Democrats say Republicans have brushed aside voters’ affordability concerns, including health insurance costs, while backing President Donald Trump’s 2025 tax and spending bill.
Sen. Bernie Sanders, I-Vt., made the argument during a committee hearing with Health and Human Services Secretary Robert F. Kennedy Jr. He said the Big Beautiful Bill had already thrown 15 mn Americans off the healthcare they need.
Sanders has used the 15 mn figure several times in recent months. He often speaks about high health insurance costs and poor access to coverage, so the claim fits his broader case against Republican healthcare policy. Still, the timing matters.
Independent estimates show mn of people are on track to lose Affordable Care Act coverage in the coming years. Only a smaller share appears to have lost coverage so far.
The One Big Beautiful Bill Act extended income tax cuts for many individuals and businesses. It also added $75 bn for Immigration and Customs Enforcement and cut safety-net programs, including Medicaid.
The Congressional Budget Office, Congress’ nonpartisan budget office, projected soon after the law passed that it would increase the number of uninsured people by 10 mn through 2034. That figure included people who had coverage through Medicaid or the Affordable Care Act.
Sanders’ statement focused on the 2025 law, but his spokesperson, Patrick Barham, said the senator also referred to the expiration of ACA marketplace premium tax credits.
Those subsidies were expected to affect about 4 mn people who buy coverage through the ACA marketplaces.
Barham said the two factors together will strip coverage from more than 15 mn Americans and raise out-of-pocket healthcare costs for mn more. He cited an analysis by the left-leaning Center on Budget and Policy Priorities.
The available data show a smaller current decline. The Centers for Medicare & Medicaid Services reported in March that 23.1 mn consumers enrolled in ACA plans for 2026, about 1 mn fewer than in 2025.
New Jersey and New York are among the states reporting lower enrollment so far. Community health centers that serve many ACA patients have also reported fewer insured patients, according to Sara Rosenbaum, a George Washington University healthcare law and policy professor.
Rosenbaum said young people have dropped insurance at higher rates, leaving older and sicker consumers in the insured pool.
That’s a risk for premium stability, according to Beinsure analysts, because a smaller and less healthy pool tends to increase pressure on rates.
Medicaid work requirements under the 2025 law are scheduled to take effect in January 2027, though some states, including Nebraska and Montana, are putting the new rules in place this year.
KFF Health News reported that most Medicaid beneficiaries affected by the work rules are expected to lose coverage because of paperwork problems, not because they do not work. Missing documentation, failed reporting, and administrative friction all count.
PolitiFact rated Sanders’ claim Mostly False. His statement said 15 mn Americans had been thrown off healthcare because of the Big Beautiful Bill.
ACA plan enrollment is down about 1 mn people from 2025. The CBO projects 10 mn more uninsured people by 2034 because of the 2025 law. Separately, about 4 mn people were expected to lose coverage subsidies when ACA tax credits expired in 2026.
The figures come close to 15 mn in projected coverage losses, but not all stem from the One Big Beautiful Bill. The losses also remain forecasts, not completed events. Sanders’ claim contains a real policy concern, but it presents future estimates as current fact.
