While public attention has largely been focused on the Middle East and on President Donald Trump’s immigration policy, Republicans in Congress are on the verge of passing massive Medicaid cuts as part of a budget bill that could lead to millions of Americans losing their health insurance benefits and, according to one recent estimate, thousands of unnecessary deaths every year.

While the GOP’s so-called “big, beautiful” bill is a smorgasbord of policy — potentially including everything from blocking AI regulation to restricting the power of the federal courts — perhaps the most consequential changes would be to Medicaid. The program, which covers low-income Americans of all ages, is now the country’s single largest insurer, covering more than 70 million people. The legislation approved by House Republicans, which is now being debated and amended by the Senate, would cut Medicaid spending by $793 billion over 10 years. The upshot is that 10.3 million fewer people would be enrolled in the program by 2034.

Those coverage losses would more than undo the progress the US has made in reducing the ranks of the uninsured over the past few years. On Tuesday, the National Center for Health Statistics reported that the number of US adults without insurance in 2024 had fallen to 27.2 million, down from 31.6 million in 2020. The GOP bill would reverse those gains and then some within a decade.

The consequences would be much more severe than the mere loss of a government health insurance card. According to one analysis of the House bill published last week in the Annals of Internal Medicine by a trio of Harvard-affiliated researchers, those losses of Medicaid coverage would lead to fewer Americans reporting good health, fewer patients getting preventive health screenings, and, at the end of the day, between 8,200 and 24,600 additional........

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