Here's how millions of people could lose health insurance if Trump's tax bill becomes law

Senate Majority Leader John Thune, R-S.D., is flanked by Sen. John Barrasso, R-Wyo., the GOP whip, left, and Finance Committee Chairman Mike Crapo, R-Idaho, speaks to reporters after passage of the budget reconciliation package of President Donald Trump's signature bill of big tax breaks and spending cuts, at the Capitol in Washington, Tuesday, July 1, 2025. (AP Photo/J. Scott Applewhite)

Roughly 11.8 million adults and children will be at risk for losing health insurance if Republicans’ domestic policy package becomes a law.

The losses won’t come all at once. The GOP’s “ One Big, Beautiful Bill Act ” makes changes that will whittle away at enrollment through federal health care programs like Medicaid and Obamacare over a decade in order to wrest nearly $1 trillion from Medicaid, the Affordable Care Act, and the Children’s Health Insurance Program.

The bill is likely to reverse years of escalating health insurance rates in the U.S., gains that have also been marked by record spending on federally-funded health care coverage. Roughly 78 million adults and children are enrolled in Medicaid’s programs, while 24 million people are enrolled in the ACA’s marketplaces.