Congressional Budget Office Letter Sets Record Straight on OBBBA’s Medicaid Provisions
WASHINGTON, D.C. – Today, the Congressional Budget Office (CBO) released updated estimates of the impacts of Medicaid policies within the House-passed One Big Beautiful Bill Act (OBBBA).
House Budget Committee Chairman Jodey Arrington (R-Texas) released the following statement in response to the letter:
"New analysis from the nonpartisan, independent CBO exposes Democrats’ phony claims that vulnerable Americans are being ‘kicked off’ of Medicaid and confirms that the only people coming off of Medicaid under OBBBA reforms are those who are ineligible, illegal, or able-bodied adults refusing to work.
Furthermore, CBO shows that the OBBBA saves states billions in Medicaid costs, which can be reinvested in their own Medicaid programs.
Finally, CBO rebukes the Democrats’ false claim that Republicans are cutting Medicaid. Under the OBBBA, the Medicaid program will continue to grow by over 30 percent over the next decade, even as Republicans root out waste, fraud, and abuse.
My Democrat colleagues have resorted to false claims and fear mongering in order to protect benefits for illegals and healthy people who refuse to work at the expense of tax payers and vulnerable Americans who depend on these programs."
Background:
Congressional Democrats have used misleading calculations to scare the American people. CBO’s letter corrects the record on the impact of the Medicaid policies within the House-passed OBBBA.
Regarding the impacts of the OBBBA by 2034, the letter notes the following:
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Federal Medicaid spending under the OBBBA grows by $204.6 billion—a 31.2 percent increase.
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4.8 million of those estimated to be without health insurance in 2034 are able-bodied adults without dependents who choose to not meet modest work or community engagement requirements:
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Over 80 percent of Americans support modest Medicaid work requirements.
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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.
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The American Enterprise Institute found that of able-bodied 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’s?125 hours per month, over?50 percent?higher than the?80 hours?of community engagement the?OBBBA?requires.
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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.
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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.
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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 2 million Americans estimated to be without health insurance in 2034.
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The OBBBA saves states $13.1 billion in Medicaid costs—freeing up resources they can choose to reinvest to further strengthen care for the most vulnerable Americans.
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1.4 million of those estimated to be without health insurance in 2034 are illegal immigrants.
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1.3 million of those 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.
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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.
The House-passed OBBBA contains commonsense Medicaid solutions to ensure the program is fiscally sustainable and able to serve the most vulnerable Americans for generations to come.
