The Trump Administration and Its Congressional Allies Are Causing the Largest Loss of Health Coverage in US History

A report from UnidosUS finds that President Donald Trump is now presiding over the greatest loss of health coverage in American history, threatening to erase 14 years of hard-won gains for Latino families.
According to the Congressional Budget Office, 8.7 million Americans will become uninsured during the Trump administration. This represents a one-third increase ? more than twice the size of the largest previous coverage loss, which took place in the early 1990s.

This loss of health coverage, the worst in American history, is also the first major loss to result entirely from elected officials’ decisions about health programs. Economic downturns caused all past major coverage losses, when people lost their jobs and accompanying health insurance. Today’s much larger losses, by contrast, are entirely self-inflicted.

Thanks to the Affordable Care Act (ACA), nearly 10 million Latinos gained health insurance coverage between the ACA’s passage in 2010 and 2024. Those gains are now in danger from federal lawmakers’ attack on healthcare programs like Medicaid and ACA private insurance (often called Obamacare).

An estimated 14 million Americans, including more than 4 million Latinos, are projected to become uninsured over the next 10 years, due to two acts of Congress. First, Congress let ACA health tax credits expire in January. This raised average health insurance costs by $1,000 a year for more than 20 million Americans, including 6.5 million Latinos. Millions of people are expected to become uninsured as a result.
Second, last summer Congress passed the federal budget which made more than $1 trillion in healthcare cuts. Those cuts impose new paperwork burdens that will strip healthcare away from hardworking families. Starting in 2027, Medicaid will terminate low-income adults unless they document either employment or barriers to work such as disability or caretaking responsibilities. And every six months, they must prove they remain eligible, even if nothing suggests that their circumstances have changed.

Such paperwork burdens can take a terrible toll on Hispanic families, many of whom have limited English proficiency and limited capacity to provide requested information online or by taking time off work to visit social services offices. Historically, 52% of Latinos who lost Medicaid at recertification were eligible but terminated because of paperwork problems. For non-Hispanic white people, 40% of those terminated were eligible — far too many, but many fewer than in Hispanic families.

The federal budget also targeted Latinos for harm by terminating health insurance for numerous lawfully present immigrants, including refugees as well as “Dreamers”— those who were brought to America as children and know no other home.

Other policies adopted by the Trump administration have also damaged Latino families’ healthcare. Indiscriminate immigration enforcement, the sharing of Medicaid records with Immigration and Customs Enforcement (ICE), and proposed public charge regulations have combined to create tremendous chilling effects. In 2025, the proportion of immigrant parents reporting that their families stopped participating in programs like Medicaid because of immigration-related concerns nearly doubled, rising from 11% to 18%. UnidosUS Affiliates serving local Hispanic communities regularly report families going without medical care, fearing that ICE agents could show up at a hospital or clinic and deport them because of how they look or talk.

No one should feel unsafe going to the doctor. No parent should be forced to avoid necessary healthcare for fear of being torn away from their children. And no one in America should be arrested and imprisoned because of how they look or talk. Yet precisely those things are happening to Latinos each and every day.
The choices made by elected officials will hurt Americans from all backgrounds. But those choices have singled out the Latino community for especially deep harm.

Our elected representatives should make their constituents’ lives better, not worse. It’s time for Congress to reverse these terrible healthcare cuts and then reconstruct the country’s healthcare programs to do a much better job of providing affordable health insurance to Latinos and other Americans.

(*) Stan Dorn, director of health policy, UnidosUS.

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