Millions will lose Medicaid under Trump's tax law. Here's the final tally.
About 10 million Americans are expected to lose health insurance under President Donald Trump's tax cut and spending law, the nonpartisan Congressional Budget Office said.
Over the next decade, 7.5 million people will lose Medicaid coverage due to changes under the law, the CBO said in an analysis released Monday, Aug. 11. Nondisabled adults on Medicaid will be required to get a job, volunteer or enroll in school to maintain their Medicaid coverage. And states must double Medicaid eligibility checks to twice a year.
Another 2.1 million people will shed Affordable Care Act coverage over the next decade, the CBO said. And 400,000 more will lose coverage due to impacts of the law — nicknamed the One Big Beautiful Bill — which was backed by Congressional Republicans.
The CBO earlier said the legislation, which Trump signed on July 4, would add $3.4 trillion to the federal deficit. The law extends the 2017 tax cuts, ends taxes on tips and overtime, and bolsters border security, among other things.
The CBO also estimated poorer Americans — those earning less than $23,750 annually and who pay about $2,300 of that in federal taxes — will lose about $1,200 per year due to Medicaid changes and reductions in food assistance. Middle-income households are expected to gain $800 to $1,200. Meanwhile, the law's tax cuts will benefit wealthier Americans by about $13,600 per year. Those families, who earn more than $690,000 annually, still will pay nearly $200,000 in federal taxes annually, the CBO said.
Sabrina Corlette, co-director of Georgetown University's Center on Health Insurance Reforms, said the CBO report shows who benefits and who doesn't under the legislation.
"This is one of the most regressive pieces of legislation I've seen," said Corlette. "The rich will get richer and the poor will get poorer."
Millions more could lose their health insurance
When the bill passed the Senate, the CBO estimated it would leave about 11.8 million Americans without health insurance through 2034. The law signed by Trump won't cut as deep because it excluded a provision that would've penalized states extending Medicaid to undocumented residents.
Still, nearly 5 million could lose coverage if Congress doesn't extend the expiring COVID-19 pandemic-era tax credits that have made Affordable Care Act plans more affordable for consumers, according to earlier CBO estimates.
Consumers who use those pandemic-era tax credits will see the amount they need to pay spike an average of more than 75%, according to KFF, a health policy nonprofit.
The combination of the tax law, expiring tax credits and overall rising medical costs will make insurance premiums more expensive for everyone. Insurers plan a median premium increase of 18% for 2026 plans, which would be the largest ACA insurance price hike since 2018, according to a Peterson-KFF Health System Tracker report released Aug. 6.