10 million more people will be uninsured because of Trump's mega-package, CBO forecasts
The projection reflects last-minute alterations to the Senate legislation that changed the CBO's prior forecast that 11.8 million more people would be uninsured in a decade. (The Senate version of the 'big, beautiful bill' ultimately became the law.)
Just before it approved its version of the bill, the Senate yanked a provision that would have reduced federal Medicaid support for states that use their own funds to provide undocumented residents and others with health insurance similar to Medicaid. The CBO's prior coverage loss estimate included 1.4 million people in such state programs.
Separately, the CBO has projected that an additional 5.1 million more people would be uninsured in 2034 due to the expiration of the enhanced Affordable Care Act premium subsidies that are set to lapse at year's end, as well as a rule proposed by the Centers on Medicare and Medicaid Services governing Obamacare enrollment and eligibility. (The rule has since been changed and finalized, but CBO has yet to update that part of its estimate.)
Although the CBO's latest estimate did not break down the impact of different provisions in the law, it previously provided details of the House-passed version, which has some differences.
The Medicaid provisions are expected to drive the most loss in coverage by far. Some 7.8 million more people would be uninsured in 2034 due to the changes, with 4.8 million of them being affected by the addition of work requirements for many low-income adult enrollees who gained coverage under Medicaid expansion, according to the CBO's review of the House bill.
(The final law extends the requirement to work, volunteer, enroll in classes or attend job training for at least 80 hours a month to parents of children ages 14 and older. The House bill exempted parents of dependent children.)
Other Medicaid provisions that are expected to result in coverage loss include requiring more frequent eligibility reviews of Medicaid expansion enrollees, delaying implementation of two Biden administration enrollment and eligibility rules, and barring states from levying new or increased taxes on health care providers, according to the CBO's review of the House bill. (The final law also reduces the cap on provider taxes in expansion states.)
The CBO estimate released Monday reaffirmed its earlier forecast that the mega-package is expected to increase the deficit by $3.4 trillion over the next decade when compared with current law, under which the individual income tax provisions of the 2017 tax cuts law would have expired at year's end.
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'Anxious Generation' Author Jonathan Haidt Shares New Worries About Kids — and Why You Should Be Concerned (Exclusive)
His book has been a bestseller for more than a year and has prompted smartphone bans in schools across the country, but in a conversation with PEOPLE, Haidt says kids are still in danger When Jonathan Haidt's book The Anxious Generation debuted last year, it immediately became a bestseller — and a must-read for many parents navigating an era of pervasive smartphones and social media. Now, more than half of all states have passed laws banning or limiting phone use in schools — 17 states passed legislation just this year — and a new research poll finds that 74% of adults in the U.S. support classroom phone bans. Australia plans to restrict social media to those aged 16 and up starting in December, and several other European countries are also considering age restrictions. In a conversation with PEOPLE, Haidt, 61, a social psychologist and professor at New York University's Stern School of Business, says he's been encouraged by the rapid changes but warns that some changes are better than others. Haidt, who offers resources for parents at and on his Substack, weighs in on criticism of his book, the fears he has for kids, and the looming danger of Artificial Intelligence. PEOPLE: Are you surprised by the success of your book? HAIDT: I knew the book would be successful because whenever I mentioned I was writing it, parents said, "We need this tomorrow, can I see a draft?" But the the speed with which parents are organizing, the speed with which schools are going phone-free. I can't even keep track of it. PEOPLE: As you note, many schools and districts have opted to go phone-free, or ban phones in classrooms in the past year. What's working – and what isn't? HAIDT: The simplest fix, and it costs no money, is phone-free schools. That means when kids come in, they put their phone in a locked pouch, or a locker, and get it back at the end of the day. But many states and schools are doing something that's not very good: They banned phones only during instructional time. They do that because they're afraid of parents who say, 'I have to reach my student all the time.' But when class ends, kids lunge for their phones. And for the first 15 minutes of the next class, they're thinking about the drama going on. Phone bans during class time do nothing to help kids make friends. They do nothing to reduce the mental illness issue. It has to be bell-to-bell. I've never heard of a school that did it all day and regretted it or went back. PEOPLE: Critics of your book say you ignore the possible benefits of screen I recently found a horrifying statistic, which is that 40% of American 2-year-olds have their own iPad. A touchscreen device is not like television. Humans have always raised their children with stories. This is how culture is passed on. A TV screen is a reasonably good way of presenting stories. If your five-year-old watches a 90-minute movie on TV with an older sibling or with you, there's nothing wrong with that. The opposite is iPad time. The kid learns, "Might there be something more interesting if I swipe?" If this starts at age two, your kids lose the ability to pay attention to anything if it's boring for even a moment. By the time kids get to middle school, if they've been swiping and seeing micro stories that aren't really stories, a lot of damage has been done to their ability to pay attention. Us college professors all say the same thing: Kids can't read books anymore. Some of our students say they can't even watch a movie. It's too long. Our attention is being shattered. Let children's frontal cortex develop before you expose them to this. It's damaging an entire generation. And you should never give a child an iPhone as their first phone. You should work your way up. I stand by my rule, no smartphone before high school. PEOPLE: I'd like to talk age bans. Australia recently banned social media for those under Don't call it a ban. We don't say there's an age ban on driving. Just minimum age. There should be a minimum age. PEOPLE: But isn't there validity to the argument that if you keep kids away from social media completely, they're won't develop tools to learn to use it effectively? HAIDT: I hear this argument a lot, but I don't think it's valid psychologically. Our kids are going to be having sex and drinking alcohol, so it is valuable to have classes on that. We should be telling them about dangers. But have you ever heard anyone say, "We need to start them early because they need to know how to do this.' That's ridiculous. These devices, and especially these apps, were designed to hook your child. They were designed with full knowledge of brain development, dopamine circuits, motivation, insecurity. These are predatory programs that prey on children. PEOPLE: One of the biggest criticisms levied against your book is that it doesn't adequately acknowledge the way in which technology has allowed people, and particularly kids who might be isolated or marginalized, to connect and organize. HAIDT: That argument confuses the internet with social media. The internet solved that problem in the '90s. If you're a gay kid in rural Nebraska, life was really hard until the internet came along and suddenly you could get information everywhere. You could find organizations to help. I love the internet. Almost everybody loves the internet. Then in the 2000s, we get one application on the internet, which is a way of linking people together, giving them a newsfeed curated by an algorithm — and the algorithm is giving them whatever it can to keep them hooked. So who do you suppose is most harmed by this? Who do you suppose is most likely to be sextorted ? It's LGBTQ kids. Who do you think is most likely to say "This is harming my mental health?" It's LGBTQ kids. I often hear about the benefits [of social media]. I say, what benefits? Creativity? Have you worked with Gen Z? They can't pay attention. They're making little videos, but not much beyond that. Social media has very few benefits for children. For adults, yes, it's useful for business. I don't have anything to say to people over 18, but children have no need to connect with strangers. Children would be more connected if they put the phone down and got together with their friends. PEOPLE: Speaking of , we're in this moment where it was banned, the ban was rescinded and now we're waiting to hear about a . What are your thoughts about TikTok and what should happen? HAIDT: TikTok is the worst of them all. No one should be on TikTok. It damages your attention and exposes our children to garbage. We did a survey of Gen Z, these were in their late teens, early 20s, 50% of them said they wish TikTok had never been invented. They use it because they have to, but they see their life would be better if it didn't exist. I have very little hope Congress will do anything to protect children. So far, they have a perfect record of never protecting children ever on the Internet. But Australia and the UK are acting, and if their plans move ahead, and if the EU joins them and other countries, platforms are going to have to make it global because they don't want a different Instagram in each country. I'm hoping the rest of the world will fix this problem that America created. PEOPLE: What are your thoughts about how education cuts could affect kids and exacerbate what you're already seeing? HAIDT: Educational ability is declining since 2012, and cuts to funding are not going to help. But the biggest driver of the decline of education is the phones in the pockets and the Chromebooks on the desks. We spent billions of dollars putting a Chromebook or iPad on every desk. We thought this was an equity issue. But it turns out anyone with a computer on their desk can't focus. I teach college students, and MBA students at NYU. Three years ago, I had to go to a no-screens policy because even my graduate students cannot pay attention if they have a computer open. They're all multitasking. Adults can't pay attention, so how the hell do we expect 9-year-olds to pay attention when they have an iPad or a Chromebook on their desk? The best thing we can do for education is first, lock the phones away. Second, get devices off the desks. PEOPLE: At our school, kids have laptops with educational games. As a parent, there's a struggle between thinking more screen time isn't great, but games can be good for As soon as we introduce the technology, scores begin to drop. So we should start with the assumption that these things are not healthy, not helping unless they're proven to help. If you gamify math, the kid will be more engaged. So we think, this is good — but it's not. Suppose you gamify a third of your child's school day. What happens? Gamification is specifically targeted at giving kids a pulse of dopamine, which creates motivation to keep going. Okay, you think, that's good, they're motivated. But the brain adjusts, the dopamine circuits adjust and it now takes more dopamine to get up to normal. So the more you give them gamified educational technology, the harder it's going to be to have their attention to anything that's not on a screen. It's the same dilemma of parents who give their kid an iPad to shut them up. Yes, it will work in the short run, but now you always have to do it because they're not capable of sitting at a restaurant while you're eating. To be clear, there may be a role for some educational technology such as Khan Academy, but the one-to-one devices was the colossal mistake. You should try to avoid schools that will put an iPad or Chromebook on your child's desk. PEOPLE: That's most public schools!HAIDT: That's right. We have to change it. PEOPLE: How do you think AI will change the landscape for social media? HAIDT: In a sense, we've already had the first contact with AI, which was the algorithms. The algorithms made social media much more powerful. Early Facebook was not very addictive. It was just, you check out your friends' pages, they check out yours. But the algorithms, driven by AI, were super intelligent at hooking children with content, especially extreme content. We've already encountered AI and we lost. And our kids have been severely damaged by it. Our technology is becoming our master. This is all before the second wave of AI began with ChatGPT in late 2022, and what AI is already doing is showing that technology is going to become 100 times more powerful as our master. Those of us who feel like we're struggling with our phone addictions, it's going to get 10 times worse. Every app is going to get better and better at giving you what keeps you. Every app is going to get better and better at replacing real life. PEOPLE: What's your big fear with AI for kids? HAIDT: The most frightening thing to me is the AI companions. Our children already are socially deprived. They have poor social skills and they're lonely. This makes them even more likely as targets, as marketing targets for AI friends. But the more AI companions enter their lives, the less room and ability there will be for real friendships. PEOPLE: You talk about the value of giving kids independence. But for letting their kids walk to the store. How can parents foster independence in a world that's wary of it? HAIDT: The first thing is to look at the real world versus the virtual world. In the '90s we thought if our kids were on computers, they were safe, but if they went outside, they'd be abducted. It turns out both of those were not true. Crime rates have dropped tremendously since the '90s. Kidnapping is almost unheard of in the U.S. by strangers. The outside world is much safer than we realized. At the same time, if you let your kids on the Internet and social media, they're going to encounter pornography and strangers who want sex or money from them. We have to change our priorities. Our children have to learn to handle risk. They don't learn that online. Talking with a sex predator online doesn't toughen or benefit them. Going outside and getting lost and finding your way back is a powerful way to strengthen kids. We have to stop fearing the real world and be more afraid of the virtual world. You might be scared to send your eight-year-old six blocks to a grocery store, but what if he does it with his best friend? It's going to be a lot more fun. Everyone's going to be more secure. The more you do this with multiple families working together, the easier it is. Our goal isn't to snatch phones and iPads and screens. Our goal is to restore the fun, healthy, human childhood that most of us had. That's been taken from our kids. It is urgent that we restore it. Our kids are coming up broken. PEOPLE: The book emphasizes the importance of play, especially outdoor free play for kids mental health and development. What options do parents have if their kids are in public schools where the structure of the day, including play time, is limited? HAIDT: Two things that are easy and cost no money. Go to and download the kit for the Let Grow Experience. It gives kids more independence and fun and growth and it's free. So suppose your school has all the third graders do it. They go home, they decide something they can do by themselves. The best ones are where they go out of the house, to a neighbor's house to borrow a cup of sugar or go to a store. Imagine a town in which all third graders do that. Suddenly no one's afraid because, well, this is homework and the school told us to do it, and everyone else is doing it. Then what happens? Everyone sees eight year olds walking on the sidewalk. Nobody has seen that since 1997. The second program is called Play Club. Many parents are afraid to let their kids out, but they do trust the school playground. So a powerful thing to do is open the playground 30 minutes before class. You need an adult nearby, so that would be a small expense. But kids are desperate for free play and they get so little recess, so if you open the playground at 7:30, a lot of the kids are going to want to come and play soccer, play games, run around. It adds more free play to their day for very little money and it doesn't take away anything else from the school day. And it reduces truancy and lateness —since COVID, a lot of kids just aren't coming to school or they're coming late. PEOPLE: That's one of the things our school does, morning runs for the Wait, what do they do? They go on runs? PEOPLE: It's a track thing. On Monday mornings they can run around the track before Wait, they literally run around? That's it? That's what they do? That's an adult thing. We're so afraid to let go and let them play. They have to have free play. They're desperate for it. It's like if we raised our kids with no vitamin C whatsoever, and they all develop rickets, and then we say, "Well, we'll give you some lotion to put on the scars." No, just give them vitamin C. PEOPLE: Finally, one of your suggestions is connect with other parents with similar mindsets on phones/social media before your kids get to middle school. But you can't always choose who your kid hangs out with. Your phone-free kid may want to hang out with a kid who has a phone. What do you say to parents who feel like they're fighting a losing battle?HAIDT: Encourage your child to bring friends to the house, but there should be a rule that they put phones in a basket by the door. My children experience this. They go to a friend's house and the friend is on the phone all day long. What's the point? But your kid's not going to be damaged by occasionally seeing a smartphone or watching some TikTok videos. Half of American kids are online almost all the basically take themselves out of the game of life. When you give your child a phone, there's a 50% risk that your kid will be in that half. It's not so bad if he spends 10 minutes here and there on his friend's phone, that's not going to destroy his brain. But if he becomes one of the half that is addicted, it will probably cause permanent brain changes. The main thing is to shift from a mindset of threat to a mindset of discovery. Childhood should be about discovery, not fear. When kids are online, it becomes much more about fear. They're anxious. There's constant drama. But if we put them out in the world with other kids, they have fun. And we need to keep our eye on giving our kids fun. Read the original article on People Solve the daily Crossword
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