Headline: CBO Report Reveals Deep Medicaid Cuts, Coverage Losses in Republican Reconciliation Bill

The Congressional Budget Office (CBO) has released a preliminary analysis warning of sweeping Medicaid cuts and significant coverage losses under the House-passed Republican budget reconciliation bill. The report finds that the package, narrowly approved by a 215-214 vote, would slash gross Medicaid and Children’s Health Insurance Program (CHIP) spending by more than $800 billion over the next decade and reduce Medicaid enrollment by at least 10.3 million people by 2034.

According to the CBO and independent policy analysts, the bill’s provisions would increase the number of uninsured Americans by at least 7.6 million, with the total uninsured likely to rise by over 10 million when factoring in additional changes to the Affordable Care Act’s marketplaces and subsidies. The legislation also eliminates requirements for states to provide Medicaid coverage during certain eligibility periods, making it harder for vulnerable populations—including children, people with disabilities, and low-income adults—to maintain continuous health coverage.

One of the most controversial elements is the acceleration of work requirements for Medicaid recipients, now proposed to take effect by December 2026. Critics argue these changes will disproportionately impact older adults, people with disabilities, and those requiring long-term care, as Medicaid currently pays for the majority of such services in the U.S.. The bill also repeals the Nursing Home Minimum Staffing Rule, raising concerns about the quality of care for seniors and people with disabilities.

Despite Republican claims that the package would restrain federal spending, the CBO suggests the bill could actually increase the federal deficit, triggering automatic cuts to Medicare and other safety-net programs under the Statutory Pay-As-You-Go Act. The projected Medicare cuts could reach $45 billion in fiscal year 2026 alone, with further reductions expected in subsequent years.

Supporters of the bill maintain that the new work requirements target only young, able-bodied adults without dependents, but the CBO’s analysis and advocacy groups warn that the broad scope of the cuts will likely leave millions without access to essential healthcare services. The debate now shifts to the Senate, where the fate of the reconciliation package and its sweeping healthcare changes remains uncertain.