KFF August 20, 2025
Allocating CBO’s Estimates of Additional Uninsured People Across the States
President Trump signed into law on July 4, 2025 a budget reconciliation package (formerly called the “One Big Beautiful Bill Act”) that will make significant changes to Medicaid and the Affordable Care Act (ACA) Marketplaces. The Congressional Budget Office (CBO) estimates that, relative to its estimates of insurance coverage prior to the law being enacted, the law will increase the number of people without health insurance in 2034 by 10 million, because of changes to Medicaid (7.5 million), the ACA Marketplaces (2.1 million), and other policies and interactions among different provisions (0.4 million). These legislative changes come at a time when enhanced premium tax credits for ACA Marketplace enrollees are...
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