Republican Budget Plan Could Result in Millions Losing Healthcare

The Hill: “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. Millions of people would lose health insurance coverage under various Republican options to cut Medicaid spending to pay for President Trump’s domestic policy agenda, according to an analysis the Congressional Budget Office (CBO) released Wednesday.

• For instance, a cap on Medicaid spending for beneficiaries in the expansion population would save $225 billion and result in 1.5 million additional people being uninsured by 2034.
• Limiting state provider taxes would save $668 billion but would mean an additional 3.9 million uninsured people by 2034.
• The analysis, requested by Rep. Frank Pallone Jr. (D-N.J.) and Sen. Ron Wyden (D-Ore.), shows the trade-offs facing Republicans as they try to pay for their party-line bill, which among other provisions would fund an extension of Trump’s 2017 tax cuts.
• “This analysis from the non-partisan, independent CBO is straightforward: the Republican plan for health care means benefit cuts and terminated health insurance for millions of Americans who count on Medicaid,” Wyden said in a statement.

Republicans have tasked the House Energy and Commerce Committee, which oversees Medicaid, to find $880 billion in savings as part of the overall goal of slashing at least $1.5 trillion. A previous CBO analysis showed that number was not achievable over the next decade without cutting Medicaid. CBO’s Wednesday report examined five of the Medicaid options Republicans have floated for the bill: eliminating the enhanced federal match for Medicaid expansion states, limiting state taxes on providers, capping federal Medicaid spending for the entire Medicaid population, capping spending for the expansion population only, and repealing a Biden-era Medicaid eligibility rule…”