A new analysis from the Congressional Budget Office (CBO) estimates a staggering 16 million people would lose health insurance under the House-passed budget reconciliation bill. This includes nearly 11 million Americans who would lose Medicaid and five million who would lose access to Affordable Care Act (ACA) policies. For context, under the failed House and Senate 2017 ACA repeal bills, 23 and 16 million people would have become uninsured, respectively. Then, as now, such losses would be catastrophic.
Largest Medicaid and SNAP Cuts in History
The CBO finds the bill would reduce federal health care spending by over $1 trillion. Medicaid would bear the brunt of the cuts ($864 billion), with harmful work requirements alone accounting for $344 billion. It would also slash SNAP by $267 billion, causing millions to lose the food assistance they need to afford groceries and meet other basic needs. For both programs, the outlined cuts would be the largest in history.
CBO is likely overstating these savings, as the analysis does not contemplate the reverberations of becoming uninsured.
Notably, CBO is likely overstating these savings, as the analysis does not contemplate the reverberations of becoming uninsured. Lack of affordable care has long been linked to worse outcomes and higher costs, for individuals and the system. Without insurance, people may delay or skip care due to cost barriers, exacerbating their conditions. Some may be unable to maintain their health from day-to-day and lose their jobs as a result. When people do finally seek care, it will be more costly than it would have been otherwise: they’ll have higher health needs and often nowhere to turn but emergency rooms.
Bill Harms Lower-Income Americans, Benefits High Earners
Despite the unprecedented scale of the House bill’s cuts to health care and food assistance, it would still raise the deficit by at least $3 trillion due to significant tax breaks that disproportionately favor high-income earners.
For [Americans who make the least amount of money], its tax changes would not outweigh its cuts; their household resources would decrease by 4%.
As with previous analysis, CBO again finds that Americans who make the least amount of money would be worse off under the House bill. For these individuals and families, its tax changes would not outweigh its cuts; their household resources would decrease by 4%. Americans who make the most, however, would see their finances increase by that same share—4%—due to windfalls in lower taxes. Independent experts at the Economic Policy Institute note another “striking symmetry” around the legislation’s resource transfer: “If the bill becomes law, the annual cuts to Medicaid would average over $70 billion in coming years—the same amount millionaires and billionaires would gain in tax cuts each year.”
This would translate to wildly uneven impacts for American taxpayers. A separate review of the House bill found that people in the top 20% of income brackets “would see an average tax cut of $12,660 next year” while “those in the lowest bracket, who earn less than about $35,000, would get a tax cut of $160.” But this is only part of the picture. Taking the program cuts into consideration, modeling indicates “the lowest-income Americans…would see their incomes fall by $820, on average, next year…a drop of 14.6%, on average.”
The Cuts are Harmful and Shortsighted
Cutting Medicaid and SNAP won’t make people healthier. It will only cause them to lose access to things that help them build and maintain their health, like preventive and primary care, prescription drugs, affordable food, and treatments for chronic conditions. Proponents of the bill claim these changes are necessary to pay for tax cuts, which they say will benefit Americans broadly and counter losses to health coverage and food assistance. But independent experts and the CBO disagree. By also worsening the deficit, the House bill would create an unsustainable fiscal environment, making these program cuts difficult to restore.
By also worsening the deficit, the House bill would create an unsustainable fiscal environment, making these program cuts difficult to restore.
Tell Your Senators: No Cuts to Care
The Senate is currently discussing next steps, with the goal of passing a bill this month. Recent reports indicate they may be considering even deeper cuts to health care programs, including Medicare. Your senators need to hear that you oppose the House-passed bill and any rollbacks to programs on which older adults and people with disabilities rely. Contact them today!
