Watchdog denies projected Medicaid coverage loss under 'big, beautiful bill'

(The Center Square) – While updated cost estimates show Republicans' multitrillion-dollar policy megabill could kick nearly 11 million people off Medicaid, a government watchdog says those recipients either have ways to retain healthcare coverage or were ineligible in the first place.

The Congressional Budget Office released Wednesday a comprehensive fiscal analysis of the House-passed budget reconciliation bill, or the One Big Beautiful Bill Act, showing it would add an estimated $3 trillion to the national debt and $2.4 trillion to primary deficits over the next decade alone.

The CBO report also estimates that the Medicaid reforms within the bill, such as adding work requirements for some recipients, would ban coverage for 10.9 million current Medicaid recipients.

"It's shocking House Republicans rushed to vote on this bill without an accounting from CBO on the millions of people who will lose their health care or the trillions of dollars it would add to the national debt," House Energy and Commerce Ranking Member Frank Pallone, D-N.J., said Wednesday.

But the Foundation for Government Accountability disputed those findings in a Wednesday report coinciding with CBO's updates.

According to FGA's data, 4.8 million current Medicaid recipients who could lose coverage are able-bodied adults without dependents who could keep their coverage if they choose to work. Another 1.6 million individuals are erroneously enrolled in Medicaid in more than one state; they would still keep their coverage in their state of residence under the Republican bill.

Roughly 1.4 million immigrants illegally living in the country – and therefore legally ineligible for Medicaid – would lose their coverage, while 1.3 million people dually eligible for both Medicaid and over healthcare coverage would retain their other coverage.

Additionally, CBO included more than 200,000 hypothetical individuals not currently enrolled in Medicaid in its analysis.

FGA Director of Data and Analytics Hayden Dublois called the CBO analysis "political storytelling" and accused the authors of "partisan bias." FGA says that more than 90% of employees in CBO's Health Division, which analyzes programs like Medicaid, are registered Democrats.

"CBO makes scary claims about how many people will lose Medicaid, but they leave out the truth: The vast majority of those counted are either enrolled in multiple states, already ineligible, have other health coverage, are illegal aliens, are able-bodied adults who can work but choose not to, or aren't even enrolled in the program," Dublois said in a statement.

The FGA report also outlines CBO's history of miscalculating Medicaid fiscal estimates.

In 2010, CBO had predicted that only 13 million able-bodied adults would gain Medicaid coverage if all 50 states expanded the program. But by 2019 – at which point roughly two-thirds of states had expanded Medicaid coverage – nearly 20 million people had been added to the rolls.

When the Affordable Care Act's individual mandate was repealed in 2017, CBO estimated that three million people would lose private health insurance and one million would lose Medicaid coverage by 2019. Instead, both private insurance and Medicaid levels rose above CBO's predictions by millions.

"It's pretty simple: CBO is biased, and its numbers consistently miss the mark by embarrassing margins," Dublois said. "Congress should be able to rely on its service agency to produce quality data. Instead, CBO has become another captive institution wrapped in non-partisan clothing."