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Gideon Lukens

@gidlukens.bsky.social
1.7K followers 628 following 283 posts

Senior Fellow and Director of Research, Health Policy @centeronbudget. Former Dep. Director for Economic Policy at OMB. Music lover. Views expressed are my own.

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Reposted by Gideon Lukens
Brendan Duke @brendanvduke.bsky.social · 08/10/2026
We just got our fiscal report card back for FY2026 from @USCBO and it's not good. We estimate the U.S. brought in 16.7% of GDP in revenue and spent 19.4% of GDP on programs — producing a non-interest deficit of 2.6% of GDP. Net interest came in at a record high 3.5% of GDP. 🧵
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Shelby Gonzales @shelbytgonzales.bsky.social · 01/10/2026
Starting today many people granted humanitarian immigration protections, including refugees, people granted asylum, and survivors of trafficking, will no longer be able to access health care through federally funded Medicaid and CHIP programs. www.cbpp.org/research/imm...
cbpp.org
Harmful Republican Megabill Takes Away Health Coverage, Food Assistance, Tax Credits From Millions of Immigrants and Their Families
The harmful Republican megabill imposes massive cuts in food assistance, health coverage, and other supports for people with low incomes and singles out immigrants with lawful status and their familie...
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Reposted by Gideon Lukens
Sharon Parrott @sharonparrott.bsky.social · 29/09/2026
The Trump Admin once again announced, w/ no prior notice & no time for Congress to respond, that it was taking illegal unilateral action — a so-called “pocket rescission” impoundment — to cause $800M+ from 11 program accounts to expire unused after 9/30. time.com/article/2026...
time.com
What Is a ‘Pocket Rescission’? Inside Trump’s Move to Cancel $810 Million in Federal Funding
The Trump Administration is seeking to claw back spending that was approved for programs including those serving immigrants, refugees, minority groups, and children.
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Reposted by Gideon Lukens
Sarah Lueck @sarahl202.bsky.social · 22/09/2026
It’s surreal to see federal officials take a victory lap today for cancelling hundreds of thousands of marketplace enrollments, while massive health coverage losses are underway. www.nytimes.com/2026/09/22/h...
nytimes.com
Trump Officials Eject 750,000 From Obamacare Markets, Claiming Fraud
Vice President JD Vance said the measure would save the government $2.2 billion.
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Shelby Gonzales @shelbytgonzales.bsky.social · 18/09/2026
Today, the Administration’s cruel new public charge policy takes effect, threatening lawful immigration and leading families, many of which include U.S. citizen children, to go without vital services that they need and are eligible for. pifcoalition.org/resources/pr...
pifcoalition.org
Millions of U.S. Citizens, Lawfully Present Immigrants, at Risk as Trump “Public Charge” Rule Takes Effect - Protecting Immigrant Families
EL PASO, TEXAS — Regulations finalized by the U.S. Department of Homeland Security (DHS) in July take effect Friday, threatening the health and wellbeing of millions of lawfully present immigrants and...
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Center on Budget and Policy Priorities @centeronbudget.bsky.social · 15/09/2026
The uninsured rate held steady at 7.9% in 2025, but that stability predates the major health coverage losses now being driven by the 2025 reconciliation law and other Trump Administration policies. @gidlukens.bsky.social explains what the new Census data show: www.cbpp.org/blog/analyzi...
cbpp.org
Uninsurance Rate Held Steady in 2025 CPS Data | Center on Budget and Policy Priorities
The portion of people in the U.S. who lack health coverage remained stable at 7.9 percent in 2025,...
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Reposted by Gideon Lukens
Claire Heyison @claireheyison.bsky.social · 10/09/2026
Millions are losing health coverage or will soon because of the expiration of PTC enhancements, the Medicaid work requirement, and other harmful Republican policies. This proposal from President Trump for $500 cash payments would do nothing to help them. thehill.com/policy/healt...
thehill.com
Trump pledges $500 ObamaCare rebate checks
The Trump administration is pledging to send $500 rebate checks to nearly 1 million Americans who the White House says were overcharged for ObamaCare coverage.  In a recorded message post…
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Gideon Lukens @gidlukens.bsky.social · 02/09/2026
The tracker features interactive maps and charts with 8 different data sources/series. You can adjust the date ranges to see # and % changes over different time periods.
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Gideon Lukens @gidlukens.bsky.social · 02/09/2026
We updated our interactive health coverage tracker that features state Medicaid & ACA marketplace data. Medicaid enrollment fell by 4.8M people from May '25 - May `26, and recent state admin data show that the coverage declines are continuing. www.cbpp.org/research/hea...
cbpp.org
Health Coverage Tracker: Millions of People Are Losing Coverage Following 2025 Republican Policy Changes
This tool tracks declines in the number of people enrolled in the ACA marketplaces and Medicaid: two sources of coverage that have been crucial to delivering affordable health care to people with low ...
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Gideon Lukens @gidlukens.bsky.social · 05/08/2026
CBPP’s interactive coverage tracker will show how the work requirement and state implementation affects people’s coverage. www.cbpp.org/research/hea...
cbpp.org
Health Coverage Tracker: Millions of People Are Losing Coverage Following 2025 Republican Policy Changes
This tool tracks declines in the number of people enrolled in the ACA marketplaces and Medicaid: two sources of coverage that have been crucial to delivering affordable health care to people with low ...
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Gideon Lukens @gidlukens.bsky.social · 05/08/2026
Medicaid coverage losses will deepen as the work requirement comes into effect nationwide in 2027. The harder the rules are for people to navigate and states to implement, the more people will lose coverage – including many with serious illnesses. www.finance.senate.gov/ranking-memb...
finance.senate.gov
Wyden, Warnock Lead Senate Democrats in Call to Stop Red Tape Requirements in Medicaid | The United States Senate Committee on Finance
Wyden, Warnock Lead Senate Democrats in Call to Stop Red Tape Requirements in Medicaid
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Gideon Lukens @gidlukens.bsky.social · 05/08/2026
Millions of people are losing health coverage due to Republican policy changes, and the numbers will continue to grow. See our new interactive state tracker featuring 8 different series of downloadable Medicaid and ACA marketplace data. www.cbpp.org/research/hea...
cbpp.org
Health Coverage Tracker: Millions of People Are Losing Coverage Following 2025 Republican Policy Changes
Some 2.2 million fewer people are enrolled in the Affordable Care Act (ACA) marketplaces as of February 2026 compared to December 2025, after Republicans chose to not extend premium tax credit...
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Reposted by Gideon Lukens
Anna Bailey (she/her) @annakbailey.bsky.social · 24/07/2026
🧵No one should be forced to sleep outside in a nation as wealthy as ours. Yet, one year ago today, Pres. Trump issued an executive order (EO) calling on federal agencies to abandon effective homelessness solutions in favor of punishing people who have nowhere safe to sleep.
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Gideon Lukens @gidlukens.bsky.social · 23/07/2026
CBO’s report provides useful system-wide context as millions lose coverage and people’s costs rise due to ACA marketplace and Medicaid cuts in the 2025 Republican reconciliation law, rule changes, and the decision to let enhanced PTCs expire. [5/5]
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Gideon Lukens @gidlukens.bsky.social · 23/07/2026
CBO highlights that while Medicaid and PTC spending is targeted to people with lower incomes, for employer coverage, “people with higher incomes…receive a larger federal subsidy.” [4/5]
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Gideon Lukens @gidlukens.bsky.social · 23/07/2026
The report finds that federal subsidies for employer coverage will grow >3X more than premium tax credits and >2X more than Medicaid/CHIP over the next 10 years. Subsidy growth for employer coverage is also higher on a per-enrollee basis. [3/5]
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Gideon Lukens @gidlukens.bsky.social · 23/07/2026
Employer coverage subsidies aren’t as visible as Medicaid & marketplace spending because they occur through tax provisions, but they’re just as real. [2/5]
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Gideon Lukens @gidlukens.bsky.social · 23/07/2026
New CBO report projects that federal subsidies for employer coverage will be 6X larger than ACA marketplace premium tax credits over 2026-2036. [1/5] www.cbo.gov/publication/...
cbo.gov
Federal Subsidies for Health Insurance, 2026 to 2036
Federal subsidies for health insurance total $33.6 trillion over the 2026–2036 period in CBO and JCT’s projections. Those estimated subsidies grow from 7.4 percent of gross domestic product (GDP) in 2...
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Gideon Lukens @gidlukens.bsky.social · 20/07/2026
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Reposted by Gideon Lukens
Shelby Gonzales @shelbytgonzales.bsky.social · 16/07/2026
Last month, SCOTUS upheld birthright citizenship, but now the Trump Admin. is finding another way to take aim at the U.S.-born children of immigrant parents with its cruel new “public charge” rule.
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Gideon Lukens @gidlukens.bsky.social · 10/07/2026
Another year of double-digit premium increases are expected in 2027, right when Medicaid and other health care cuts ramp up. And this comes after ~3 million people already dropped #ACA marketplace coverage as premium tax credit enhancements expired. youtu.be/KthkxUfhW-c?...
youtu.be
Meet the Press NOW — July 9
YouTube video by NBC News
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Reposted by Gideon Lukens
Claire Heyison @claireheyison.bsky.social · 01/07/2026
New CMS data confirms large enrollment drops after Congressional Republicans and President Trump let PTC enhancements expire last year. ~3 million people dropped coverage between 2025 and 2026. More will likely follow suit as premiums stack up throughout the year. www.cbpp.org/blog/nearly-...
cbpp.org
Nearly 3 Million Fewer People Secured Marketplace Coverage After Republican Health Care Cuts, New Data Show
This is the largest drop in effectuated enrollment since the ACA marketplaces were established.
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Reposted by Gideon Lukens
Sarah Lueck @sarahl202.bsky.social · 01/07/2026
Sadly, this is only the start. Republican health care cuts will take away coverage from millions. Nearly Three Million Fewer People Enrolled in Marketplace Coverage After Affordability Cuts www.cbpp.org/media/76680
cbpp.org
Nearly Three Million Fewer People Enrolled in Marketplace Coverage After Affordability Cuts
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Gideon Lukens @gidlukens.bsky.social · 27/06/2026
New data show that #ACA marketplace enrollment fell by ~3 million people as premiums spiked following the failure of Congressional Republicans to extend PTC enhancements. This is Feb 2026 data - expect further coverage loss as the year goes on and monthly premiums pile up.
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Reposted by Gideon Lukens
Sarah Lueck @sarahl202.bsky.social · 25/06/2026
As some House Rs call for reconciliation 3.0, many want to expand health savings accounts. But HSAs mainly benefit higher-income people, and they do little to improve affordability for those struggling the most with health costs. read more by @nicolerapfogel.bsky.social www.cbpp.org/blog/five-re...
cbpp.org
Five Reasons HSAs Aren’t the Answer to the Health Care Affordability Crisis
In the wake of their actions that have worsened health care affordability, President Trump and some in Congress have pushed expanding health savings accounts (HSAs). The problem is HSAs are not the an...
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Reposted by Gideon Lukens
Katie Bergh @katiebergh.bsky.social · 24/06/2026
New USDA data confirm as many as 36 states will soon face massive new costs to continue SNAP – increasing the risk that even more struggling families could soon lose food assistance & some states could even end SNAP altogether. Congress must delay this cost shift for all states.
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Allison Orris @aorris.bsky.social · 16/06/2026
The Trump Administration's analysis justifying its #Medicaid work requirement rule is deeply flawed. @gidlukens.bsky.social explains how the analysis ignores evidence showing work requirements cause large coverage losses while failing to increase employment. www.cbpp.org/research/hea... ----
cbpp.org
Analysis Justifying Trump Administration’s Medicaid Work Requirement Rule Is Deeply Flawed
The 2025 reconciliation law instituted a harmful policy taking Medicaid coverage away from people not meeting a harsh work requirement, and the Trump Administration recently finalized a rule that...
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Gideon Lukens @gidlukens.bsky.social · 12/06/2026
Make no mistake: directly funding CSRs is a major cut to the #ACA marketplace. And it comes on top of huge premium hikes and coverage losses for millions of ppl due to the Republican reconciliation bill and marketplace rule changes. tinyurl.com/ycyypjrc
tinyurl.com
Higher Marketplace Premiums Take a Toll on Enrollment and on Marketplace Enrollees
Congressional Republicans failed to extend premium tax credit (PTC) enhancements at the end of 2025, and now the harm of higher marketplace premium costs is beginning to show up.
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Gideon Lukens @gidlukens.bsky.social · 12/06/2026
Enrollees in the highest income group would tend to see lower premiums, but they are greatly outnumbered by enrollees with moderate incomes who would face higher premiums.
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Gideon Lukens @gidlukens.bsky.social · 12/06/2026
Directly funding CSRs would reduce those tax credits for millions of ppl with moderate incomes, who would then face higher out-of-pocket premiums.
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Gideon Lukens @gidlukens.bsky.social · 12/06/2026
CSRs help marketplace enrollees with lower incomes pay for deductibles and other cost sharing. Insurers are required to offer CSRs, and they indirectly recover this additional expense from the fed govt through higher premium tax credits.
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Gideon Lukens @gidlukens.bsky.social · 12/06/2026
The impacts could be even greater than CBO’s estimates, after taking into account recent trends in state policies: tinyurl.com/4mpd68dn
tinyurl.com
Latest Premium Tax Credit Proposal Would Raise Premiums for Millions of People
This piece examines the CARE Act with a focus on the provisions that affect affordability and coverage.
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Gideon Lukens @gidlukens.bsky.social · 12/06/2026
CBO most recently estimated that directly funding CSRs would cut $37 billion in federal funding over 10 years while leaving an average of 300,000 ppl per year uninsured because of out-of-pocket premiums hikes. www.cbo.gov/publication/...
cbo.gov
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Gideon Lukens @gidlukens.bsky.social · 12/06/2026
Directly funding cost-sharing reductions (CSRs), as Republicans are apparently considering, would INCREASE out-of-pocket premiums for millions of #ACA marketplace enrollees, cut funding by tens of billions of $, and leave hundreds of thousands of ppl uninsured.
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Gideon Lukens @gidlukens.bsky.social · 09/06/2026
More from my colleagues Jen Wagner & @aorris.bsky.social on how restricting medical frailty could lead to coverage losses for people w/ serious health conditions: tinyurl.com/mw9k8e8z
tinyurl.com
Administration’s Last-Minute Restrictions Likely to Worsen Impact of Medicaid Work Requirement
The Trump Administration’s final rule implementing the new Medicaid work requirement makes major, last-minute policy shifts that will likely increase the number of people who are denied or lose health...
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Gideon Lukens @gidlukens.bsky.social · 09/06/2026
The extra red tape required for the medical frailty exemption will greatly increase coverage loss from #Medicaid work requirements. Even before the rule, CBO estimated that 5.3 million people would lose their coverage and become uninsured. tinyurl.com/urbvk466
tinyurl.com
How sick is sick enough? New Medicaid work rule worries patient advocates, states.
Trump administration wants ill recipients to prove they can’t work every six months. Doctors, advocates and state officials wonder how.
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Reposted by Gideon Lukens
Shelby Gonzales @shelbytgonzales.bsky.social · 05/06/2026
Even as more people across our nation are struggling to afford gas, groceries, health care, and housing, Congressional Republicans are prioritizing the Administration's violent & callous detention and deportation machine over helping people across our nation afford basic needs.
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Allison Orris @aorris.bsky.social · 03/06/2026
The #Medicaid work requirement enacted by last year’s Republican reconciliation law was already bad enough. The Trump administration’s new interim final rule makes a bad policy worse...here's a little more on why: www.cbpp.org/research/hea...
cbpp.org
Administration’s Last-Minute Restrictions Likely to Worsen Impact of Medicaid Work Requirement
The Trump Administration’s final rule implementing the new Medicaid work requirement makes major, last-minute policy shifts that will likely increase the number of people who are denied or lose health...
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Gideon Lukens @gidlukens.bsky.social · 03/06/2026
Sadly, the millions of people who are losing coverage due to Administration policies are real, and it’s wishful thinking to pretend otherwise. www.cbpp.org/research/hea...
cbpp.org
Higher Marketplace Premiums Take a Toll on Enrollment and on Marketplace Enrollees
Congressional Republicans failed to extend premium tax credit (PTC) enhancements at the end of 2025, and now the harm of higher marketplace premium costs is beginning to show up.
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Gideon Lukens @gidlukens.bsky.social · 03/06/2026
Yesterday, @DrOzCMS falsely claimed that the ACA marketplace is full of “phantom” enrollees, referencing a number presumably pulled from Paragon paper that repeats the same flawed and thoroughly debunked analysis as its previous iterations. tinyurl.com/5n6cz7da
tinyurl.com
Setting the Record Straight on Premium Tax Credit Enhancements
Enhancements to premium tax credits (PTCs) cut out-of-pocket premiums by more than half, on average, for over 20 million Affordable Care Act (ACA) marketplace enrollees, making health care more...
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Gideon Lukens @gidlukens.bsky.social · 02/06/2026
I guess CMS doesn't expect ppl to click on those links!
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Gideon Lukens @gidlukens.bsky.social · 02/06/2026
The report also includes a (less than 1-page) literature review including studies of several programs…but not Medicaid. That may be because the three peer-reviewed Medicaid studies all found no impacts of work requirements on employment or hours worked.
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Gideon Lukens @gidlukens.bsky.social · 02/06/2026
In their release of the #Medicaid work requirements rule, CMS touts an ASPE report as evidence that work requirements increase employment. In fact, the report simply assumes “illustrative” impacts that are “not necessarily what is or will occur in the real world”. tinyurl.com/2czhrtcw
tinyurl.com
Medicaid Work Requirements Incentivize Employment and Are Estimated to Reduce Poverty
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Allison Orris @aorris.bsky.social · 02/06/2026
The #Medicaid work requirement enacted by last year’s Republican reconciliation law was already bad enough – taking away coverage from millions who don’t show either that they’re working enough or are exempt. But the Trump administration’s final rule makes a bad policy worse.
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Sarah Lueck @sarahl202.bsky.social · 01/06/2026
We just moved a step closer to a Medicaid work requirement, a major cut made by last year’s Republican reconciliation law that will take away health coverage from millions of people. The Trump administration issued a rule that makes bad policy even worse. www.cms.gov/newsroom/fac...
cms.gov
Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC) | CMS
Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC)
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Katie Bergh @katiebergh.bsky.social · 27/05/2026
NEW: In just the 12 states with available data, the number of children receiving SNAP has fallen by more than 700,000 since H.R. 1's unprecedented SNAP cuts were enacted last July — despite claims from Republican lawmakers that kids wouldn't lose benefits.
cbpp.org
Sharp Drop in Number of Children Receiving SNAP Food Assistance Under New Federal Law
While cutting SNAP eligibility for children was not a stated target of H.R. 1’s proponents, the cost shift and access barriers are resulting in serious losses of food assistance for low-income childre...
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Gideon Lukens @gidlukens.bsky.social · 22/04/2026
While CBO’s estimates of baseline program costs have changed for various reasons since their previous projections in 2024, one thing that hasn’t changed is the fact that OBBBA made huge cuts to Medicaid.
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Gideon Lukens @gidlukens.bsky.social · 22/04/2026
These updated baseline projections are consistent with CBO’s analysis of OBBBA, which they estimated would cause 10 million people to become uninsured - 7.5 million from its Medicaid provisions. tinyurl.com/3h5p3ffp
tinyurl.com
By the Numbers: Harmful Republican Megabill Will Take Health Coverage Away From Millions of People and Raise Families’ Costs
The Republican reconciliation law, enacted on July 4, will take health coverage away from millions of people and dramatically raise health care costs for millions more.
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Gideon Lukens @gidlukens.bsky.social · 22/04/2026
Meanwhile, CBO projects that the number of people who are uninsured will rise by roughly 11 million.
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Gideon Lukens @gidlukens.bsky.social · 22/04/2026
Make no mistake: CBO continues to estimate huge cuts to #Medicaid from OBBBA, last year’s reconciliation bill, despite Trump Admin officials’ false claims otherwise. In fact, CBO projects that 7 million ppl will lose #ACA Medicaid expansion coverage from 2025 to 2032.
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