A legislative proposal under consideration in the US Senate would increase the number of uninsured individuals by 11.8 million over the next decade and reduce Affordable Care Act (ACA) marketplace costs by 0.5%, according to a new analysis from the Congressional Budget Office (CBO).
The CBO report projects that by 2034, approximately 1.4 million of those losing coverage would be individuals without verified citizenship or adequate immigration status. The proposed legislation would add an estimated $3.25 trillion to the federal deficit by the end of the same period.
The health insurance industry raised concerns about the proposal’s potential impact. In a statement, America's Health Insurance Plans (AHIP) said the current version of the bill could disrupt Medicaid and individual market coverage.
"Americans are looking for stability and certainty with their health care, yet the budget proposal before the Senate will disrupt the health coverage and affordable access to care millions of Americans rely on in Medicaid and the individual market," the AHIP said in a report from AM Best.
The group also warned that the expiration of existing ACA tax credits, when paired with the bill’s provisions, could drive more individuals into an individual insurance market with reduced competition.
The bill would also impose new work requirements for nondisabled adults under age 65 enrolled in Medicaid. The CBO estimates that this change alone could result in 5.2 million people losing eligibility for the program.
Critics have raised concerns that these requirements would disproportionately affect individuals in low-wage or unstable jobs, who may struggle to consistently meet the reporting standards required to maintain coverage.
The current version of the bill calls for cutting Medicaid funding by $930 billion, which would harm access to care for all Americans and strain the ability of hospitals to provide care due to an expected influx of uncompensated care, the American Hospital Association said.
Previously, the AHA projected that hospitals would see a $232 billion reduction in federal payments over the coming 10 years.
Outside of its impact on ACA costs, the bill also includes a 10-year moratorium on new state-level regulations governing the use of artificial intelligence. State insurance commissioners have expressed concern that the provision could hinder their ability to oversee how AI is deployed in underwriting and claims management.
They argue that a freeze on regulation would limit state oversight in a rapidly evolving technology space, potentially increasing the risk of discriminatory outcomes or opaque decision-making processes in insurance products.
The Senate is expected to vote on the legislation as early as today. President Donald Trump has indicated a desire to sign the bill ahead of the July 4 deadline he has referenced.
What are your thoughts on this story? Please feel free to share your comments below.
