Democrat Sen. Bernie Sanders, I-Vt., claimed that Republicans have ignored voters' concerns about affordability, including health insurance, in support of President Donald Trump's 2025 tax and spending bill. The One Big Beautiful Bill Act extended income tax cuts for individuals, added $75 billion in new funds for Immigration and Customs Enforcement, and made significant cuts to safety net programs, including Medicaid. The Congressional Budget Office predicted that the law would increase the number of uninsured by 10 million through 2034, including people who had been covered by Medicaid or the Affordable Care Act. However, Sanders' spokesperson claimed that Sanders was referring to the expiration of premium tax credits for people purchasing insurance through the ACA marketplaces, which is expected to affect about 4 million people. The Centers for Medicare & Medicaid Services reported in March that 23.1 million consumers were enrolled in ACA plans for 2026, about 1 million less than in 2025. However it has been noted that data shows a decline in enrollment.