Millions of Americans Could Lose Money If They Ignore This New

The GOP mega bill slashes Medicaid and ACA coverage, leaving millions uninsured and raising health care costs, CBO warns, as safety nets face historic cuts.

Dec 18, 2025 - 11:56
Millions of Americans Could Lose Money If They Ignore This New
Millions of Americans Could Lose Money If They Ignore This New

The harmful Republican megabill, enacted on July 4, will take health coverage away from millions of people and dramatically raise health care costs for millions more. The so-called “Big Beautiful Bill” is anything but beautiful; it will cause widespread harm by making massive cuts to Medicaid, Affordable Care Act (ACA) marketplace coverage, and SNAP, which will raise costs on families and make it much harder for them to afford the high cost of groceries and health care.

The law cuts $1.1 trillion from Medicaid and ACA marketplaces, according to Congressional Budget Office (CBO) estimates. Major cuts include a provision that takes away Medicaid from people who are eligible for the ACA Medicaid expansion but can’t show that they meet a work requirement, other red tape that will block people from enrolling in health coverage they are eligible for, and provisions that take away health coverage, across all major programs, from most categories of immigrants living lawfully in the U.S.

Under the Republican health plan:

  • Roughly 15 million people will lose health coverage and become uninsured by 2034 because of the Medicaid and ACA marketplace cuts in the Republican megabill, the law’s failure to extend enhanced premium tax credits for ACA marketplace coverage, and other harmful ACA marketplace rule changes, according to CBO estimates.
  • CBO estimates that 10 million people will become uninsured due to Medicaid and ACA marketplace cuts in the law, including 7.5 million people who will lose Medicaid in 2034 (with interactions).
  • An additional 4.2 million will lose marketplace coverage because the law failed to extend the premium tax credit enhancements, which lower annual premiums by more than $700, on average, for people who receive them.
  • Another 900,000 in losses come from earlier CBO estimates related to an ACA marketplace rule the Trump Administration has since finalized. (Updated estimates accounting for the final rule and its potential interactions with the law are not available at this time.)

    When people lose their health coverage, they lose access to preventive and primary care, care for life-threatening conditions, and treatments for chronic conditions. For example, a person with diabetes who loses health coverage will lose the ability to properly manage their condition so they can maintain their health as well as their employment.


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