On June 17, the Congressional Budget Office (CBO) and the Joint Committee on Taxation released updated estimates of the spending cuts and tax breaks in the House version of Trump’s One Big Beautiful Bill. While these findings give a broad sense of the scale of the cuts to healthcare spending, some of the proposed cuts deserve additional scrutiny.

The new CBO estimates include the effects of tax cuts on economic growth and on interest rates, as well as other indirect effects on the economy. The results of this analysis are reported in the table below. The tax cuts predominantly for the wealthy and corporations reduce revenues by more than $3.5 trillion over 10 years ending in 2034. Cuts in spending amount to about $1.2 trillion over the same period. This increases the deficit by more than $2.3 trillion, not counting the resulting increase in interest payments on the debt. Including $441 billion in those payments leads to the estimated increase in the deficit of almost $2.8 trillion.

This is a huge increase in the deficit over the next 10 years, driven by tax cuts thatraise the incomes of the wealthiest 10 percent of American households by an average of $12,000 a year by while the poorest 10 percent would lose $1,600 a year from reductions in Medicaid and the Supplemental Nutrition Assistance Program.

Shockingly, a trillion dollars in spending cuts out of the total of $1.2 trillion that will offset about a third of the tax cuts come from cuts in healthcare spending. These are not abstract numbers. Healthcare spending cuts result in millions of individuals and families losing their health insurance.

The bulk of health spending cuts come from cuts in Medicaid. This program, which insures poor and disabled people and provides long-term care benefits that help many middle-income families, is slated to be cut by about $700 billion. The remaining $300 billion reduction in healthcare spending comes from the elimination of subsidies to help individuals and families afford health insurance premiums and other cuts to programs.

Medicaid Cuts

The Senate version of Trump’s One Big Beautiful Bill is even more draconian andincludes deeper cuts to Medicaid than the House bill, but CBO has not yet evaluated its cost savings. It looks like cuts to Medicaid will only get worse as the House and Senate work to reconcile their two bills.

The House bill includes the following provisions that cut federal spending on Medicaid:

Establishes work requirements for adult enrollees who don’t have disabilities or dependents.

Bans new or increased state provider taxes and tightens standards for what is legally permissible.

Orders states to verify addresses and maintain updated information on Medicaid enrollees.

Suspends a regulation designed to ease enrollment in Medicaid, the Children’s Health Insurance Program and the Basic Health Program.

Requires eligibility redeterminations every six months for adults covered under the Medicaid expansion.

Mandates cost-sharing up to $35 for........

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