A Republican budget bill could lead to millions of Americans losing health coverage and falling deeper into medical debt, with Black families among those most at risk, experts warn.
The “One Big Beautiful Bill Act” proposes $1.1 trillion in federal health-care cuts. If passed, the bill could raise medical debt in the U.S. by $50 billion, according to a report from the think tank Third Way, as reported by CNBC.
Black Americans already face higher rates of medical debt. A study by the Kaiser Family Foundation found that 40 percent of Black adults reported problems paying medical bills, compared to 29 percent of white adults.
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And the National Consumer Law Center says nearly 28 percent of Black households carry medical debt, compared to 17 percent of white non-Hispanic households.
“This kind of legislation would only widen the gap,” said David Kendall, a senior fellow at Third Way. “Medical debt stands in the way of the American dream, and we shouldn’t make it worse.”
Third Way estimates that 5.4 million more people in the U.S. could find themselves in families with medical debt if the health cuts go through. That includes 2.2 million people losing Medicaid and 3.2 million more affected by changes to the Affordable Care Act, or ACA.
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Households that previously had no medical debt could see new bills averaging $22,800, according to the report. Families who already owe money could add another $8,790 on top of their existing debts, which average $13,490.
“That’s going to put people’s dreams back, if they’re hoping to go to college or hoping to have a solid retirement or hoping to buy another house,” Kendall said.
The Congressional Budget Office, or CBO, said the bill could lead to 16 million people losing health coverage. That includes 7.8 million people on Medicaid and 8.2 million with ACA coverage.
The CBO estimates that 11 million would lose coverage due to the bill’s provisions, while four million more would lose insurance if ACA subsidies are allowed to expire, which the bill does not extend. An additional 900,000 could lose coverage due to Trump-era rule changes.
Altogether, Third Way says the result would be a 15 percent increase in medical debt over the current $340 billion already owed by Americans.
Lawmakers and advocates are raising alarms. In a letter to Republican leaders, Sens. Jeff Merkley, Cory Booker, Chuck Schumer and Ron Wyden said addressing medical debt is a “national priority” with growing bipartisan support. The senators pointed out that 16 states have already moved to either cancel medical debt or remove it from credit reports.
“Medical debt is a complex problem, but having health insurance coverage makes a measurable difference,” the letter says.
They cited a 2013 study published in The New England Journal of Medicine, which found that expanding Medicaid in Oregon lowered medical debt by more than 13 percentage points.
Losing coverage can lead people to skip care, delay treatment, or go without essentials like food, housing, or childcare, the lawmakers warned. And it’s not just a personal issue — growing medical debt can drag down the economy, too.
The White House says the proposed cuts are aimed at eliminating “waste, fraud and abuse.” Supporters of the bill, including the Trump administration, argue it could provide a boost for working and middle-class families by lowering taxes and increasing wages.
But critics aren’t buying it.
“If the Republican reconciliation bill passes these drastic health care cuts into law, working class families across America risk going further into medical debt,” the senators wrote. “It is not too late to stop these cuts.”
