The nonpartisan Congressional Budget Office estimated that the One Big Beautiful Bill Act will reduce federal Medicaid spending by more than $900 billion over a decade. But in a series of congressional hearings last month, Health and Human Services Secretary Robert F. Kennedy Jr. misleadingly claimed that “there are no cuts to Medicaid” as a result of that 2025 law.
In the first State of the Union address of his second term, President Donald Trump proclaimed that “our nation is back, bigger, better, richer and stronger than ever before.” But our review of his speech found that he distorted a number of facts about the state of the economy, health care, immigration and other topics.
In our latest installment of the Project 2025 series, we look at some of the social safety net policy changes sought by Project 2025 and proposed or accomplished by Trump.
In the battle over how the One Big Beautiful Bill Act affects rural hospitals, Health and Human Services Secretary Robert F. Kennedy Jr. has touted a five-year $50 billion fund as “an infusion of cash” that will “restore and revitalize” rural communities. But his statements ignore the higher estimated Medicaid spending cuts to rural areas under the law.
Contrary to President Donald Trump’s claim that no one will die as a result of the Republican budget bill, an analysis from the University of Pennsylvania and Yale University estimated that the legislation’s changes to Medicaid and the Affordable Care Act will result in at least 42,500 preventable deaths each year. At the same time, independent Sen. Bernie Sanders has slightly overstated the estimate.
The Congressional Budget Office estimated that the House version of the One Big Beautiful Bill Act would reduce Medicaid enrollment and cause millions of people to become uninsured by 2034. It didn’t say that “5 million” of the people who are “going to lose insurance” would have “other insurance” so “they’re still insured,” as National Economic Council Director Kevin Hassett misleadingly claimed.
As the Republican budget bill, called the One Big Beautiful Bill Act, nears the July 4 deadline set by the White House, lawmakers have been ramping up the rhetoric. We referee the claims from both sides.
Republicans say that able-bodied adults who don’t work would lose Medicaid coverage under the House tax-cuts-and-spending bill, while Democrats say the legislation would hurt vulnerable groups. The bill’s main target is those able-bodied adults, but other groups would lose coverage due to paperwork burdens and other provisions in the bill, health policy experts say.
A House-passed reconciliation bill would reduce federal funding to states that provide state-funded health insurance to people in the U.S. illegally, resulting in 1.4 million people losing coverage, according to a preliminary Congressional Budget Office analysis. But President Donald Trump and Republican lawmakers have wrongly cast the bill as removing these immigrants from Medicaid.
A preliminary Congressional Budget Office analysis said that a Republican legislative proposal that makes changes to Medicaid and the Affordable Care Act would leave “at least 8.6 million” people without health insurance by 2034. But many Democrats have exaggerated the figure, claiming that 13.7 million would lose their insurance under the proposal.