Millions of Americans May Lose Health Insurance Coverage Under House Tax-and-Spending Bill

The House tax-and-spending legislative package, a priority for President Donald Trump's second administration, could cause millions of Americans enrolled in Medicaid to lose their health insurance coverage. The nonpartisan Congressional Budget Office (CBO) estimates that 10.9 million Americans would lose their health insurance by 2034 if the bill were to become law, with as many as 7.8 million losing access to Medicaid. This could occur due to new bureaucratic obstacles introduced by the bill, including work requirements and increased enrollment complexity.

Key Takeaways:

• The House tax-and-spending legislative package could cause millions of Americans enrolled in Medicaid to lose their health insurance coverage, with the CBO estimating 10.9 million Americans losing coverage by 2034.
• The bill would reduce incentives for states to expand Medicaid programs, making it less likely for Texas and other states to expand eligibility in the future.
• The proposed changes would also make it harder for states to come up with their share of Medicaid funding by limiting "provider taxes," which are charged to hospitals, doctors, and other medical providers.
• The legislation would increase the number of Americans losing their health insurance coverage, with "other estimates suggesting that the number of Americans losing their coverage could run even higher."
• The House bill would also make it harder for people to get or keep Medicaid coverage by introducing "work requirements" and reducing the time Americans have to enroll in Marketplace plans.
• The bill would eliminate certain subsidies, making the enrollment process more complicated and leading to increased premiums.
• The effects of the bill would be compounded by further changes by individual states, including the introduction of monthly premiums for Medicaid coverage and reduced eligibility for certain groups or services.

Statistics:

• 25.3 million Americans lacked insurance in 2023, down from 46.5 million in 2010, with most of the decline occurring because of the Affordable Care Act (ACA) of 2010.
• The CBO estimates that 10.9 million Americans would lose their health insurance by 2034 if the House version of the tax-and-spending package were to become law.
• 7.8 million people would lose access to Medicaid, with another 2.1 million people who the CBO estimates would end up uninsured losing coverage they bought in the ACA's marketplaces.
• The proposed policy changes and the uninsured, including the expiring of some ACA-related measures and new regulations, could lead to a total of 16 million Americans losing their health insurance coverage.
• Approximately 24 million Americans get health insurance through Affordable Care Act Marketplace plans, which would be affected by changes in the House bill, including reduced enrollment time and eliminated subsidies.
• The CBO expects more than 2 million beneficiaries to lose coverage due to these new policies, with combined effects from Trump regulatory decisions potentially leading to more than 5 million Americans losing coverage.

Sources:

• The Conversation -- USA -- By Simon F. Haeder, Associate Professor of Public Health, Texas A&M University
• Congressional Budget Office (CBO)
• The House of Representatives (passage of the tax-and-spending legislative package)