The full list of tax provisions counted for children include: Extension and Enhancement of Increased Child Tax Credit (Sec. 70104); Extension and Enhancement of Increased Limitation on Contributions to ABLE Accounts (Sec. 70115); Extension and Enhancement of Savers Credit Allowed for ABLE Contributions (Sec. 70116); Extension of Rollovers from Qualified Tuition Programs to ABLE Accounts Permitted (Sec. 70117); Trump Accounts and Contribution Pilot Program (Sec. 70204); Extension and Enhancement of Paid Family and Medical Leave Credit (Sec. 70304); Enhancement of Employer-Provided Child Care Credit (Sec. 70401); Enhancement of Adoption Credit (Sec. 70402); Recognizing Indian Tribal Governments for Purposes of Determining Whether a Child Has Special Needs (Sec. 70403); Enhancement of the Dependent Care Assistance Program (Sec. 70404); Enhancement of Child and Dependent Care Tax Credit (Sec. 70405); and Tax Credit for Contributions of Individuals to Scholarship Granting Organizations (Sec. 70411).
Congressional Budget Office. “Estimated Budgetary Effects of Public Law 119-21, to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14, Relative to CBO’s January 2025 Baseline, As enacted on July 4, 2025.” Congressional Budget Office, 21 July 2025, https://www.cbo.gov/publication/61570. Accessed 13 August 2025.
Major Medicaid provisions in OBBBA that are predicted to result in children losing health care coverage include Provider Taxes; Moratorium on Implementation of Rule Relating to Eligibility and Enrollment for Medicaid, CHIP, and the Basic Health Program; Requirement for States to Establish Medicaid Community Engagement Requirements for Certain Individuals; and interactions between Medicaid provisions. Combining a CBO letter to congressional Democrats on coverage effects of individual Medicaid provisions in OBBBA with a Center for American Progress analysis of potential effects of Medicaid work requirements on households with children, we estimate that around 1 million children would lose coverage.
Congressional Budget Office. “Estimated Budgetary Effects of Public Law 119-21, to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14, Relative to CBO’s January 2025 Baseline, As enacted on July 4, 2025.” Congressional Budget Office, 21 July 2025, https://www.cbo.gov/publication/61570. Accessed 13 August 2025. And; Congressional Budget Office. “Letter to Honorable Ron Wyden, Honorable Frank Pallone, Jr., and Honorable Richard E. Neal Re: Estimated Effects on the Number of Uninsured People in 2034 Resulting From Policies Incorporated Within CBO’s Baseline Projections and H.R. 1, the One Big Beautiful Bill Act.” Congressional Budget Office, 4 June 2025, https://www.cbo.gov/system/files/2025-06/Wyden-Pallone-Neal_Letter_6-4-25.pdf%5C. Accessed 13 August 2025. And; Andara, Kennedy, and Roberts, Lily. “Congressional Republicans Are Planning One of the Largest-Ever Cuts to Basic Supports for Children.” Center for American Progress, 10 May 2025, https://www.americanprogress.org/article/congressional-republicans-are-planning-one-of-the-largest-ever-cuts-to-basic-supports-for-children/. Accessed 13 August 2025.
In addition, there are roughly $26 billion in revenue reductions resulting from the Medicaid policies. We do not think that this is likely to be captured by Medicaid beneficiaries. But even if it were, 10% would go to children by our assumptions, and the total effect would be about $2.6 billion over the 10-year window.
Wright Burak, Elisabeth, and Johnson, Kay. “Worth Repeating: Pregnant Women, Infants, Young Children are NOT Protected in Proposed Medicaid Cuts.” Georgetown University School of Public Policy Center for Children and Families, 1 July 2025, https://ccf.georgetown.edu/2025/07/01/worth-repeating-pregnant-women-infants-young-children-are-not-protected-in-proposed-medicaid-cuts/. Accessed 13 August 2025.
Reddy, Anireddy. “Medicaid cuts will hurt all American children—not just those publicly insured.” Stat News, 2 July 2025, https://www.statnews.com/2025/07/02/medicaid-cuts-trump-american-children-pediatric-hospital-systems-struggling/. Accessed 13 August 2025.
Center for Budget and Policy Priorities. “By the Numbers: Senate Republican Leadership’s Reconciliation Bill Takes Food Assistance Away From Millions of People.” Center for Budget and Policy Priorities, 30 June 2025, https://www.cbpp.org/research/food-assistance/by-the-numbers-senate-republican-leaderships-reconciliation-bill-takes. Accessed 13 August 2025. And; Center for Budget and Policy Priorities. “Research Note: Senate Republican Leaders’ Proposal Risks Deep Cuts to Food Assistance, Some States Ending SNAP Entirely.” Center for Budget and Policy Priorities, 30 June 2025, https://www.cbpp.org/research/food-assistance/senate-republican-leaders-proposal-risks-deep-cuts-to-food-assistance-some. Accessed 13 August 2025. And; Center for Budget and Policy Priorities. “Senate Agriculture Committee’s Revised Work Requirement Would Risk Taking Away Food Assistance From More Than 5 Million People: State Estimates.” Center for Budget and Policy Priorities, 27 June 2025, https://www.cbpp.org/research/food-assistance/senate-agriculture-committees-revised-work-requirement-would-risk-taking. Accessed 13 August 2025. And; Congressional Budget Office. “Letter to Honorable Amy Klobuchar and Honorable Angie Craig Re: Potential Effects on the Supplemental Nutrition Assistance Program of Reconciliation Recommendations Pursuant to H. Con. Res. 14, as Ordered Reported by the House Committee on Agriculture on May 12, 2025.” Congressional Budget Office, 22 May 2025, https://www.cbo.gov/system/files/2025-05/Klobuchar-Craig-Letter-SNAP_5-22-25.pdf. Accessed 13 August 2025.
Congressional Budget Office. “Estimated Budgetary Effects of Public Law 119-21, to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14, Relative to CBO’s January 2025 Baseline, As enacted on July 4, 2025.” Congressional Budget Office, 21 July 2025, https://www.cbo.gov/publication/61570. Accessed 13 August 2025.
If we used a different method from the Urban Institute’s Kids’ Share report of annual federal spending on children, then cuts to kids would grow from $53 billion to $104 billion. Because some of the SNAP-related provisions in OBBBA are intended to target working-age adults more than other groups, we decided that an across-the-board percentage based on yearly program spending was a less appropriate way of calculating the impact on kids.
For more information, see Phillips, Eden, Daly, Hannah, Nikolopoulos, Hahn, Heather, Casas, Michelle, Lou, Cary, and Steuerle, C. Eugene. “Data Appendix to Kids’ Share 2024: Report on Federal Expenditures on Children through 2023 and Future Projections.” Urban Institute, 30 September 2024, https://www.urban.org/research/publication/kids-share-2024. Accessed 13 August 2025.
Congressional Budget Office. “Effects on Deficits and the Debt of Public Law 119-21 and of Making Certain Tax Policies in the Act Permanent.” Congressional Budget Office, 4 August 2025, https://www.cbo.gov/publication/61466. Accessed 13 August 2025.