As part of the reconciliation process that resulted in the enactment of the 2025 reconciliation act (Public Law 119-21), the House Committee on Energy and Commerce and the Senate Committee on Finance were instructed to recommend legislative changes that met specified budget targets over the 2025-2034 period. This document provides an explanation of CBO’s estimate for the budgetary effects of title VII, Finance, subtitle B, Health, chapter 1, Medicaid, of P.L. 119-21, as enacted in July 2025. The amounts shown in the text and tables are the same as those that CBO estimated in July 2025.
CBO and the staff of the Joint Committee on Taxation (JCT) estimate that implementing the provisions in chapter 1 will reduce the deficit by $886.8 billion over the 2025-2034 period. CBO estimates that the combined effects of the provisions in the chapter will increase the number of people without health insurance by 7.5 million in 2034.
