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CBO: Nearly 11 million people will be uninsured if GOP megabill becomes law

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June 4, 2025
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CBO: Nearly 11 million people will be uninsured if GOP megabill becomes law
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Nearly 11 million people would lose health insurance under the House Republican tax bill, mostly due to cuts to Medicaid and the Affordable Care Act (ACA), according to the nonpartisan Congressional Budget Office (CBO). 

The CBO’s latest report estimates that 10.9 million people would be uninsured over the next decade if the spending package, which includes much of President Trump’s legislative agenda, were enacted.   

That total includes an estimated 1.4 million people in state-funded health programs without verified citizenship, nationality or satisfactory immigration status. The legislation would impose new restrictions on states that use their own money to provide health insurance for immigrants lacking permanent legal status. 

According to the analysis, about 7.8 million would lose Medicaid coverage under strict work requirements and more frequent eligibility checks, and millions more would lose coverage through changes to the ACA exchanges.  

The official projections give Democrats new attack points against the legislation, which they argue will take away people’s health insurance to give billionaires a tax break.  

“It’s shocking House Republicans rushed to vote on this bill without an accounting from CBO on the millions of people who will lose their health care or the trillions of dollars it would add to the national debt,” Rep. Frank Pallone Jr. (N.J.), the top Democrat on the House Energy and Commerce Committee, said in a statement. 

“The truth is Republican leaders raced to pass this bill under cover of night because they didn’t want the American people or even their own members to know about its catastrophic consequences,” he added.

Republicans are likely to downplay the significance of the analysis. They say the bill protects the vulnerable people who need insurance the most and takes away benefits from immigrants and people who can work but choose not to. 

“You don’t need to go back that far to see how wrong the CBO has been,” House Majority Leader Steve Scalise (R-La.) said at a news conference Wednesday. “When it comes time to make prognostications on economic growth, they’ve always been wrong.”   

Some GOP senators have expressed concerns about some of the Medicaid provisions and say they won’t support the bill without changes. But work requirements remain popular even among lawmakers seeking changes, despite projected coverage losses.

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