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Not even a year after President Donald Trump signed the largest healthcare cuts in US history into law, around five million Americans have lost insurance coverage, according to a report out Monday from Protect Our Care, which predicted that the crisis was "only going to get worse."

The massive budget and tax legislation passed by Republicans last July, known as the One Big Beautiful Bill Act, slashed nearly $1 trillion from Medicaid and the Children's Health Insurance Program (CHIP) over the next decade while introducing tax breaks that are expected to hand an additional $1 trillion to the richest 1% of Americans.

“Five million and counting. That’s the human toll of the spiraling Republican healthcare affordability crisis,” said Protect Our Care president Brad Woodhouse. “Just one year after Trump and congressional Republicans made the largest cuts to healthcare in history to fund tax breaks for billionaires and big corporations on Wall Street, millions have lost the care they depended on to stay alive and healthy."

Citing the most recent data from the Centers for Medicare and Medicaid Services (CMS) and state agencies, the report found that the number of Americans enrolled in Medicaid and CHIP had fallen to just 76.9 million, down from 80.8 million a year before—a decline of more than 3.8 million people.

Another 1.2 million are also estimated to have lost coverage due to the massive spike in premiums after Republicans voted not to renew tax credits for consumers under the Affordable Care Act (ACA) that lowered costs for Americans who purchased coverage through ACA marketplaces.

During open enrollment in 2025, 24.3 million Americans selected insurance plans through the ACA. This year, as the average premium was projected to more than double on average, the number of Americans enrolled through the ACA fell to just 23.1 million—a drop of nearly 1.2 million.

The millions of other families still enrolled in insurance through the ACA exchanges saw an average increase of $780, and according to KFF, it's only been that low because many families have opted to switch to cheaper, less comprehensive plans.

The loss of insurance coverage "is only a small piece of the puzzle," Woodhouse said.

"Millions more are making impossible choices every day to keep their coverage, including skipping rent or cutting back on groceries so they can see a doctor," he said. "Their pain and suffering are incalculable."

The report said the coverage losses over the first year are "just the beginning" and that "millions more will lose coverage once deeper cuts go into effect."

The full slate of changes to Medicaid from the GOP bill has not yet been enacted. Next year, many adult recipients will be required to submit proof that they are doing at least 80 hours of work or other qualifying activity each month in order to maintain benefits, which the nonpartisan Congressional Budget Office (CBO) estimated could increase the uninsured population by 5.3 million by 2034.

Another paperwork hurdle, the requirement that certain Medicaid expansion enrollees prove their eligibility every six months, is expected to result in another 700,000 people becoming uninsured by 2034.

In total, CBO analyses estimate that over the next decade, roughly 15 million Americans would lose their insurance coverage as a result of the legislation.

"These are our neighbors, our friends, our loved ones. These are small business owners and farmers. These are seniors. Veterans. Moms," Woodhouse said. "These are millions of working people now scrambling to find insulin pumps, taking thousands out of retirement just to see a doctor for that cough that’s not getting better, or, worse, not getting care at all."

With healthcare costs now a top concern among voters—66% of whom said they were worried about affording it, according to a KFF poll in January—cuts to healthcare spending appear to be a glaring liability for Republicans entering the midterm elections.

Another KFF poll from April found that 37% of voters said they trusted Democrats to address healthcare costs, while just 26% said they trusted Republicans. Meanwhile, 67% of voters said they disapproved of the Trump administration's handling of healthcare costs.

"Every single day, the affordability crisis mounts, and more Americans will find themselves joining the five million struggling to keep up with skyrocketing healthcare costs," Woodhouse said. "The American people won’t forget this betrayal in November.”

Democrats have seized on Monday's report as part of their election pitch, including Rep. Greg Landsman, who faces a competitive reelection fight in Ohio's 1st Congressional District.

He wrote on social media Tuesday that Republicans "cut healthcare by nearly a trillion to pay for tax cuts for the super wealthy... five million people no longer have healthcare."

"The healthcare crisis in America is dominating the lives of millions, and will soon dominate all of our lives," he said. "We need a new Congress to restore people’s healthcare and to end this crisis. There is no other way."