Millions of Americans stand to lose their health coverage.
That’s the grim warning from the Congressional Budget Office (CBO), which released new estimates showing that Republican-backed proposals to cut federal Medicaid spending could result in sweeping losses in coverage — as many as 8.6 million people in the most extreme scenario.
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The cuts, under consideration as part of a broader push to offset the cost of Donald Trump’s proposed “big, beautiful bill,” would target the very programs that expanded access to care under the Affordable Care Act. From rolling back federal funding for Medicaid expansion to repealing enrollment protections, each option on the table could leave millions of low-income Americans without health insurance.
Requested by Democratic leaders Sen. Ron Wyden (D-OR) and Rep. Frank Pallone (D-NJ), the CBO analysis lays out a stark picture of what these proposals could mean in practice — not abstract budget savings, but concrete losses in care:
Reducing federal Medicaid payments in ACA expansion states: 5.5 million would lose coverage.
Capping federal Medicaid funding: 3.3 million could be cut off.
Repealing Biden-era enrollment protections: 2.3 million would be stripped of coverage.
Restricting state provider taxes (a major Medicaid financing tool): 8.6 million people affected.
Republicans argue these measures are aimed at reforming a bloated system and ensuring long-term sustainability. But for critics — and potentially for voters — the math is simple: millions off Medicaid, fewer protections for vulnerable populations, and a rollback of hard-won gains from the ACA era.
Even House Speaker Mike Johnson has begun to walk back some of the more severe options, saying Tuesday that one proposal is no longer being considered. Yet others remain under active discussion, and with an $880 billion deficit-reduction target looming, Medicaid appears to be firmly in the GOP’s crosshairs.
Stay tuned. This is going to be a major battle on Capitol Hill. I will have coverage for you every step of the way.
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