Health Coverage for 16 Million Said at Risk With GOP Plan (1)

June 4, 2025, 6:53 PM UTCUpdated: June 4, 2025, 7:29 PM UTC

The number of people in the US without health insurance is poised to increase by 16 million by 2034 under Republican plans for spending cuts, the Congressional Budget Office estimated.

The nonpartisan budget scorekeeper released the figures Wednesday after analyzing the potential effects of House Republicans’ reconciliation legislation (H.R. 1) passed last month and the party’s plan to allow enhanced premium tax credits to expire.

The potential for steep health coverage losses remains a political liability for Republicans who are trying to reduce health-related costs in order to help pay for President Donald Trump’s tax and spending bill. The president has said the legislation isn’t cutting Medicaid, but is targeting waste and abuse in the program.

Trump Obscures Medicaid Cuts in Bid to Pass Massive Tax Bill

Democrats immediately leveraged the CBO’s findings to voice opposition to the GOP plan.

“The results of this cruel system are clear: millions will lose coverage, health care costs will go up for all Americans, and tens of thousands will die,” Senate Finance ranking member Ron Wyden (D-Ore.), House Ways and Means ranking member Richard Neal (D-Mass.) and House Energy and Commerce ranking member Frank Pallone (D-N.J.) said in a statement.

The estimates were included in a letter to Democrats who asked how the One Big Beautiful Bill Act, the expiration of premium tax credits, and a proposed rule to tighten up Affordable Care Act enrollment would affect the number of people without insurance.

Health Coverage for Millions of Americans at Risk Under GOP Plan

The reconciliation bill alone—which the GOP plans to pass using a budget mechanism without needing Democrats’ support—would lead to around 11 million more people without insurance. CBO estimates that proposed Medicaid work requirements for adults aged 19 to 64 without dependents would increase the number of uninsured by 4.8 million by 2034.

Medicaid Work Requirements Pose Capacity Challenge for States

To contact the reporter on this story: Erin Durkin in Washington at edurkin@bloombergindustry.com

To contact the editors responsible for this story: Michaela Ross at mross@bgov.com; Robin Meszoly at rmeszoly@bgov.com

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