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Republicans Push to Roll Back ObamaCare in Trump’s Big Spending Bill

by Kaia

Republicans are aiming to significantly reduce ObamaCare coverage through a House-approved megabill. This move could cause millions of Americans to lose their health insurance. The goal is to use the savings to help pay for extending President Trump’s tax cuts.

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These changes resemble earlier debates over repealing the health care law in 2017 but have received less public attention amid controversies over deep Medicaid cuts in the bill.

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Democrats want to highlight the rollback, arguing the bill essentially repeals parts of ObamaCare, even though Republicans avoid calling it that.

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Senator Ron Wyden (D-Ore.) said Monday, “They just won’t admit it. Instead, they use tricky language to cut benefits.” He warned Senate Republicans that cutting health care coverage would be a “death sentence” for their constituents and pledged to fight these cuts nationwide.

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Wyden and Senate Minority Leader Chuck Schumer (D-N.Y.) led a briefing Tuesday with 50 hospitals, insurance companies, unions, and advocacy groups. The goal was to plan a strategy against the health care cuts.

According to someone familiar with the meeting, Democrats stressed the urgency of stopping the largest Medicaid cut in U.S. history. They warned that dismantling the Affordable Care Act (ACA) could cause insurance costs to rise for tens of millions.

Medicaid cuts are politically sensitive for Republicans because many low-income voters in their base rely on the program.

Some Senate Republicans have expressed concerns about the Medicaid reductions. Senator Josh Hawley (R-Mo.) said he opposes any cuts that would hurt people who need Medicaid the most. He said Tuesday, “I’m worried about legal residents and citizens in my state who could lose coverage.”

However, Hawley is less worried about changes to the ACA itself. The Congressional Budget Office has said the bill could cause at least 3 million people to lose insurance. Hawley said, “There are many concerns, but Medicaid is my main focus.”

Senator Jim Justice (R-W.Va.) also voiced concern about a freeze on provider taxes, which many states use to fund Medicaid. Still, Justice signaled support for passing the bill. He said, “If we do nothing, we hurt ourselves. The president is trying to move us forward, and I want to support him.”

The bill’s changes are less drastic than the failed 2017 repeal, which would have left 30 million uninsured. It would not end Medicaid expansion, eliminate insurance exchanges, or remove protections for people with preexisting conditions.

Instead, the changes are technical but would make it harder for people to enroll in coverage. This could slow down the rapid growth in ACA exchange enrollments seen in recent years.

Key provisions include ending automatic reenrollment for subsidy recipients, stopping provisional subsidy payments pending verification, shortening the open enrollment period, and ending some special enrollment periods that help people sign up.

The bill would also restrict coverage for some legal immigrants. Currently, U.S. citizens and lawful immigrants can enroll and receive subsidies. The bill would limit subsidies to green card holders, excluding asylum seekers, Temporary Protected Status holders, and immigrants in their five-year Medicaid waiting period.

Enrollment in ACA plans reached a record 24.3 million in 2025, with growth notably in Republican-led states, according to the Kaiser Family Foundation.

Supporters of the bill argue this growth includes many fraudulent enrollments that drive up costs. They say some people falsely report incomes to get larger subsidies.

Brian Blase, president of the conservative Paragon Health Institute, estimated 4 to 5 million people enrolled fraudulently in ACA plans without paying premiums.

Blase claims Republicans want to return the health law to its original size when it first launched.

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