The Congressional Budget Office estimates that 7.8 million Americans across the U.S. would lose their coverage through Medicaid – the public program that provides health insurance to low-income families and individuals – under the One Big Beautiful Bill Act making its way through Congress.

That includes 248,000 to 414,000 of my fellow residents of Michigan based on the House Reconciliation Bill in early June 2025. There are similarly deep projected cuts within the Senate version of the legislation.

Many of these people are working Americans who would lose Medicaid because of the onerous paperwork involved with the proposed work requirements.

They wouldn’t be able to get coverage in the Affordable Care Act Marketplaces after losing Medicaid. Premiums and out-of-pocket costs are likely to be too high for those making less than 100% to 138% of the federal poverty level who do not qualify for health insurance marketplace subsidies. Funding for this program is also under threat.

And despite being employed, they also wouldn’t be able to get health insurance through their employers because it is either too expensive or not offered to them. Researchers estimate that coverage losses would lead to thousands of medically preventable deaths across the country because people would be unable to access health care without insurance.

I am a physician, health economist and policy researcher who has cared for patients on Medicaid and written about health care in the U.S. for over eight years. I think it’s important to understand the role of Medicaid within the broader insurance landscape. Medicaid has become a crucial source of health coverage for low-wage workers.

A few years ago, Michigan was slated to institute Medicaid........

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