The Congressional Budget Office (CBO) released an estimate Wednesday indicating that nearly 11 million people would lose health insurance coverage by 2034 under a major budget proposal supported by the White House and congressional Republicans.
According to a statement accompanying a CBO spreadsheet, enacting the “Big Beautiful Bill” would “increase by 10.9 million the number of people without health insurance in 2034.” That figure includes approximately 1.4 million illegal immigrants, or individuals “without verified citizenship, nationality, or satisfactory immigration status,” who would no longer be covered by state-funded programs.
The projected coverage loss is primarily attributed to proposed reductions in Medicaid, the federal health program for low-income individuals and families. The CBO estimates that Medicaid enrollment would drop by more than 7.8 million people due to these cuts. Republicans have said the reductions aim to eliminate fraud, waste, and abuse.
In addition, around 1.3 million people are expected to lose coverage because of changes to the Affordable Care Act, also known as Obamacare. However, the CBO also projects that the bill would “lower gross benchmark premiums, on average, in marketplace plans established by the Affordable Care Act by an estimated 12.2 percent in 2034.”
The legislation is a cornerstone of President Donald Trump’s policy agenda. It includes a $4.5 trillion extension of expiring tax cuts, increased spending on immigration and border security, and significant reductions in funding for Medicaid, food assistance programs, and climate-related initiatives.
The Energy and Commerce section of the bill is projected to save $1 trillion over the next decade, with most of those savings stemming from Medicaid cuts. Overall, the CBO estimates that the legislation would add $2.4 trillion to the national debt over ten years. It would reduce federal revenues by $3.7 trillion while lowering net spending by $1.3 trillion.
Republican lawmakers and the White House have largely dismissed the CBO’s findings. Some GOP members argue the analysis does not account for economic growth the bill could generate.
“This bill will actually reduce the deficit if you recognize the historical economic growth that has always been there,” said House Majority Leader Steve Scalise (R-La.) during a Wednesday press conference.
The CBO report arrives amid criticism from Tesla CEO and former White House adviser Elon Musk, who on Tuesday called the bill a “disgusting abomination” in a series of social media posts. Musk warned the legislation would substantially raise the national debt.
House Speaker Mike Johnson (R-La.) responded by saying he had spoken with Musk recently and believes the criticism stems from the bill’s elimination of electric vehicle tax credits. “I know that the EV mandate is very important to him; that is going away because the government should not be subsidizing these things as part of the Green New Deal,” Johnson said Tuesday. “I know that has an effect on his business and I lament that.”
The White House, for its part, affirmed Trump’s support for the bill and downplayed Musk’s remarks.