Proposed cuts to health insurance programs in the budget bill being pushed through Congress by President Donald Trump could put hundreds of thousands of health care jobs at risk — jeopardizing one of the few notably strong areas of the U.S. job market.
Congressional Republicans are advancing a budget plan that would cause nearly 8 million people on Medicaid to lose their health insurance coverage, according to estimates by the Congressional Budget Office, with an additional 2 million people to lose coverage through the Affordable Care Act if Congress remains on track to let health insurance tax subsidies expire at the end of the year.
Less funding for Medicaid and fewer people with health insurance would mean a drop-off in doctor’s office visits, prescription refills and medical procedures — and, as a result, fewer workers needed to support those types of services. It could lead to the loss of nearly 500,000 health care jobs over the next decade, according to an analysis by George Washington University and the Commonwealth Fund. The expiration of the ACA tax subsidies, which were enacted in 2021, would result in the loss of an additional 140,000 jobs, a separate analysis from George Washington University found.
“Hospitals will close, health centers will close, pharmacies in some parts of the country will close because they will lose revenue,” said Leighton Ku, director for the Center for Health Policy Research at George Washington University, who worked on the analyses. “There are going to be job losses, and we’re talking about middle class jobs being lost.”
That would be a blow to one of the strongest, steadiest areas of the job market in recent years. Health care accounted for nearly half of the jobs added in the U.S. in May, according to the Bureau of Labor Statistics. Last year, around half of the 2.2 million jobs added to the economy were in health care-related sectors, according to an analysis by S&P Global. That has helped offset job cuts and stagnant growth in other sectors of the labor market, like retail and manufacturing.
“Right now, a lot of what is driving these positive headline numbers and bolstering the labor market is the health care sector,” said Allison Shrivastava, an economist with job listing site Indeed.com. “It’s something that has been a constant. The health care sector has been a pretty big mainstay as the rest of the labor market has cooled.”
The health insurance provisions are part of a broader spending bill that has passed the House and is currently making its way through the Senate. The legislation, which Republicans have dubbed the “Big Beautiful Bill Act,” would cut around $800 billion from Medicaid, the health insurance program for the poor and disabled, in order to help offset some of the $4 trillion in tax cut extensions in the bill for individuals and corporations.
A version of the bill currently in the Senate, which plans to start voting on the legislation next week, would go even further in reducing spending on Medicaid, by including a provision to limit states’ use of taxes on hospitals and other health care providers that help states fund their share of the Medicaid program.
The cuts would take a particular toll on health care providers in rural areas, where patients are more likely to be insured through Medicaid than those in metro areas. Researchers at Georgetown University found that 40% of children in small and rural towns receive their health insurance from Medicaid.
Already, one-third of all rural hospitals in the country are at risk of closing because of financial difficulties, according to a report this month from the Center for Healthcare Quality and Payment Reform.
Also at risk are Community Health Centers, which employ more than 300,000 workers and receive a portion of their funding from the federal government. Those centers, which serve at least 32 million mostly lower-income patients a year, get about 40% of their revenue from Medicaid.
“Our health centers operate on razor-thin margins, so any kind of disruption in payments or reimbursements, even for a short time, can have a significant impact,” said Joe Dunn, chief policy officer for the National Association of Community Health Centers. “About 40% of health centers are in rural America, and oftentimes they are the only primary care in that community. We have health centers in towns of a few hundred people, and there may not be any other kind of health care network there.”
Absent any policy changes from Congress, the health care sector had appeared to be on track for continued growth — and largely isolated from wider concerns about tariffs and an economic slowdown. The number of job postings for doctors and surgeons on Indeed.com are about 90% higher than their pre-pandemic levels, listings for home health aides are up 46%, and openings for nurses are up 16%, Shrivastava said.
Health care job postings on ZipRecruiter.com represent 27% of all active job listings and health care postings are beginning to make up a larger share of new job postings, according to data from ZipRecruiter.
A loss of that hiring momentum from funding cuts would leave one less positive driver for the job market.
“Right now, the labor market as a whole is arguably in a stagnant position,” said Shrivastava. “People are not wanting to leave their jobs, they’re nervous about whether or not they’ll be able to find another job, and companies aren’t really looking to hire. Health care has been the exception to that.”
