President Trump and his Republican backers have been determined to gut the Affordable Care Act (ACA) and expanded Medicaid coverage ever since his first term in office. This year he is finally getting his way, putting the health of tens of millions of Americans at risk.
It is racial minorities and the chronically ill who will be the most harmed.
A year ago, Congress passed the so-called One Big Beautiful Bill Act, putting in place onerous new eligibility requirements for Medicaid coverage, including work requirements. Medicaid enrollees ages 19 to 64 must complete at least 80 hours a month of work, community service, job training or education to maintain coverage, unless they qualify for an exemption. All states must comply with the new rule by Jan. 1, 2027.
The combination of ACA cuts and new barriers to Medicaid enrollment will likely cause historic coverage losses across the United States for years to come, according to new research: Nearly 16 million people stand to lose coverage by 2034.











