The sweeping package of tax and spending cuts passed by House Republicans last month would add $2.4 trillion to the deficit over 10 years and result in nearly 11 million people losing health insurance coverage, the Congressional Budget Office estimated in an analysis released Wednesday. The increase in the number of uninsured includes roughly 1.4 million people who would no longer be covered because of their immigration status.
House Republicans had made last-minute changes to their bill and approved it in a 215-214 vote without a full score of the final package from the budget office. The latest analysis is largely in line with an earlier CBO projection that the GOP plan would add $2.3 trillion to the deficit — but the late changes made by House Republican leaders, which helped win over both moderate and conservative holdouts who were threatening to sink the bill, ended up increasing the overall cost of the bill. The CBO analysis forecasts a roughly $3.7 trillion reduction in 10-year revenue due to tax cuts, with that cost partially counterbalanced by $1.3 trillion in spending cuts.
President Donald Trump, the White House and congressional Republicans have repeatedly bashed the CBO, claiming that its estimates fail to factor in the tremendous growth that they say the legislation will unleash. House Speaker Mike Johnson went so far as to claim in a television interview on Sunday that the bill would actually reduce the deficit.
The CBO analysis does not include those so-called dynamic effects, though the budget office said an analysis of the economic effects of the bill is in the works. The latest analysis also doesn’t include the cost of additional interest payments on the higher debt, which would push the total cost of the bill toward $3 trillion.
The package is now before the Senate, where this highly anticipated new CBO analysis might add to the headwinds that could slow or derail the legislation. It certainly offered new ammunition to critics of the plan.
Even before the latest CBO numbers came out, some Republican senators have been criticizing elements of the package, with conservatives complaining that it fails to cut enough spending and others expressing concerns about the cuts to Medicaid or clean energy tax breaks.
Tariffs would reduce deficit: The CBO also issued a score of Trump’s tariff plan on Wednesday. It found that the tariffs would produce an estimated $2.8 trillion in revenue over 10 years, assuming the tariffs stayed at the same relatively high level as in mid-May. The tariffs would also shrink the economy relative to the baseline while raising inflation.
The assumption that Trump’s tariff regime will be permanent is a bit shaky, given the uncertain dynamics of trade over time, legal challenges to the Trump plans and the president’s expressed interest in reducing tariffs through deals with virtually every country in the world.
Nevertheless, the White House cited the tariff score as it argued that the GOP tax bill will not increase the deficit. “If you cite the CBO’s faulty score, you must also cite CBO’s forecast that President Trump’s tariffs will cut the deficit by $2.8 trillion over the next decade,” the White House said in a statement.
More attacks from Musk: Billionaire Elon Musk on Tuesday slammed the bill as a “disgusting abomination” because it would add trillions to the nation’s “crushingly unsustainable debt.” Musk continued his attacks on the legislation on Wednesday. “A new spending bill should be drafted that doesn’t massively grow the deficit and increase the debt ceiling by 5 TRILLION DOLLARS,” he posted on X. A second post urged his followers: “Call your Senator, Call your Congressman, Bankrupting America is NOT ok! KILL the BILL.”
It’s not clear whether that pressure from Musk will have any effect on lawmakers, many of whom have downplayed or dismissed the Tesla founder’s criticisms. At a news conference Wednesday before Musk’s latest barrage, Johnson told reporters he thinks Musk is “flat wrong” and offered to speak with him again. “I think he's way off on this, and I've told him as much, and I've said it publicly and privately,” Johnson said.
Democrats blast fiscal and health costs: Democrats used the CBO’s latest analysis to repeat their criticisms of the Republican bill. “Even after the biggest cuts to health care and food assistance in U.S. history, the Republican bill for billionaires would still add a historic amount to our debt — all to give the ultra-rich more tax breaks,” Rep. Brendan Boyle, the top Democrat on the House Budget Committee, said in a statement. “Republicans cry crocodile tears over the debt when Democrats are in charge — but explode it when they’re in power. The Republican debt crisis will destabilize the economy and drive up mortgage rates, car loans, and credit card bills — making life more expensive for everyone.”
Democratic lawmakers also pointed to another new analysis from the CBO that said the GOP budget bill and likely changes to policies surrounding the Affordable Care Act would lead to a total of 16 million people losing health coverage — 10.9 million as a result of the new Republican legislation and 5.1 million from the end of an expanded ACA tax credit and a proposed administration rule for ACA marketplaces. (In its analysis of the GOP megabill, CBO also estimated that benchmark premiums for insurance plans purchased on the Affordable Care Act exchanges would be lower by an estimated 12.2 percent by 2034.)
“The Republican health agenda is all about making it harder to get health care,” Reps. Frank Pallone and Richard Neal and Sen. Ron Wyden said in a joint statement. “Every step of the way, this abomination of a bill creates barriers and mazes designed to demoralize and discourage Americans as they try to get affordable health care. The results of this cruel system are clear: millions will lose coverage, health care costs will go up for all Americans, and tens of thousands will die.”
Republicans have insisted that they are only targeting waste, fraud and abuse in Medicaid and removing ineligible people from the program.
“Whether you call it a cut in benefits or not, an estimated 10.9 million people would lose health insurance as a result of changes to Medicaid and the ACA passed by the House,” Larry Levitt, executive vice president for health policy at KFF, a nonpartisan health care foundation, wrote on X. “This would be the biggest rollback in federal support for health care ever.”
The bottom line: Key Republican senators headed to the White House on Wednesday to meet with the president and try to resolve some differences on the bill. Changes are likely in the Senate, and it’s clear that the battle over Trump’s “big, beautiful bill” is far from over.