On Aug. 11, the Congressional Budget Office (CBO) updated its estimate of the impact of the One Big Beautiful Bill Act, reaffirming that 10 million more people may become uninsured by 2034 (subscription required). The CBO cited the bill’s Medicaid work requirements, which go into effect at the end of 2026, as the primary factor driving coverage losses, leading to approximately 5.3 million individuals losing coverage. In total, CBO projects 7.5 million will lose insurance coverage due to all Medicaid provisions combined, and another 2.1 million will lose coverage due to changes to provisions affecting the Affordable Care Act. The latest projection is similar to estimates CBO provided before the One Big Beautiful Bill Act was passed.