CBO's latest #MedicaidMassacre projection: Up to 15.5M losing coverage (when combined w/IRA subsidy expiration)?

So, the Congressional Budget Office has published updated estimates of the budgetary impact of the House Republican budget plan (officially called the "One Big Beautiful BIll Act" (seriously); more appropriately called the #MedicaidMassacre bill by certain individuals (ahem) were to pass & be implemented.

In addition to all the dollar amounts tossed around, however, the spreadsheet also includes some important footnotes, including the following (h/t Larry Levitt of KFF for the heads up):

Under the Title IV - Energy & Commerce tab is this:

If the reconciliation recommendations of the House Committee on Energy and Commerce were enacted, CBO estimates that the number of people without health insurance would increase by 8.6 million in 2034. Of that increase, 7.6 million would be attributable to part 1 of subtitle D (Medicaid) and 1.0 million would be attributable to part 2 of subtitle D (Affordable Care Act). (CBO's estimate for part 1 of subtitle D includes an interaction with part 2 of subtitle D.)

Included in that 8.6 million total are an estimated 1.4 million people without verified citizenship, nationality, or satisfactory immigration status who, if section 41110 were enacted, would no longer be covered in state-only funded programs in 2034.

Under the Title XI - Ways & Means tab is this:

If the reconciliation recommendations of the House Committee on Ways and Means were enacted, CBO estimates that the number of people without health insurance would increase by 2.1 million in 2034.

That's 10.7 million Americans projected to lose healthcare coverage.

But wait, there's more! Jason Levitis of the Urban Institute responded to Levitt by noting that...

Another technical note is that this score includes only 1/2 the effects of the E&C piece codifying the Marketplace proposed rule, per normal CBO practice and this email they sent to staff. So relative to current law, it's another .95M.

Make it 11.7 million total...except that there's also this, from last December, regarding the failure to extend the upgraded APTC subsidies under the Inflation Reduction Act which are scheduled to expire at the end of this year. I don't think this is addressed anywhere in either the bill language or the current CBO projection, since not extending the subsidies is part of existing law:

CBO estimates that, relative to extending the tax credits, not extending them—either for a year or permanently—will increase the number of people without health insurance. The agency expects some people will exit the marketplaces and become uninsured because of higher out-of-pocket costs for health insurance premiums.

Without an extension through 2026, CBO estimates, the number of people without insurance will rise by 2.2 million in that year. Without a permanent extension, CBO estimates, the number of uninsured people will rise by 2.2 million in 2026, by 3.7 million in 2027, and by 3.8 million, on average, in each year over the 2026-2034 period. (The initial increase is significantly smaller because CBO expects that some people will remain temporarily enrolled after the expanded credits expire at the end of 2025. CBO assumes enrollees would need time to fully respond to the expiration, for example, because of automatic renewal policies.)

You could argue that I'm "cheating" a bit here since, again, Congress taking no action whatsoever would result in the IRA subsidies expiring, but the fact remains that if the current version of the House GOP bill is implemented and the IRA subsidies aren't extended, the CBO appears to be projecting a whopping 15.5 million more Americans to be uninsured by 2034 than would be if the budget bill isn't implemented and the IRA subsidies are made permanent.

In addition, while I could be wrong about this, but it looks to me as though this latest CBO projection still assumes the Job Loss Penalty (aka "work reporting requirements") wouldn't kick in until 2029 even though yesterday it was reported that the House GOP is bumping them up by 2 years to 12/31/26 (it looks like they're assuming ~$150 million in administrative preparation costs in 2026-2028):

Assuming I'm correct about this, I don't think this would impact the ~7.6 million expected to be uninsured in 2034, but it would mean that several million of them would lose coverage up to 2 years earlier.