Millions May Lose Healthcare Under Trump's New Budget Bill, Says CBO
WASHINGTON, D.C. — June 29, 2025
A sweeping federal budget proposal championed by former President Donald Trump could lead to nearly 12 million Americans losing access to healthcare, according to a new analysis released by the Congressional Budget Office (CBO) this week.
The controversial legislation — widely referred to by Republicans as the "Big Beautiful Bill" — narrowly cleared a procedural vote in the U.S. Senate on Saturday night. But the fight to pass it into law is far from over, with both Democratic and Republican lawmakers voicing serious concerns about its impact on healthcare access, Medicaid funding, and the national debt.
CBO Estimates $3.3 Trillion Debt Increase
The non-partisan CBO report estimates that if passed in its current form, the legislation would add $3.3 trillion to the national debt over the next decade. The bill includes provisions for major tax reductions, including:
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Elimination of taxes on overtime wages and tips
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A deduction on Social Security income
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Extension of Trump-era 2017 tax cuts
However, the bill offsets these tax breaks with massive spending cuts, primarily to federal aid programs such as Medicaid, drawing criticism from both sides of the aisle.
Medicaid Cuts Could Hit Millions
The CBO calculates that the proposed budget would slash Medicaid funding by $1 trillion, putting millions at risk — particularly low-income families, the elderly, and rural communities.
The bill introduces new work requirements for Medicaid recipients, restricts how much states can tax medical providers (a key funding source), and shifts more cost responsibility to individual states beginning in 2028.
These measures, according to the report, could leave as many as 12 million Americans without healthcare coverage.
Republican Senators Break Ranks
While the bill narrowly passed its first procedural hurdle with a 51–49 vote, it remains uncertain whether it can gather enough support for final approval.
Senator Thom Tillis (R-NC) became one of the most prominent Republicans to oppose the bill, announcing he would not seek re-election after voting against it.
“This legislation would cost my state billions in healthcare losses and harm rural hospitals already struggling,” Tillis said Sunday.
Senator Rand Paul (R-KY) also expressed opposition, citing the projected impact on the national debt.
Democrats Decry 'Tax Cuts for the Wealthy'
Democrats are united in their opposition to the legislation, accusing Republicans of prioritizing tax cuts over public welfare.
“This is tax cuts for the wealthy, paid for by taking healthcare from millions,” said Senator Mark Warner (D-VA) on CNN.
In an effort to delay the vote, Democratic lawmakers have invoked Senate rules requiring a full reading of the nearly 1,000-page bill on the chamber floor.
Amendments Added to Satisfy Holdouts
In response to criticism, Senate Republicans made last-minute changes, including an expansion of the Rural Hospital Relief Fund from $15 billion to $25 billion.
Still, concerns remain over:
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Work requirements for Medicaid and SNAP (food stamps)
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Burdens placed on state healthcare systems
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The overall economic sustainability of the bill’s tax reductions
Final Vote Looms with Uncertain Outcome
With only a 53-seat majority in the Senate, Republicans can afford just three defections — assuming Vice President JD Vance casts the tie-breaking vote.
The Senate now has 20 hours of debate time before a final vote can be scheduled. If passed, the legislation must return to the House of Representatives for final approval before it can reach Trump’s desk.
The White House has issued a statement warning that failure to pass the bill before the self-imposed July 4 deadline would be considered the “ultimate betrayal” of the Republican platform.
What’s at Stake?
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12 million Americans may lose Medicaid coverage
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$3.3 trillion could be added to the national debt
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Major tax breaks for businesses and upper-income earners
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Significant funding shifts from federal to state programs
Supporters of the bill claim it’s a necessary move to eliminate waste, encourage employment, and reward productivity.
“We don’t pay people to be lazy,” said Senator Markwayne Mullin (R-OK). “We want to give them opportunity and a helping hand when they need it — not a lifelong dependency.”
Conclusion
As the debate continues, the future of Trump's Big Beautiful Bill hangs in the balance. The outcome could reshape the nation’s healthcare system, tax policies, and social safety net for years to come — with millions of Americans watching closely.