CBO projects OBBBA to increase uninsured by 10 million, federal deficit by $3.4 trillion

The Congressional Budget Office today released its estimate of the budgetary effects of the One Big Beautiful Bill Act, as enacted. CBO projects the law will increase the number of people without insurance by 10 million in 2034, as well as increase the budget deficit by $3.4 trillion over the 2025-2034 period relative to CBO’s 2025 baseline. This includes an estimated $1.06 trillion reduction in federal spending for changes made to the Medicaid program and Health Insurance Marketplaces in Subtitle B. Most of the reductions in this section can be attributed to provisions that implement community engagement (or “work”) requirements for Medicaid expansion beneficiaries ($325.6 billion reduction), freeze Medicaid provider taxes ($191.1 billion reduction) and reduce funding for state directed payments ($149.4 billion reduction).