Congress and RFK Jr. Said the Kids Were Protected, but the Numbers Reveal the Truth

Secretary RFK Jr. said there are no cuts in Medicaid. The 3 million children losing Medicaid coverage and their parents would like a word.

Nearly 3 million, or almost 1-in-10, children are projected to lose Medicaid coverage over the next decade. That is the finding in the Congressional Budget Office’s (CBO) February 2026 baseline projections redently presented to congressional staff.

Those projections demonstrate the so-called “One Big Beautiful Bill” (OBBB) isn’t a hypothetical threat to children’s health coverage. It is a baseline reality with disturbing implications for our nation’s children and millions of adults.

This matters because, as Congress debated the OBBB last year, reassurances echoed from congressional leadership and Secretary Robert F. Kennedy Jr. again and again: don’t worry about the kids. Children are protected. They told us the Medicaid cuts targeted able-bodied adults (who also need health care, by the way) — not sick children, not vulnerable families, and certainly not the nearly half of all American children and pregnant women who depend on Medicaid or the Children’s Health Insurance Program (CHIP) for their health care.

These claims that there are no real cuts were and continue to be false.

The Largest Medicaid Cuts in History

To understand how nearly 3 million children lose coverage, you have to understand the scale of what Congress enacted. The nonpartisan CBO estimates that the OBBB cuts federal Medicaid and CHIP spending by nearly $1.2 trillion through 2036 — the largest cuts to the program in its 60-year history.

Across all health coverage provisions, millions of people are projected to lose insurance by 2036, with 9 million of those losses coming directly from Medicaid and CHIP. The law adds an estimated $2.8 trillion to the national debt, even as it hands the wealthiest Americans a tax windfall.

Those numbers are not just talking points. They are the official, nonpartisan findings of the same CBO that congressional leaders routinely cite when it suits them. Health and Human Services Secretary RFK Jr. has tried to wave them away, arguing that since overall Medicaid spending will still grow over time, there are no real cuts.

Health policy experts across the ideological spectrum have called this what it is: smoke and mirrors. Everything in health care gets more expensive over time. Spending less than you would have spent is a cut. By definition, 9 million people losing Medicaid coverage, including nearly 3 million children, is a cut.

How Children Get Caught in the Crossfire

Proponents of the OBBB may be technically correct that children were not the direct target of the law’s most sweeping provision — the work requirements imposed on Medicaid expansion adults. Children do not have to prove they are working to keep their coverage. So how do nearly 3 million children end up losing it?

Kids lose coverage because they do not exist in isolation from their families. When a parent loses Medicaid — because the paperwork is too complicated, because the state’s system isn’t automated correctly, because they work but can’t document 80 hours a month in a gig economy — their children often fall off the rolls with them. Research on Arkansas and Georgia’s prior experiments with Medicaid work requirements found that a substantial share of people who lost coverage were actually eligible; they simply couldn’t navigate the red tape.

OBBB also drastically cut federal matching dollars to states for provider taxes and state directed payments, which states use to fund their Medicaid programs and support health care providers, especially those that serve children, including pediatricians, children’s hospitals, and rural hospitals. The bill’s restrictions on these mechanisms will force states to reduce pediatric providers payments, eligibility, and benefits.

These cuts, disenrollment incentives, and churn don’t discriminate. Children get swept up in the whirlpool.

There is also what researchers call the “unwelcome mat” effect: when a parent is terminated from Medicaid, their children – even if still eligible – often don’t get re-enrolled. The family doesn’t realize the child remains eligible. Sometimes the bureaucracy wrongly disenrolls the whole family.

Others try to enroll, get lost in the bureaucracy and paperwork barriers, and give up. The result is the same: a child who qualifies for coverage goes without it.

Consequently, the majority of children uninsured in this country are eligible for coverage but unenrolled. This is about to get much worse, as children will share in every one of the negative consequences from OBBB’s cuts.

Where Congress Could Have Cut, and Chose Not To

Here is what makes the choice to cut children’s health care so hard to defend on the merits: Congress had other options. The same CBO baseline presentation that documents children losing Medicaid coverage also shows where federal health spending is actually exploding — and it isn’t child health.

Medicare is the fastest-growing component of mandatory spending in the federal budget, projected to increase by 88% between 2026 and 2036. Medicare drug costs — Part D — are leading the charge. Private insurance plans that administer the Part D benefit anticipated a 35% increase in their per-enrollee costs in 2026 alone, far exceeding what CBO had projected.

That single development forced CBO to revise its Medicare drug spending estimates upward by $600 billion. Part D spending per beneficiary is now projected to exceed $4,000 by 2035, compared to projections of under $3,000 just a year ago.

And then there is Medicare (dis)Advantage — the private managed care plans that now cover a majority of Medicare beneficiaries. Medicare Advantage group plans are projected to cost over nearly $10 trillion between FY 2026 and 2036. These plans have been documented by CBO, the Government Accountability Office (GAO), and independent researchers to receive overpayments from the federal government — billions of dollars annually in excess of what traditional Medicare would cost for the same patients.

Reforming Medicare Advantage payment rates has been a bipartisan policy recommendation for years. And yet, Congress has not acted, and Secretary Kennedy recently gave them another $13 billion.

In this video of the exchange between Rep. Alexandria Ocasio-Cortez (D-NY) and Secretary Kennedy, the difference in RFK Jr.’s rhetoric here is stark. While RFK Jr. has been defending over $1 trillion in Medicaid cuts as “not a cut,” here he describes the $13 billion in addition funding that he gave Medicare managed care plans was to prevent them from taking actions that would “impair patient choice.”

So, when it comes to 3 million children losing health coverage, the Secretary argues there are “no cuts.” But if Medicare HMOs threaten to leave, run ads, and lobby the Administration for more money, suddenly Secretary Kennedy chooses to “balance the impact on patients” with $13 billion in additional Medicare Advantage payments.

The Arithmetic of Who Wins and Who Loses

The CBO’s distributional analysis makes the intentions of this law plain. The highest-earning 10% of Americans will see their incomes rise by 2.7% by 2034, primarily from the tax cuts the OBBB made permanent. The lowest-earning 10% of Americans — the families most likely to rely on Medicaid and the Supplemental Nutrition Assistance Program (SNAP) — will see their incomes fall by 3.1%, primarily from the benefit cuts. Multiple analysts have described the OBBB as one of the most regressive pieces of legislation in American history: the largest upward transfer of wealth from poor to rich enacted.

And at the bottom of that pyramid, as always, are children — who didn’t vote for this, who have no lobbyists, who have no PAC money, and who will spend decades living with the consequences of a decision made entirely by adults.

This Is a Choice, Not an Inevitability

None of this was an accident or an unfortunate side effect. Medicaid was deliberately cut by nearly $1.2 trillion dollars to help finance $4 trillion or more in tax cuts. Children’s coverage is being reduced as a predictable consequence of that political choice.

Let’s not forget that Office of Management and Budget (OMB) Director Russ Vought, while serving as the president of the Center for Renewing America, proposed to significantly slash Medicaid coverage:

The proposal would allow states to refocus their efforts on the most vulnerable populations — including the aged, blind, and disabled — for whom Medicaid was originally designed to assist.

Note which group is NOT identified in Vought’s list of protected and deserving populations: CHILDREN.

Children have always been a budget cutting target, despite reassurances offered during the OBBB debate — that children were protected and that it was only about waste and fraud. Those arguments were designed to be a distraction and to make an indefensible policy easier to defend. Some became true believers about their own rhetoric talking points.

Here is Rep. Julie Fedorchak’s (R-ND) explanation right after passage of OBBB:

QUESTION: Did the reconciliation bill cut Medicaid for mothers, children, seniors, and people with disabilities?

ANSWER: Absolutely not. These reforms strengthen the program by focusing resources on those it was intended to serve.

She adds:

QUESTION: Will tens of millions of Americans lose Medicaid coverage?

ANSWER: No. That claim is not supported by the facts and has been debunked….

Quite frankly, the only thing “debunked” are the answers that there are no cuts or losses of coverage.

The Congresswoman goes on to claim that only “illegal immigrants” will lose coverage and “able-bodied individuals” will lose coverage, even though undocumented immigrants have been ineligible for Medicaid coverage since 1996, and CBO clearly estimates that nearly 3 million children (not able-bodied workers) are going to lose coverage.

Congress could have made and still could make different choices. It can restore the enhanced premium tax credits in the Affordable Care Act (ACA). It can repeal or significantly modify the Medicaid work requirements before they take full effect in 2027. It can address Medicare Advantage overpayments and runaway drug costs instead of reaching into the pockets of low-income children. Every one of those decisions is reversible.

What is not reversible is the harm done to a child who goes without health care for months or years because a law made it too complicated for their family to stay enrolled. The missed diagnosis. The unmanaged asthma. The untreated behavioral health crisis. The emergency room visit that might have been a routine checkup.

At a time when families continue to face increasing grocery, child care, housing, energy, and health care costs and when federal investments in children are already near historic lows, children deserve more than words and false promises. They deserve policies that prioritize and respond to their actual needs.

Kids can’t wait.