Senate GOP Health Bill Projects $1.1 Trillion in Health Program Cuts, 11.8 Million More Uninsured

A new analysis from the Congressional Budget Office (CBO) projects that the Senate Republican health bill would result in more extensive cuts and a greater number of Americans losing health insurance coverage than previously estimated.

Published on July 1, 2025

health insurance
A stethoscope rests on top of a very expensive medical invoice that has line items for different services provided.

A new analysis from the Congressional Budget Office (CBO) projects that the Senate Republican health bill would result in more extensive cuts and a greater number of Americans losing health insurance coverage than previously estimated. The report, published on June 29, 2025, outlines the financial and coverage implications of the legislation currently under Senate consideration.

According to the CBO, the proposed bill would reduce federal spending on Medicaid, Medicare, and Affordable Care Act (ACA) programs by over $1.1 trillion through 2034. Of that total, more than $1 trillion would come from Medicaid alone. The legislation is projected to leave 11.8 million more people without insurance by 2034.

Key savings in the Senate version of the bill stem from two major provisions:

  • Work requirements for Medicaid: A new national work requirement would apply to poor parents of children over age 14 and to childless adults without disabilities. The CBO estimates this measure would account for over $325 billion in federal savings over a decade.
  • Restrictions on provider taxes and state payments: The bill includes new limits on state mechanisms used to fund Medicaid, including taxes on medical providers and state-directed payments. These restrictions are projected to cut an additional $375 billion in spending. Unlike the House bill, the Senate version mandates states to reduce these provider taxes starting in 2027.

In response to concerns from senators representing rural states, a $25 billion fund was added to support rural health care providers. Nonetheless, opposition remains. Senator Thom Tillis of North Carolina voted against advancing the bill, citing the proposed Medicaid reductions. Senators Susan Collins (Maine) and Josh Hawley (Missouri) also expressed reservations about the cuts. Hawley, while criticizing the Medicaid provisions, voted to proceed with the legislation.

The bill’s content continues to evolve. The Senate parliamentarian recently ruled that several health provisions, including those aimed at increasing spending for Alaska and Hawaii and easing paperwork for Medicaid enrollees, violated Senate rules. These provisions had been included to address concerns from key senators such as Lisa Murkowski of Alaska, who supported the bill’s advancement.

Senator Ron Johnson of Wisconsin indicated plans to propose an amendment to further cut Medicaid by phasing out enhanced federal funding for ACA Medicaid expansion populations. If adopted, the amendment would likely deepen the spending reductions and increase the number of uninsured.

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