CBO: Nearly 11 million Americans to lose insurance under Trump bill

CBO: Nearly 11 million Americans to lose insurance under Trump bill

Washington — The Congressional Budget Office (CBO) has released projections indicating that nearly 11 million Americans could lose their health insurance under the Republican tax bill proposed by President Trump. This estimate, published on June 4, 2025, provides a significant source of savings to help finance the president's tax cuts.

The CBO report highlights that approximately 7.8 million people would lose Medicaid coverage, while the remaining losses would stem from the Affordable Care Act's (ACA) exchanges. Among those losing coverage are 1.4 million immigrants who lack or cannot prove legal status, which would give them access to insurance [1].

The bill imposes new restrictions on health insurance targeted at states that use their own funds to cover undocumented immigrants. Hospitals, which are particularly vulnerable, are expected to use these CBO projections to advocate for changes in the Senate that could mitigate enrollment losses.

The health care provisions in the bill can be categorized into two main buckets: Medicaid cuts and reforms to the ACA marketplaces. Additionally, the bill includes reforms to drug middlemen, which amount to $664 million in government savings. It also aims to boost payments to doctors by $8.9 billion over a decade by partially basing their Medicare payment rates on medical inflation [1].

The CBO's projections have sparked debate among lawmakers. While some Republicans argue that the bill only affects those without jobs who are able to work, Democrats have criticized the bill for taking insurance from low-income voters to pay for tax cuts that disproportionately benefit the wealthy. The CBO's estimates are expected to be a major talking point for Democrats in the upcoming midterm elections [2].

The CBO's analysis also includes estimates that the bill could add $2.42 trillion to federal budget deficits over the next decade, fueled by $3.67 trillion in lost revenue from tax cuts and $1.25 trillion worth of spending cuts. However, the CBO also estimated that Trump's tariffs could reduce deficits by $2.8 trillion over the same period, assuming the levies stay in place for a full decade [2].

Senators are expected to make changes to the House bill, though they are not anticipated to write a new bill from scratch due to time constraints. Republicans aim to pass the bill before July 4, but the real deadline might be when the government reaches its borrowing limit, expected sometime late summer [1].

References:
[1] https://www.statnews.com/2025/06/04/trump-tax-bill-health-care-impact-cbo-says-nearly-11-million-people-will-lose-insurance/
[2] https://www.bloomberg.com/news/newsletters/2025-06-04/the-cbo-has-good-news-and-bad-news-on-trump-tax-bill