06/05/2025

CBO: 16 Million Could Lose Coverage; $1 Trillion in Federal Healthcare Cuts Projected

On June 4, the nonpartisan Congressional Budget Office (CBO) released an updated fiscal analysis of the House-passed One Big Beautiful Bill Act (OBBB). The revised score reflects new amendments and clarifies the financial and coverage implications of the legislation as passed on May 22.

According to the CBO, an estimated 16 million individuals are expected to lose health insurance coverage if the bill is enacted:

• 10.9 million will lose coverage directly due to the bill's provisions, including nearly 8 million losing Medicaid and the rest losing ACA Marketplace coverage.
  
  
• An additional 5.1 million will lose coverage due to related administrative changes: namely, the codification of the Trump-era Marketplace rule and the expiration of enhanced premium tax credits at the end of 2025, which are not extended in the legislation.

In total, these combined changes would leave 16 million people without coverage.

Driving much of the impact are accelerated timelines for implementing Medicaid work requirements and increased eligibility redeterminations—amendments made just before House passage. These changes, CBO notes, contribute to significantly higher projected federal savings.

The updated analysis forecasts $1 trillion in cuts to federal healthcare spending over the next decade, including more than $800 billion in Medicaid funding reductions.

As LeadingAge continues to monitor the legislative process, we will provide members with updates on how these changes could impact older adults, long-term care providers, and the broader healthcare landscape in Ohio.

The full CBO score can be accessed here.