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The nonpartisan Congressional Budget Office (CBO) released its final estimates on the impact of the reconciliation legislation.
The findings: Over the next decade, the law will increase the federal deficit by $3.4 trillion and cause 10 million people to lose health insurance.
- While it would save more than $1 trillion by cutting Medicaid, CBO predicts that the package’s costs will far outweigh its savings.
The details: The new uninsured estimate of 10 million people is below a prior estimate for a draft version of the bill, which suggested 11.8 million people would lose insurance coverage.
- One reason for the lower number is that a proposal that would have reduced Medicaid funding for states that offer coverage to undocumented immigrants (using the states’ own funds) was omitted from the final law. That policy would have led to an estimated 1.4 million undocumented immigrants losing coverage.
- CBO said it will offer details on the reasons for the differences in the estimates in the coming weeks.
Why it’s important: 10 million people losing insurance coverage is still a huge number, and we expect there to be significant impact on people with SUD. Addiction treatment is largely unaffordable without insurance coverage.
Read more: GOP megabill’s final score: $3.4T in red ink and 10 million kicked off health insurance, CBO says; 10 million expected to lose health insurance under Trump’s tax cut law, CBO says
Published
July 2025