Late Saturday the Senate voted to proceed to debate on the One Big Beautiful Bill Act, which is the opposite of beautiful: the Congressional Budget Office (CBO) now confirms the legislation will cut.....
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Sarah Lueck @sarahl202.bsky.social · 29/06/2025
New Congressional Budget Office (CBO) numbers confirm what we already knew – the reconciliation bill is getting worse, not better. The Senate bill will cut health care more deeply than the House bill and leave more people uninsured. www.cbo.gov/publication/...
cbo.gov
Estimated Budgetary Effects of an Amendment in the Nature of a Substitute to H.R. 1, the One Big Beautiful Bill Act, Relative to the Budget Enforcement Baseline for Consideration in the Senate
As posted on the website of the Senate Committee on the Budget on June 27, 2025
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Shelby Gonzales @shelbytgonzales.bsky.social · 28/06/2025
The latest Senate Republican plan retains a deeply harmful provision that tramples over state rights’ to make decisions about how to use their own funds to ensure their state residents can access comprehensive health coverage.
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Sarah Lueck @sarahl202.bsky.social · 28/06/2025
Senate Republican leaders appear to be barreling ahead with their harmful reconciliation bill. Reminder that the Republican health agenda would take us backward on covering the uninsured, largely reversing #ACA gains. 👎 (h/t @pkrugman.bsky.social for the graphic idea)
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Katie Bergh @katiebergh.bsky.social · 28/06/2025
Senate Republicans are rushing to pass a bill that would take #SNAP food assistance away entirely from millions of low-income people & cut food benefits for millions more. Some states could even end SNAP entirely. But Senators still have time to reject these harmful policies.
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Sarah Lueck @sarahl202.bsky.social · 28/06/2025
www.cbpp.org/press/statem...
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Peggy Bailey @peggybaileydc.bsky.social · 28/06/2025
Every major bill language release is happening under the cover of night. Tracks since the bill is so unpopular. Are Senators really going to set millions of families backwards by taking health coverage & food asst away from them? Is that why they got into politics? Really?
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Sarah Lueck @sarahl202.bsky.social · 26/06/2025
The reconciliation bill puts health benefits for tipped workers at risk. ⬇️
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Allison Orris @aorris.bsky.social · 26/06/2025
As Senate Republican leaders rush their bill to a vote, they are focused on band-aid fixes to clear process hurdles. Instead, they should stop moving forward with harmful legislation that takes health care away from millions of people.
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Sarah Lueck @sarahl202.bsky.social · 25/06/2025
$1 trillion > $15 billion And a capped fund that Congress could shrink or cannibalize in the future isn’t a substitute for the foundation of rural hospital stability: Medicaid. www.cbpp.org/blog/trackin...
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Gbenga Ajilore @gbenga-ajilore.bsky.social · 24/06/2025
Now that I'm verified on BlueSky (‼️), I want to highlight how rural communities will be harmed by the GOP's budget bill and why people shouldn't just "get over it" or that "we're all going to die." See my piece on the impact on rural economies: www.cbpp.org/research/fed...
cbpp.org
House Republican Reconciliation Bill Would Harm Rural Households, Communities, and Economies | Center on Budget and Policy Priorities
The bill continues the pattern under this Administration of hurting the people the President pledged to help.
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Sarah Lueck @sarahl202.bsky.social · 24/06/2025
The "one big beautiful bill," which would leave some 16m uninsured, is making people say some ugly things. Sen. McConnell: "They'll get over it." Sen. Ernst: "Well, we all are going to die." CMS Administrator Oz: "Prove that you matter."
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