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Senate Republicans advance budget bill cutting Medicaid and curbing ACA coverage

Healthcare advocates have launched a seven-figure ad campaign to block the legislation’s rollback of ACA subsidies

Brenda Patoine of Vermont joins over a thousand people at a march against efforts to dismantle and defund the healthcare system in Washington, on March 12, 2025.
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Overview

  • Senate debate centers on the “One Big Beautiful Bill Act,” a reconciliation package that would trim federal Medicaid outlays by roughly $700 billion over the next decade.
  • Congressional Budget Office estimates show the plan could reduce ACA marketplace and Medicaid enrollment by about 10.7 million and end expanded premium tax credits, leaving an estimated 5 million uninsured.
  • The proposal would halt automatic ACA plan re-enrollments, narrow open enrollment windows and delay Biden-era rules designed to streamline transitions between Medicaid, CHIP and private plans.
  • Keep Americans Covered, a coalition of health advocates, is running a seven-figure ad campaign targeting swing-state senators to oppose the bill’s provisions.
  • Health policy experts warn the package amounts to a backdoor repeal of key ACA protections and would disproportionately harm low-income families and people with pre-existing conditions.