Republicans are pushing for a significant reduction in Obamacare coverage through the House Passed Megaville, potentially resulting in millions losing their insurance to finance Trump’s tax break extension.
The modifications echo some of the debates from the 2017 attempts to repeal the Healthcare Act, yet they have largely escaped public attention amidst a fierce discourse on the bill’s multi-billion-dollar cuts to Medicaid.
Democrats are advocating for changes, arguing that the legislation effectively eliminates Obamacare, even if Republicans do not phrase it that way.
“They simply refuse to admit it. The fact is, they employ clever language to cut profits,” Senator Ron Wyden (D-Ore.) stated during a briefing on Monday. “Senate Republicans must understand that reducing healthcare is a death sentence for their members, and we will make that clear nationwide.”
Wyden, along with Senate Minority Leader Chuck Schumer (D-N.Y.), hosted a briefing on Tuesday that included representatives from 50 hospitals, healthcare providers, insurance companies, labor unions, and advocacy groups, discussing the implications of cuts to health insurance.
Senate Democrats emphasized that now is the critical moment to halt the largest cuts in American history to Medicaid and the dismantling of the Affordable Care Act (ACA), according to sources familiar with the conference.
Medicaid presents a politically challenging target for Republicans, as their constituents mostly comprise low-income voters who are directly affected.
Senate Republican Bullock has voiced dissatisfaction with the Medicaid cuts, indicating that he cannot support the bill without amendments.
For instance, Senator Josh Hawley (R-Mo.) has consistently indicated his opposition to provisions that would reduce Medicaid benefits for those in need.
“I am here legally, representing the constituents in my state, and I am deeply concerned about losing medical coverage,” Hawley stated on Tuesday.
Despite this, he expressed less concern over the changes to the ACA, which the Congressional Budget Office notes could result in significant health insurance losses.
“I have worries, but Medicaid is my primary focus,” Hawley remarked.
Similarly, Senator Jim Justice (R-W.Va.) expressed specific worries about freezing the provider tax utilized by many states to fund their Medicaid programs.
However, when questioned about the ACA, Justice expressed his intent to support legislation.
“There are various concerns to address, and adjustments will be necessary,” he commented. “Ultimately, if we do nothing, we harm ourselves. We have a president trying to move us forward…and I genuinely want to support the president.”
The proposed changes in the bill are less severe than previous repeal attempts and will not terminate Medicaid expansion, eliminate protections for individuals with existing conditions, or target legal safeguards.
Although the adjustments may be technical, their overall impact could complicate insurance registration and reverse substantial growth trends in health exchanges.
The bill would end automatic re-registration of ACA plans for recipients of grants and prevent individuals from receiving ACA grants provisionally if additional verification is required.
It also shortens enrollment periods and concludes specific special registration windows, making it simpler for individuals to enroll in coverage.
Furthermore, the law could restrict some legal immigrants from obtaining health insurance.
Under current regulations, U.S. citizens and legally documented immigrants can enroll under the ACA and receive premium assistance.
However, the proposed legislation would confine grant eligibility to “legal permanent residents” or green card holders.
According to KFF, exchange registrations reached a remarkable 24.3 million in 2025, marking the fourth consecutive year of growth, much of which is seen in Republican-leaning states.
This growth is partly attributed to fraudulent registrations that some argue lead to increased spending; proponents of the bill assert that individuals misrepresent their income and qualify for higher subsidies, which in turn reduce premiums.
Brian Blaze, president of the conservative think tank Paragon Health Institute, estimates that between 4 and 5 million individuals were fraudulently registered in the ACA exchange plan without paying premiums.
Blaze contends that Republicans are simply seeking to revert to the initial intent of the healthcare law when it was first enacted.
Source: thehill.com