Millions remain uninsured or underinsured as recent legislation brings shifts to Medicaid and marketplace programs.
As the cost of living rises, healthcare remains a pressing issue for many Americans.
Research from the Centers for Disease Control and Prevention (CDC) found that despite the uninsured rate dropping by 15%, more than 27 million Americans did not have health insurance in 2024, with many insurers proposing price increases of 18% for 2026.
“It will be a tumultuous few years as insurers and people who rely on the marketplace for health insurance ride this out,” Jennifer Sullivan, director of health coverage access at the Center on Budget and Policy Priorities, told CNN.
More than 36% of adults postponed receiving healthcare because of the cost, and 75%—three in four—of uninsured adults under 65 did not receive care for the same reason.
The Absence of Universal Healthcare
Healthcare in the U.S. is privatized, making it the only developed country without universal healthcare. Black, Latino and Indigenous Americans are more likely to lack health insurance compared to white Americans. Studies have also found that 100 million people — 41% of adults — have medical debt due to the rising costs of care.
“Debt is no longer just a bug in our system. It is one of the main products,” said Dr. Rishi Manchanda, who worked with low-income patients in California, in an interview with NPR.
“We have a health care system almost perfectly designed to create debt.”
Despite the passage of the Affordable Care Act (ACA), also known as Obamacare, in 2010, many young adults still struggle to receive health insurance after turning 26 — the age when they are removed from their parents’ plans.
“The ACA was groundbreaking legislation, including the idea that every American needs health care,” Rep. Maxwell Frost, the first Gen Z member of Congress, told The New York Times.
“But there are pitfalls, and one of them is that when young adults turn 26, they fall into this abyss.”
In that same report, Daisy Creager, an Oklahoma resident, detailed her experience finding a marketplace insurance plan. It was expensive and “didn’t cover a lot,” she said. Days later, she came home to find her ex-husband unconscious from a diabetic coma. He had to be treated in the intensive care unit (ICU).
“I think I’ve done everything right,” Creager said.
“So why am I in a position where the health insurance available to me doesn’t cover what I need, or I can barely afford my premiums, or worse, at times I don’t even have it?”
The ACA also attempted to expand Medicaid, which provides health care for low-income and disabled Americans. However, in 2012, the Supreme Court ruled that states could not be forced to expand the program. Since then, 10 states have not expanded Medicaid, including Alabama, Florida, Kansas, Mississippi, South Carolina, Tennessee, Texas and Wyoming. Georgia allows coverage only for those working at least 80 hours a month and reporting it.
Supreme Court 2012 Ruling
The Impact of Trump’s “Big Beautiful Bill”
A previous report from The Introspective detailed the “Big Beautiful” spending bill, with a major component being tax cuts.
“We’re adding things like the biggest tax cut in the history of our country, a child tax credit — so many things are being added that we wouldn’t even have time to discuss them when we were doing it,” President Donald Trump said in the report.
“It includes the largest tax cut in American history, the largest spending cut — $1.7 trillion. And yet you won’t even notice it. Just waste, fraud and abuse in American history.”
The bill also raised controversy over proposed cuts to Medicaid, including the 80-hour-per-month work requirement, and the Supplemental Nutrition Assistance Program (SNAP), the formal name for food stamps. Nearly 17 million people are projected to lose health insurance by 2034.
“This is one of the most regressive pieces of legislation I’ve seen,” Sabrina Corlette, co-director of Georgetown University’s Center on Health Insurance Reforms, told USA Today.
“The rich will get richer and the poor will get poorer.”
CBO Estimate
In states such as Tennessee, 77% of households receive SNAP benefits, with 243,037 people expected to lose health insurance. In Maryland, more than 204,446 people are expected to lose coverage. In Michigan, 371,475 people are expected to lose coverage. In Washington, D.C., nearly 47,000 people are expected to lose insurance, with 43,000 losing Medicaid coverage.
In Illinois, where nearly 450,000 people could lose coverage, Gov. JB Pritzker criticized the legislation as “shameful,” stating that it would be “very hard” to recover.
“The state of Illinois can’t cover the cost — no state in the country can cover the cost of reinstating that health insurance that is today paid for mostly by the federal government, partly by state government,” he said in a report by ABC Chicago.
Estimates from the Urban Institute found that the healthcare cuts in the “Big Beautiful Bill” could cause three in 10 young adults to lose access to care, raising concerns as the cost of living continues to rise.
Response
While the legislation has been criticized, many have supported the bill while dismissing estimates of people losing health insurance.
“The prolonged lie exacerbated by Democrats that 17 million individuals will lose health care coverage from the One Big Beautiful Bill Act has finally been dispelled by the Congressional Budget Office,” Rep. Brett Guthrie, chairman of the House Committee on Energy and Commerce, said in a press release.
“It’s easy to scare people with coverage loss estimates, but the facts are clear — the vast majority of these individuals are either choosing to lose coverage or aren’t actually eligible for Medicaid, and nearly all are eligible for other forms of coverage,” he added.
“I think about Americans all across the country, who work hard every day but have to pay with their own taxpayer dollars for the health care of millions of able-bodied Americans who are choosing not to work. Republicans will continue to find commonsense solutions that ensure these programs are available for those who need them most, for generations to come.”
In a report by The Guardian, many voters also supported the legislation, claiming the bill brings “absolutely beautiful, critical, important, and responsible fiscal changes that our overly bloated bureaucracy of a government is way overdue for, and in desperate need of.”
“The disgusting career politicians have been extremely fiscally irresponsible for many decades, and all the U.S. citizens will pay the price for it. This needed to be addressed a long time ago, and finally there is a politician willing to be ridiculed for doing what is needed. It may not be what everyone thinks will be nice, fuzzy and warm feeling, but it is the responsible thing to do,” said Kyle Hansen, an IT professional in Wisconsin.
Another voter named Dee also supported the bill, stating it would alleviate the “heavily taxed middle class and lower class,” while simultaneously criticizing former President Joe Biden.
“This bill is a no-brainer! Americans first!” she said.
However, in that same report, an anonymous voter from Pennsylvania criticized the measure.
“I think [it] is a scam to the American people. We cut all the programs for poverty-stricken kids and raise the national debt anyway. Where is all the money going?” the voter said.
Sen. Elizabeth Warren criticized the bill before its passage, stating that the legislation gave “huge tax breaks to a handful of billionaires.”
“[W]e proved why we stay in the fight, because actually, there are pieces of this bill that we got better… It’s always the reminder: all of those calls matter,” she said, referring to compromises made between Democrats and Republicans regarding the bill.
“We stay in it not because it’s an easy fight, not because we’re guaranteed to win every time. We stay in it because it’s the right fight.”
The Introspective 
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