The short answer
The 15 million is real, but it is a forecast. The Congressional Budget Office (CBO) projects that Trump’s 2025 budget law, plus the expired ACA subsidies, will leave about 14 to 16 million more people uninsured by 2034. For this year, 2026, CBO’s own estimate was about 3.5 million. In 2025, nothing that affects coverage had taken effect, and the number of uninsured Americans didn’t change.
So the number Sanders cites is real: it is CBO’s. What is misleading is the tense. “Took” presents a projection for nine years out as something already done, and the losses measured so far are far smaller than 15 million.
The post
Trump promised to “Drain the Swamp.” Then he made $2 billion off the presidency.
He promised to “Make America Healthy Again.” Then he took healthcare from 15 million people.
He promised “No More Wars.” Then he attacked Iran.
Say NO to Trump. Say NO to a Republican Congress.
This page checks only the healthcare line. The $2 billion and Iran lines are not checked here.
Row by row
| The question | What the data shows | Verdict |
|---|---|---|
| Trump’s budget law passed | The One Big Beautiful Bill Act became law on July 4, 2025 (P.L. 119-21), with large Medicaid and ACA marketplace changes. | Claim right Not in dispute. |
| Congress let the extra ACA subsidies expire | The enhanced premium tax credits ended Dec 31, 2025, and were not extended (CRS). | Claim right Their end date was written into law in 2022, by a Democratic Congress. Republicans chose not to extend them. Counting the full effect as something Trump “took” is the most generous reading for the claim. |
| Does CBO project about 15 million more uninsured? | Yes, for 2034: 10 million from the law (CBO, Aug 2025) plus 4.2 million from the subsidies expiring. CBO’s combined June 2025 figure was 16 million (KFF summary of CBO). | Claim right The number is real. It comes from the government’s own scorekeeper. |
| 2025: had anything been “taken”? | Nothing that affects coverage was in effect yet, and the subsidies were paid all year. Census: 26.7 million uninsured all year (7.9%), statistically unchanged from 2024 (Census CPS). CDC’s survey: 28.0 million (8.3%) vs 27.2 million (8.2%) in 2024, also not a significant change (NHIS). | Not taken yet No measurable loss of coverage in 2025. |
| 2026: what did CBO project, and what happened? | CBO projected about 1.3 million more uninsured from the law (CBO) and 2.2 million from the expired subsidies (CBO via trade press): about 3.5 million. No 2026 uninsured count exists yet. The two enrollment figures available are not uninsured counts. Marketplace paid enrollment fell 2.6 million, Feb 2025 to Feb 2026 (CMS data), and HHS says part of that was removing improper sign-ups (ASPE). Medicaid enrollment fell 5.1 million, June 2025 to June 2026 (KFF/CMS), mostly not because of this law’s provisions. | Too early to measure Even CBO’s own estimate for this year is under a quarter of 15 million. People who left a program may have moved to other coverage. |
| 2027: when the biggest cut starts | Medicaid work requirements begin in January 2027. CBO projects 5.2 million more uninsured from the law that year, 2.2 million of it from the work requirement, plus 3.7 million from the subsidies (HFMA on CBO). | Not started yet The largest single driver of the 15 million has not started. |
| 2034: where 15 million comes from | About 14–16 million more uninsured than without the law and with the subsidies extended. That is CBO’s projection for nine years from now. | Right number, wrong tense The figure is a real CBO projection. “Took” presents it as already done, which leaves a false impression. |
Scorecard: right that the law passed, that the subsidies lapsed, and that CBO projects about 15 million. Misleading in presenting that projection as already done. In 2025, the only year with a finished count, there was no measurable change.
The accurate version
“CBO projects that Trump’s budget law and the lapse of the extra ACA subsidies will leave about 15 million more Americans uninsured by 2034. The biggest piece, Medicaid work requirements, starts in January.” Every word of that can be checked, and the record backs it.
The takeaway
CBO’s forecast is stark on its own terms: by 2034, about one more American in every twenty-four would be uninsured, about half of them people losing Medicaid (7.5 million of the law’s 10 million, per CBO). The numbers Sanders cites are real, and they have the government’s own scorekeeper behind them. Presenting them as a done deal leaves a false impression, and it throws that advantage away. Anyone can check that 26.7 million people were uninsured in 2025, statistically the same as 2024. Once a reader catches the tense, they stop trusting the number, and then they don’t believe the forecast either. The work requirements start in January. The honest case is to say what is coming and when, then measure it as it arrives.
“One in every twenty-four” is Census’s 2025 population of 337.9 million divided by 14.2 million (about 23.8).
Method and caveats
- Projections are CBO’s year-by-year estimates of added uninsured people compared with its own baselines. The law’s estimate (Aug 2025) is measured against CBO’s January 2025 baseline. The subsidy estimate (Dec 2024) is measured against keeping the subsidies permanently. Adding them is approximate; CBO’s own combined estimate, which accounts for overlap, was 16 million for 2034.
- CBO’s website blocked our automated access. The law’s year-by-year figures (1.3M, 5.2M, 6.8M, 8.6M … 10M) come from Georgetown’s Center for Children and Families’ reading of CBO’s August 2025 table. CBO’s series starts in 2026, with no 2025 effect. The subsidy figures (2.2M in 2026, 3.7M in 2027, 4.2M in 2034) come from trade-press reports quoting CBO’s Dec 2024 letter, not the letter itself.
- The uninsured come from Census’s Current Population Survey (uninsured for all of 2025) and CDC’s National Health Interview Survey (uninsured at the time of interview, preliminary). Census’s American Community Survey changed its insurance question in 2025, so its 2025 figure can’t be compared with 2024 and is not used.
- 2026: no national uninsured count exists yet. CDC’s latest report covers 2025, and Census’s 2026 report is due in Sept 2027. Marketplace and Medicaid enrollment counts who left a program, not who ended up uninsured; nothing here estimates uninsured from them.
- The Medicaid figure is KFF’s summary of CMS data (“Medicaid enrollment declined by 5.1 million or 6% from June 2025 through June 2026”). June 2026 data are preliminary.
Sources
- The claim: @BernieSanders on X, Oct 29, 2026.
- CBO, the law: Distributional Effects of P.L. 119-21 (Aug 2025); year-by-year coverage figures via Georgetown CCF; timing by provision via HFMA; combined 16 million via KFF.
- CBO, the subsidies: The Effects of Not Extending the Expanded Premium Tax Credits (Dec 2024), figures as reported by Healthcare Finance News; expiration date via Congressional Research Service R48290.
- Census: Health Insurance Coverage in the United States: 2025 (PDF), Sept 15, 2026; ACS 2025 question change.
- CDC: NHIS Early Release, 2025 (May 2026); list of early releases.
- CMS marketplace: effectuated enrollment Feb 2025 vs Feb 2026 via CBPP and KFF; HHS/ASPE 2026 enrollment report.
- CMS Medicaid/CHIP: KFF Medicaid/CHIP enrollment tracker (CMS data updated Sept 25, 2026).
The post is quoted verbatim. No figure on this page is estimated except the labeled stacked totals and the “one in every twenty-four” ratio.