The Medicaid portion of the House GOP’s massive domestic policy bill would result in 10.3 million people losing Medicaid coverage by 2034 and 7.6 million people going uninsured, according to a partial (CBO) Congressional Budget Office estimate.
Republicans released the estimates just ahead of the start of Tuesday’s markup of the Energy and Commerce portion of the party-line legislation, which is key to enacting President Trump’s agenda.
The uninsured numbers include 1.4 million people without verified citizenship who would be removed from the program and 4.8 million people who would lose coverage because of work requirements, the committee said.
All told, the Medicaid portions of the GOP proposal would save $625 billion over a 10-year period. The panel is tasked with finding at least $880 billion in savings, and CBO said they were on track to exceed that amount.
The biggest savings in the bill would come from the federal work requirements, which would account for about $301 billion over seven years. The provision would require childless adults aged 19-64 years old to prove they work, go to school or volunteer for 80 hours a month.
Experts say most Medicaid beneficiaries are working, and work requirements force enrollees to complete burdensome paperwork requirements. According to a CBO analysis of a 2023 Republican bill, work requirements had no impact on the employment status or hours worked by Medicaid recipients.
Overturning Biden-era Medicaid rules on eligibility determinations would save nearly $163 billion, and a moratorium on new provider taxes that states use to help finance their programs would save roughly $87 billion.
Most of the coverage losses would occur after the 2026 midterm elections; work requirements wouldn’t take effect until 2028.
Republicans have said the changes are needed to preserve Medicaid for the people who need it most, not the “able-bodied” and migrants without legal status who they say are bloating the program’s spending.
