Dear friend,

There has been a lot of misinformation about Medicaid out there and I want to provide updated estimates of the impacts of adjustments to Medicaid policies in the One Big Beautiful Bill Act (OBBB), from the Congressional BudgetOffice(CBO). Liberals are trying to scare the American people by using misleading calculations. The CBO letter, linked in this release from the House Budget Committee, corrects the record.

• In 2034, 4.8 million individuals estimated to be without health insurance will be healthy adults without dependents who choose to not meet modest work or community engagement requirements:
  • Over 80 percent of Americans support modest Medicaid work requirements.
  • The bill requires these Medicaid recipients to work, volunteer, receive education, or participate in a work program for an average of 20 hours a week. A 2022 analysis found that between 40 percent and 56 percent of childless healthy Medicaid recipients age 19–64 would not have been in compliance in 2022.
  • TheAmerican Enterprise Institute found that of healthy Medicaid recipients without dependents, those not working spend as much time playing video games and watching TV as those who do work spend on work—4.2 hours per day. That’s1 25 hours per month, over 50 percent higher than the 80 hours of community engagement the OBBBA requires.
  • Medicaid community engagement requirements under the House-passed bill would NOT apply to individuals who are: Pregnant women; minors and seniors; foster youth under 26; Tribal members; medically frail; those meeting TANF/SNAP work requirements; caregivers; or currently and recently incarcerated.
• 1.6 million Americans estimated to be without health insurance in 2034 will have access to other forms of subsidized health insurance, including the option to stay on Medicaid.
• Medicaid is a federal-state partnership, with states responsible for managing the program and sharing the cost. States’ decisions on management of their own Medicaid programs, not federal policy, would be responsible for two million Americans estimated to be without health insurance in 2034.
  • The OBBBAsaves states $13.1 billionin Medicaid costs—freeing up resources they can choose to reinvest to further strengthen care for the most vulnerable Americans.
• 1.4 million individuals estimated to be without health insurance in 2034 are illegal immigrants.
• 1.3 million individuals estimated to be without health insurance in 2034 are already ineligible for the Medicaid program. The OBBBA ends Biden-era regulations that kept ineligible individuals enrolled—restoring integrity to the program.
• CBO projects Medicaid enrollment in 2034 to be 79.5 million people under the OBBBA—higher than the total number of people enrolled in Medicaid as of January 2025.