Quantifying How the 2025 Reconciliation Law Will Affect the Uninsured Rate in NYS and Beyond

(Sept. 30, 2025) According to recent estimates from the Congressional Budget Office (CBO), the number of uninsured people will increase by more than 14 million by 2034. NY could be among the hardest-hit states, with an estimated 860k people losing their coverage, of which 760k would become uninsured due to changes in Medicaid. 68k are expected to lose coverage due to changes in the Affordable Care Act (ACA), and 32k are expected to become uninsured due to changes to Medicare and policy interactions. This sum represents 4% of New Yorkers. This data was published as part of a larger brief from the Kaiser Family Foundation (KFF) that aims to quantify how the Trump administration’s budget reconciliation package will affect the uninsured rate across the U.S. by 2034. The estimates come from the CBO, which observed that relative to the rate of insurance coverage prior to the law being enacted, the law will increase the number of people without health insurance to 10 million by 2034. This is due to changes to Medicaid, the ACA Marketplaces, and other policies and interactions among different provisions. This estimate does not take into account the expected expiration of the ACA’s enhanced premium tax credits, which, when accounted for, could result in 14 million Americans becoming uninsured by 2034. Furthermore, the Trump administration’s ACA Marketplace Integrity and Affordability rule that was finalized earlier this year was not taken into account either, so the overall change in the number of uninsured people could be even larger. According to estimates from the CBO, anywhere from 640k to 1.1 million New Yorkers could lose coverage, based on a 25% range of uncertainty. To read the full brief from KFF, click here.

Contact: Eric Dumas, edumas@leadingageny.org, 518-867-8851