Republican Proposal Risks Health Coverage Losses for Millions by 2034

Republican proposals to cut Affordable Care Act (ACA) subsidies and impose Medicaid work requirements could cause millions of Americans to lose health insurance coverage in the coming years. The Congressional Budget Office (CBO) estimates that ending expanded ACA premium tax credits and implementing Medicaid changes could leave between 5.7 million and as many as 13.7 million people uninsured by 2034. ACA enrollment is currently at an all-time high due in part to enhanced tax credits that lower premiums for 85% of marketplace enrollees, but these credits are set to expire unless extended by Congress. The GOP-led effort to reduce federal spending on ACA subsidies, which would begin in 2026, faces criticism from Democrats who warn it would trigger the largest loss of coverage in history. Medicaid beneficiaries aged 19 to 64 could also lose coverage if work or community engagement requirements starting in 2029 are imposed, raising concerns among advocates and sparking protests. Health care advocates argue these cuts would disproportionately impact low-income and underserved communities, increasing premiums and reducing access to essential health services.