New estimates from the Congressional Budget Office show 10 million more Americans will be without health care coverage in the next 10 years after the passage of President Trump’s budget reconciliation legislation, known as the One Big Beautiful Bill Act, approved by Congress earlier this month.
That includes 300,000 people in Virginia. Most of the coverage losses would come from changes to Medicaid eligibility and funding.
It’s important to note that in Virginia, Medicaid is called Cardinal Care.
The name change happened in 2023 as part of efforts to streamline the program.
Virginia is not the only state with different names for Medicaid. In Tennessee, it’s called TennCare. In Washington state, it’s Apple Health.
But the program is basically the same: a joint federal-state health insurance program that provides care for low-income adults, children, and people with disabilities.
The new law adds work requirements and makes changes to funding that experts say could force people off the program.
It also could cost Virginia hospitals $2 billion a year, according to the Virginia Hospital and Healthcare Association (VHHA).
“If staffing levels have to be adjusted as a result of this, that could impact the wait that people have for care, so yes, this will most likely, most directly impact people who are on Medicaid, including those who may lose coverage and benefits as a result of this,” said Julian Walker, vice president of communications for the VHHA. “But it will have broader economic, public health and access to care issues for people across our society.”
Separately, the legislation makes changes to tax credits for insurance plans purchased on the Affordable Care Act marketplace. That could also force people to drop coverage because it’s too expensive. Walker said that could lead to higher costs for everyone, as uninsured people are more likely to turn to hospital emergency rooms for care, which is more expensive.
“They also are now unable to pay for the care they have and the cost of that care gets absorbed by the system and ultimately gets reflected in the cost of insurance that everyone pays, that businesses pay to provide insurance for their employees, that employees pay from deductions from their checks for premiums and what they pay out of pocket and co-pays in deductibles,” he said.
Supporters of the bill, including Rep. Morgan Griffith, R-Va., said the legislation would make the system more efficient and the cuts will not be as drastic as feared.
“There’s not one thing in that bill that affects the regular Medicaid population. So not a single disabled person is going to lose their Medicaid benefits,” Griffith told 10 News earlier this month.
While the Medicaid changes mostly take effect beginning in late 2026 or early 2027, the ACA tax credit changes take effect in 2026.