The Big, Bullshit Bill: Stripping Health Insurance from Millions

Okay, lets go through this one more time, since MAGA can not seem to grasp this shit. The Big, Bullshit Bill passed and is now set to leave about 10 million more Americans without health insurance by 2034 - and millions more lose it as the ACA subsidies it didn’t renew run out. Thats not hyperbole - thats what the nonpartisan Congressional Budget Office is telling us. But apparently some people are still having trouble understanding that this is not because of waste, fraud or abuse.

So one more time for the slow folks. Your beloved Trump bill that passed the House today accomplishes this healthcare massacre through multiple ways: it guts Medicaid with brutal work requirements, makes it harder to get and keep ACA coverage, and lets enhanced marketplace subsidies expire at the end of this year. Each one screws over different groups of people, but together they create the kind of coverage disaster we havent seen since before Obamacare existed. The final Senate version cuts nearly $1 trillion from Medicaid over the next decade - and over $1 trillion from healthcare overall. Let me break down who gets screwed and when, since apparently this needs to be explained slowly.

The centerpiece of these coverage losses comes from new Medicaid work requirements that take effect at the end of 2026. Adults aged 19-64 who got coverage through ACA Medicaid expansion would need to work or participate in qualifying activities for 80 hours per month to keep their insurance. The Congressional Budget Office estimates these work requirements alone would cause over 5 million people to lose coverage.

Think about that - these people losing coverage is baked into the budget - meaning - theyre counting on it. Its not - oh you need to go get a job and lets see who ends up being able to keep their coverage - theyre saying We know 5 million people will NOT be able to succeed in this requirement. I have already written extensively on the fact that people who are on Medicaid are on it because they are ill and they can not survive without it. It is a last resort. It is a pain in the ass. Its not covering checkups - its covering essential prescriptions and services. But if these people cant find some shitty job that will let them work 20 hours a week, and find childcare, and transportation, and gas money and etc etc - they will lose their health insurance. The bullshit myth of the 35-year-old able bodied man sponging off Medicaid - is not a thing. Medicaid is not a check that gets sent to you. Its health insurance - it pays for necessary healthcare.

The Senate version that passed makes it even worse by limiting parental exemptions to only those with children 13 and under, rather than all parents with dependent children like the House originally proposed. So if youre a single parent with a 15-year-old, congratulations - youre now subject to work requirements because apparently parenting teenagers doesnt count as real work. The timeline is deliberately brutal. States have until the end of 2026 to put these requirements in place, and the federal rules aren’t due until June 2026. That gives states barely seven months to build systems that have already proven to be complete disasters in places like Arkansas, where 18,000 people lost coverage without any meaningful increase in employment.

The bill also forces states to recheck eligibility every six months instead of once a year for adults who got Medicaid through the ACA expansion, creating more opportunities for people to get kicked off due to paperwork problems. It also adds new cost-sharing requirements for expansion enrollees, making healthcare less affordable for people who are already struggling. While Republicans are busy dismantling Medicaid, theyre also making it harder to get and keep ACA marketplace coverage. A separate Trump administration rule shortens open enrollment on HealthCare.gov by a month, ending it on December 15 instead of January 15. And the bill eliminates year-round enrollment for low-income people and ends automatic renewals for most ACA policyholders.

Think about that. Theyre shortening the enrollment period because they are counting on people missing the window. ONE MORE TIME! THINK ABOUT THAT! Their only ideas for saving money is creating obstacles for people!The bill also lets enhanced ACA marketplace subsidies expire at the end of this year. These subsidies currently help about 22 million of the 24 million people who buy insurance through ACA marketplaces. When these subsidies disappear, the Congressional Budget Office projects marketplace enrollment would drop from 22.8 million in 2025 to 18.9 million in 2026, falling as low as 15.4 million by 2030.

They LITERALLY took away subsidies for healthcare to give tax breaks to billionaires. These are not illegal immigrants - and they HAVE jobs. They pay taxes and have their entire lives. The one thing that helped millions of people get healthcare was just stolen from them.

You might not realize that YOU are getting one of these subsidies - is your insurance through the ACA?People making just above 400% of the poverty level - about $62,600 for a single person - face the full price of marketplace plans without any financial assistance. The numbers get ugly fast. A 60-year-old couple making $82,000 would see their premium payments at least double in most congressional districts, and triple or more in 328 districts. Two 40-year-old parents with two children making $125,000 in West Virginia would go from paying $885 to $2,918 per month - an increase of over $24,000 per year.

One more time: $885 to $2,918 Please explain how knocking these people off of their healthcare is addressing waste, fraud or abuse?This will hit rural areas especially hard - you know, the places that voted for Trump because he promised to make healthcare better. BUT THEY DONT UNDERSTAND THAT THEYRE THE TARGET BECAUSE ALL FOX NEWS TALKS ABOUT IS ILLEGAL IMMIGRANTS.

Lets put this in perspective for those still struggling to keep up. The number of uninsured Americans dropped from 45.2 million in 2013 to 26.4 million in 2022 - a historic decline. This bill would essentially reverse most of those gains.

When people lose insurance, they dont just disappear into thin air. They show up in emergency rooms when their conditions become critical, creating over $1 trillion in additional uncompensated care costs. Rural hospitals - already struggling - would face massive increases in uncompensated care just as their Medicaid revenues get slashed. This will lead to hospital closures. There is also research that shows these cuts will result in 1 in 4 nursing homes closing - so if your parent is in one - I hope you have an extra room.

Republicans spent years promising to repeal and replace Obamacare with something better. After failing spectacularly in 2017, they found a different approach - just gut it piece by piece and call it fiscal responsibility. Classic GOP strategy: break the system, then point to the broken pieces as proof government doesnt work.

The bill is now sitting on Trumps desk waiting for his signature. Once he signs it - which hes expected to do any day now - the clock starts ticking on one of the largest rollbacks of healthcare coverage in American history. My advice is for everyone to make appointments with your doctors and get up-to-date on your prescriptions and tests - cause most peoples insurance is going up in 6 months.

Correction, October 7th, 2026: This post first said the bill passed the Senate today - the Senate passed it July 1st and the House passed it July 3rd. It also said the bill would strip insurance from 17 million Americans (the Congressional Budget Office’s figure for the law is about 10 million more uninsured by 2034, with millions more losing coverage as the ACA subsidies run out), that it cuts over $1 trillion from Medicaid alone (nearly $1 trillion from Medicaid, over $1 trillion from healthcare overall), that the parent exemption stops at 14 (it’s 13), that federal guidance comes at the end of 2025 (the rules are due by June 2026), that the bill shortens open enrollment (a separate administration rule does), that the subsidies help 93% of 24.2 million marketplace customers (about 22 million of 24 million), and that 400% of the poverty line is about $60,240 for one person (it’s about $62,600 for 2026 plans).

Update, October 7th, 2026: The line on eligibility checks now says the six-month rechecks are for adults who got Medicaid through the ACA expansion.