A Republican-led proposal to scale back Affordable Care Act (ACA) subsidies could result in millions of Americans losing their health insurance, according to new estimates from the Congressional Budget Office (CBO).
The CBO estimates were requested by top Democrats in the House Energy and Commerce, House Ways and Means, and Senate Finance Committees, Senator Ron Wyden and Representatives Neal Dunn and Frank Pallone.
Newsweek has contacted the press secretaries of Representatives Pallone and Neal and Senator Wyden, outside of regular working hours via email for comment. The CBO told Newsweek they didn’t have any additional comment to share at this time.
Why It Matters
The proposed rollback comes at a time when ACA enrollment is at an all-time high, and the CBO estimated that at least 5.7 million people would lose coverage entirely by 2034 under the proposed changes.
Across three various policies that could be brought into action, the expiration of expanded premium tax credits, the finalizing of the 2025 Marketplace Integrity and Affordability Rule and possible changes to Medicaid, the CBO estimated that as many as 13.7 million Americans would be left without health coverage by 2034.
Representatives Pallone and Neal and Senator Wyden said in a joint statement that if the policy were to go ahead, and the GOP let the policy lowering the costs of ACA plans expire: “Trump and Republicans are opening the floodgates for the biggest theft of health coverage we have ever seen.”
Michael Macor/San Francisco Chronicle via AP
What To Know
The plan, advanced as part of a broader budget reconciliation effort in the GOP-controlled House, would significantly reduce federal spending on ACA marketplace subsidies starting in 2026.
The CBO’s projections were circulated to House Democratic staff in a series of internal emails released on May 11, 2025.
The documents reveal that if enacted, the proposed subsidy rollback would strip coverage from millions, particularly hitting low-income adults who depend on enhanced premium tax credits to afford health plans under the ACA.
The out-of-pocket costs for all privately insured Americans, including those with employment-based coverage, would increase by $450 for individuals and $900 for families as a result of the policy.
The proposal could therefore have far-reaching implications for healthcare access and affordability, especially in states that did not expand Medicaid and where marketplace subsidies serve as a lifeline for lower-income residents.
The policy targets enhanced premium tax credits that were first implemented during the COVID-19 pandemic to make ACA plans more affordable.
These credits cap the percentage of income that households must pay toward premiums and expanded eligibility for subsidies to higher-income families.
Republicans argue that the rollback is a necessary step to rein in federal spending and reduce the deficit. However, critics say the cuts disproportionately affect low- and middle-income Americans who rely on ACA subsidies to maintain health coverage.
What People Are Saying
Democrat Representatives Pallone and Neal and Senator Wyden, said: “Cold, hard math paints a grim picture— the Republicans’ long pursued golden goose of dismantling and undermining the ACA means millions of Americans will see their premiums skyrocket and their care reduced or outright stolen. By not extending the improvements to the Premium Tax Credits, by using reconciliation to codify cruel new rules that will make it harder for people to get care, Trump and Republicans are opening the floodgates for the biggest theft of health coverage we have ever seen. The nonpartisan CBO is now telling us that 5.7 million stand to lose their care if Republicans get their way on the ACA, with the number rising when you factor in their cruel Medicaid cuts and additional legislative changes.”
They added: “Through their budget, their vision is for a poorer, sicker America. If they choose to not extend these credits, they are choosing to rip health care from millions. The horrific consequences will lie squarely at their feet.”
What Happens Next
Without Congressional action, the subsidies are set to expire regardless of the new GOP proposal, leaving millions vulnerable to higher premiums and possible loss of coverage.
