As 2025 winds down amid concerns about “affordability,” Americans have added incentives to wish family, friends and themselves a “healthy New Year.” An AP-NORC poll reports that 60 percent of respondents are “extremely” or “very” worried about health care cost increases. 

Substantial cuts to Medicaid in the Trump administration’s One Big Beautiful Bill and a refusal by Republicans to renew Affordable Care Act tax credit subsidies will bring the total of uninsured Americans to about 31 million by 2027. Tens of millions more will experience sticker shock when they get their health insurance bills from the ACA, Medicaid, Medicare and private companies. 

Over the next decade, federal government spending on Medicaid in FY 2026.), which serves 72 million Americans, accounting for 20 percent of expenditures on health care in the United States and 50 percent of long-term care, will go down by $911 billion in FY 2026.)