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

Strategic Insights -

The House tax-and-spending legislative package, championed by President Donald Trump, could have far-reaching consequences for millions of Americans enrolled in Medicaid. The nonpartisan Congressional Budget Office estimates that 10.9 million Americans would lose their health insurance by 2034 if the bill becomes law, with as many as 7.8 million losing access to Medicaid. This would exacerbate the issue of uncompensated care, where hospitals are forced to absorb the costs of treating uninsured patients. The bill would also reduce incentives for states to expand their Medicaid programs, making it less likely that Texas and other states would expand coverage.

Key Takeaways:

  • The House tax-and-spending bill could lead to a significant increase in the number of uninsured Americans, with the Congressional Budget Office estimating that 10.9 million people would lose their health insurance by 2034.
  • 7.8 million of those losing Medicaid coverage would be due to the introduction of work requirements, which would force applicants to certify that they are working at least 80 hours a month or engaged in comparable activities.
  • The bill would also reduce incentives for states to expand their Medicaid programs, making it less likely that Texas and other states would expand coverage.
  • The introduction of work requirements would lead to close to 5 million people being denied Medicaid coverage.
  • The bill would increase how often Medicaid beneficiaries have to reapply to the program to keep their coverage from once every 12 months to twice a year.
  • Many of those who aren't kicked out would also face either new or higher co-payments for appointments and procedures.
  • The bill would also affect the more than 24 million Americans who get health insurance through Affordable Care Act Marketplace plans, making it harder to get this coverage and increasing premiums.

Statistics:

  • 25.3 million Americans lacked insurance in 2023, down sharply from 46.5 million in 2010.
  • 10.9 million Americans would lose their health insurance by 2034 if the bill becomes law.
  • 7.8 million would lose access to Medicaid.
  • 2.1 million people who the CBO estimates would end up uninsured are Americans who today have coverage they bought in the marketplaces that the Affordable Care Act created.
  • The number of Americans losing their coverage could run even higher, with some estimates suggesting it could be as high as 16 million.

Sources:

  • The Conversation -- USA -- By Simon F. Haeder, Associate Professor of Public Health, Texas A&M University
  • Congressional Budget Office estimates that 10.9 million Americans would lose their health insurance by 2034 if the bill becomes law.
  • Jacob Wackerhausen/iStock via Getty Images Plus