Nearly 11 million more people would be uninsured over the next decade if provisions that affect Medicaid and Obamacare health insurance plans are enacted under the Republican tax megabill, according to estimates released by the Congressional Budget Office on Wednesday.
Democrats will likely use the estimate to try to stop the bill from advancing. However, President Donald Trump and House Speaker Mike Johnson (R-LA) argue that the legislation, titled the One Big Beautiful Bill Act, does not cut healthcare programs but rather eliminates waste, fraud, and abuse.
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Democrats and a handful of Republicans have pushed back on the bill’s healthcare provisions, particularly the institution of work requirements for certain Medicaid recipients.
Changes to Medicaid and Obamacare in the Energy and Commerce Committee portion of the bill would result in 9.1 million uninsured people, while the Ways and Means provisions would result in 2.3 million newly uninsured people by 2034. The overlap between the programs reduces the uninsured rate by half a million, for a grand total of 10.9 million uninsured people by 2034.
Roughly 25 million people in the United States were uninsured in 2023, according to the left-leaning healthcare think tank KFF.
KFF President Larry Levitt classified the bill as a massive reduction in federal support for health insurance.
“Whether you call it a cut in benefits or not, an estimated 10.9 million people would lose health insurance as a result of changes to Medicaid and the ACA passed by the House,” Levitt said. “This would be the biggest rollback in federal support for health care ever.”
The increase in uninsured people would mainly result from Medicaid changes.
The Medicaid work requirements in the House version of the bill only apply to the Medicaid expansion population, able-bodied adults without dependents, who are given eligibility for Medicaid coverage under Obamacare.
Nearly two-thirds, or 64%, of Medicaid adults are employed full or part time, with only 8% of nondisabled or elderly Medicaid adults without dependents not working, according to KFF.
Critics of work requirements argue that they essentially cut beneficiaries off by requiring too much red tape to maintain coverage.
A spokesperson for the House Energy and Commerce committee previously told the Washington Examiner that the reconciliation bill’s purpose “was to root out waste, fraud, and abuse across the entire federal government.”
“Congressional Republicans achieved this by ensuring program integrity of programs like Medicaid by removing the funding of illegal immigrants and enacting commonsense work requirements on able-bodied adults without dependents, which I might add has significant exemptions, notices, and grace periods,” the spokesperson said.
THE ONE BIG BEAUTIFUL BILL ACT WOULD ERODE OBAMACARE
About 15%, or 1.4 million, of the newly uninsured people from changes to Medicaid and Obamacare would be removed from government-subsidized healthcare coverage by 2034 because they are immigrants without legal authorization, according to the CBO calculation.
The bill also makes marginal changes to Obamacare, including shortening the open enrollment period, eliminating automatic enrollment into marketplace exchange insurance plans, and eliminating self-attestation of income changes to continue receiving subsidized insurance.