The Coming Health Care Apocalypse, by Paul Krugman, 27 Jun 2025 | One chart on the Big Ugly Bill | O apocalipse iminente da saúde !

Still worn out from travel, so today’s post will basically consist of a single chart trying to illustrate the sheer ugliness of the One Big Beautiful Bill Act, in a way that I hope cuts through the blizzard of numbers and projections out there.

I hope most people following policy at all — which unfortunately misses a substantial part of the electorate — know that soon, maybe within a few days, Republicans appear highly likely to pass legislation that combines big tax cuts for the rich with savage cuts to programs that help lower-income Americans, including Medicaid and SNAP (food stamps). Loss of health insurance coverage won’t be the only source of mass misery from this legislation, but it’s the biggest and easiest to illustrate.

So let’s review what happened over the past 15 years. The Affordable Care Act, aka Obamacare, was enacted in 2010 but only went into full effect in 2014. It fell short of achieving universal health care, especially because many red states refused to expand Medicaid even when the federal government offered to pay for it. It is also somewhat complicated, because of the compromises made to limit disruption of the existing system.

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