Bernie Sanders says GOP bill would strip Medicaid, health care from 13.7 million. That’s too high.

The Republican proposal to cut federal spending will end up kicking millions of Americans off health insurance, including Medicaid, Democrats say.

"Republicans just unveiled their ‘big, beautiful bill,’ which will take Medicaid & health insurance away from 13.7 million Americans, shutter hospitals & cause premiums to skyrocket across the country. Insane," said Sen. Bernie Sanders, I-Vt., in a May 12 X post. Sanders was referring to President Donald Trump’s name for the big budget bill. 

Many other Democrats cited the same estimate — 13.7 million. 

The figure stems from an analysis by the Congressional Budget Office, Congress’ nonpartisan budget-analysis arm. But CBO offered several estimates, and Sanders, like other Democrats, focused on the highest one. The bill — if it became law —  would remove 8.6 million Americans from Medicaid, CBO said.

The 13.7 million figure includes changes being considered but not part of the budget bill now being debated.

"The actual effect on coverage depends on what is signed into law, how program changes are implemented by the state, and changes in the overall economy," said Joseph Antos, a health care specialist with the conservative American Enterprise Institute. But he added, "It's close enough for government work.

KFF, which includes PolitiFact partner KFF Health News, found that if these changes go into effect, it would reverse years of falling uninsured rates that followed the Affordable Care Act’s implementation.

The future of the legislation is uncertain. The House Budget Committee voted down a comprehensive draft bill amid a conservative Republican backlash May 16. Some Senate Republicans have criticized the House legislation’s Medicaid provisions, among other changes. Trump, who said in May he would not cut Medicaid, called for Republicans to unite behind the legislation.

House committee budget plan is one reason that millions would lose coverage

Republicans are looking for massive budget cuts to meet the goal of fully extending Trump’s 2017 tax bill and adding new tax cuts without exploding the federal deficit. The House Republican budget plan adopted Feb. 25 opened the door to reducing spending on Medicaid, even though it doesn’t name the program.

That budget plan directed the House Energy and Commerce Committee to find ways to cut the deficit by at least $880 billion over the next decade. With Trump opposing cuts to Medicare, the only target that’s big enough to support such cuts is Medicaid.

Medicaid, a health care program for low-income people, provides services for about one in five Americans.

On May 11, the House Energy and Commerce Committee released its budget reconciliation plan, which addresses both Medicaid and the Affordable Care Act.

As members of both parties typically do in the run-up to considering legislation, Democrats asked CBO to review the proposal for its fiscal and insurance coverage impacts. CBO wrote in a preliminary estimate that "the legislation would reduce the number of people with health insurance by at least 8.6 million in 2034."

Democrats also asked CBO to analyze other potential actions, and these other calculations explain the difference between the 8.6 million and 13.7 million estimates for newly uninsured people. 

It says that 4.2 million people would lose insurance if enhanced tax credits for premiums are allowed to lapse. It also said 1.8 million people would lose insurance if the Marketplace Integrity and Affordability Rule — a regulation being proposed by the Trump administration — is finalized. The enhanced tax credits are not included in the reconciliation bill, but the marketplace rule is.

CBO found that "these three actions would increase the number of people without health insurance by at least 13.7 million in 2034."

The CBO cautioned that its estimates could change as policies develop.

Sanders spokesperson Anna Bahr acknowledged to PolitiFact that not all of the 13.7 million figure stems from the "big, beautiful bill." But she said that the fact that the bill did not extend the expiring premium credits is effectively a policy choice that Republicans should be held accountable for, too.

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Donald Trump

stated on May 20, 2025 in remarks to reporters in the U.S. Capitol

In the House bill, “we’re not changing Medicaid,” only cutting “waste, fraud and abuse.”

"Their exclusion of this tax policy in their tax bill is their own choice," Bahr said. "They’re in charge of the House, the Senate, and the White House, and as a consequence of the choices they are making about what is and is not in their ‘big, beautiful bill,’ 13.7 million fewer Americans will have health insurance over the budget window. "

The Inflation Reduction Act, signed by then-President Joe Biden, extended the subsidies through 2025. "There was an effort last session by the Democrats to extend or make permanent the enhanced premium tax credits, but the Republicans did not want to participate in that," said Linda Blumberg, a Georgetown University public policy research professor. 

At least two Republican senators have said they would vote to extend the enhanced premium tax credits: Alaska’s Lisa Murkowski and North Carolina’s Thom Tillis.

On May 16, the Trump White House touted the legislation as "a generational chance to protect Medicaid for Americans" and said it would remove recipients in the U.S. illegally from the program. White House spokesman Kush Desai told Fox News Digital that the Medicaid changes will "improve care for those who this program is intended to serve: pregnant women, the disabled, seniors and low-income families."

Under current law, immigrants in the U.S. illegally are not eligible for federally funded Medicaid. However, Adam Searing, a Georgetown associate professor and expert on Medicaid, wrote that a provision of the legislation has a goal to reduce state-only funded health coverage for lower-income immigrants in the U.S. illegally. This provision could end coverage for 1.4 million people in the U.S. illegally, according to a CBO projection.

Our ruling

Sanders said, "Republicans just unveiled their ‘big, beautiful bill,’ which will take Medicaid & health insurance away from 13.7 million Americans."

By itself, this bill would reduce health insurance by 8.6 million. The 13.7 million figure includes the impact from other policies that can plausibly be ascribed to Republicans. The larger estimate, by the Congressional Budget Office, includes the effects of several other policies, including the expiration of premium subsidies for the Affordable Care Act; Republicans have offered limited legislative buy-in to extending these subsidies. 

In addition, some of the people who would lose insurance are in the U.S. illegally, so would not be covered by the term Sanders used, "Americans."

The office said its analysis remains ongoing and that the number could rise. 

The statement is partially accurate but ignores information or takes it out of context, so we rate it Half True.

CORRECTION, May 19, 2025: The bill considered by the Budget Committee includes language on the Marketplace Integrity and Affordability Rule. We updated the story to reflect this point.

RELATED: Can House Republicans cut $880 billion without slashing Medicaid? It’s likely impossible.