From left, Senate majority John Tune (R-South Dakota), Sen. John Barrasso (R-Wyoming) and Sen. Mike Krapo (R-Idaho) left the White House West Wing on June 4th, 2025. Reduced Medicaid and Clean Energy Tax Credit.
Photographer: Eric Lee/Bloomberg via Getty Images
Republicans at Capitol Hill are weighing laws that cut billions of dollars in funding for affordable care laws and are estimated to cause millions of people to lose health insurance. Many of their members may not be satisfied with it, Pauling suggests.
A new study by KFF, a nonpartisan group that conducts health policy research, shows that nearly half of adults, or 45%, are registered in health plans provided through the ACA insurance market, are identified as Republicans.
(Over three-quarters of Republican ACA users are identified as “MAGA” Republicans. These MAGA Republicans combine 31% of ACA buyers.)
Meanwhile, 35% of Democrats have health insurance through the ACA, KFF found.
House Republicans passed a multi-billion dollar tax and spending package in May, when it was estimated to be estimated to cut approximately $900 billion from health programs such as Medicaid and the ACA.
Senate Republicans are now considering the measure, which includes many of President Donald Trump’s domestic policy priorities. Republicans are about to pass the Megaville by July 4th.
According to the Congressional Budget Office, if the GOP does not enact written laws and extends the tax credits that lower the monthly ACA Health Premium, around 15 million people will lose their health insurance.
“The large Republican districts using the program are potentially facing cuts,” said Audrey Carney, senior research analyst at the KFF poll research program.
The survey was conducted between May 5 and 26th in a nationally representative sample of 2,539 US adults, including 247 people who purchased 247 health insurance.
Republicans are likely self-employed
Health plans provided through the ACA exchange will be primarily through Americans who are not covered through their jobs, or through public programs such as Medicare and Medicaid, experts said.
Self-employed people fall into this reporting gap – and self-employed Americans tend to lean right. This is likely to make more Republicans appear to be registered with the ACA health plan compared to Democrats, Carney said.
“Republicans are more likely to be entrepreneurs than Democrats,” according to a 2023 paper published by researchers at Columbia University, the University of California, San Diego and the University of Alberta.
Around 5.5% of Republicans become entrepreneurs, but that applies to 3.7% of Democrats, they found.
Many red spots did not expand Medicaid
Affordable Care Act has expanded Medicaid coverage to more households.
However, 10 states have not adopted expansions: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming. All voted for Trump in the 2024 presidential election.
Republicans say that John Graves, an emailed by John Graves professor of health policy and medicine at Vanderbilt University School of Medicine, said Republicans are “highly likely to live in a non-expandable state.”
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Here’s why this is important for registering an ACA: “In a non-expanded state, the population is wider for tax credits,” says Carolyn McClanahan, a Jacksonville, Florida-based physician and certified financial planner. She is a member of the CNBC Financial Advisors Council.
In states that have expanded Medicaid, nearly every adult with income qualifies for up to 138% of the federal poverty line (approximately $22,000 for a single household in 2025).
In states that did not expand Medicaid, a larger population will be eligible for subsidies to make ACA health plans cheaper, Graves said. Subsidized exchanges are available to people, particularly 100% to 138% of the federal poverty line.
“Given the heavy subsidies in that income range and the majority of people who are otherwise uninsured, that would suggest that people identifying more GOPs will go to low-income people (subsidized) exchange routes,” Graves wrote.
Affordable Care Acts have been slandered by Republicans since it passed during President Barack Obama’s tenure. However, KFF’s KFF’s Kearney said that provisions within the law have a wide range of appeal, including creating an ACA market, coverage of people with existing conditions, and the ability to remain in parents’ health plans until the age of 26.
As of 2023, one in seven U.S. residents had registered with the ACA market plan at some point since 2014 when the state launched its market plan.
“Our votes show that when we ask about the goodwill of the ACA itself, Republicans consider it quite a disadvantage,” she said. “But the actual provisions within it are very popular and popular among Republicans.”
