Health Affairs November 7, 2025
President Donald Trump and Elon Musk’s Department of Government Efficiency (DOGE) have taken a chainsaw to the US federal government, slashing programs, personnel, research, and global aid. The recently enacted One Big Beautiful Bill Act (OBBBA) budget reconciliation package, meanwhile, cuts nearly $1 trillion from Medicaid and the Affordable Care Act over the next decade—adding more than 10 million to the ranks of the uninsured. The OBBBA also slashes nearly $290 billion from food subsidies for the poor and could trigger $490 billion in cuts from Medicare.
The president and his congressional allies claim these cuts are needed remedies for waste, fraud, and abuse. Yet, they turn a blind eye to the trillions of dollars that private insurers drain from...
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