From the perspective of rich people benefiting from slashing the corporate tax rate, the bill the Senate is currently considering — and could vote on this week — is a tax cut bill. But from the perspective of America’s poor, the bill looks more like a health care cut.
The proposal would abolish Obamacare’s individual mandate and, according to the Congressional Budget Office, reduce the number of people with health insurance by 4 million in 2019 and 13 million in 2027. The people no longer pushed to enroll by the mandate are overwhelmingly lower and middle class and don’t get insurance from their employers. Instead, they typically sign up for Medicaid or for subsidized insurance on the Obamacare marketplaces.
That means that when looking at who wins and loses from the tax bill, you can’t just look at who pays more or less in taxes. You have to look at who gets more or less Medicaid and insurance subsidy money too. A new report from the CBO does exactly that.
The CBO breaks down the billions of dollars in annual changes to spending and tax revenue by income group, up to people making more than $1 million. What they find is that while the rich as a group benefit each year (as do people making more than $75,000, on aggregate) the desperately poor, earning $10,000 or less a year, lose out consistently — and by 2021, people earning $40,000 a year or less start losing out as well.
By 2027, when all the individual tax cuts in the law have been phased out to pay for permanent corporate rates, the situation is considerably bleaker. The combination of benefit cuts and tax hikes for people earning between $10,000 and $30,000 are one-third bigger than they were in 2025.
The amounts in the table are in billions: The table is saying, for instance, that people earning under $10,000 lose $8.7 billion as a group in 2025 under the bill, whereas people earning $1 million or more gain $15.8 billion as a group. It doesn’t tell us how much a typical family earning under $10,000 would lose, or how much a typical millionaire would gain, or which groups gain or lose more or less per person.
The aggregate gains to the group of people earning $100,000 to $200,000 a year are much greater than those to the group of people earning $1 million or more — but that's only because there are a lot more people making $100,000 to $200,000 a year than there are millionaires.
And the table actually leaves out some factors that would make the Senate bill look even worse. For instance, it doesn’t include the costs to upper-middle-class people who buy individual health insurance without a subsidy. Those people would face much higher premiums, because the individual mandate’s repeal would push healthy people off the insurance rolls. Because that change doesn’t affect federal spending, it doesn’t show up on the CBO ledger. The CBO also doesn’t attempt to estimate the effect of slashing the estate tax, a change that exclusively helps the ultrarich.
But it’s nonetheless the most comprehensive accounting of who wins and loses from the spending and revenue changes in the tax bill. And the conclusion is clear: The rich consistently win, and the poor consistently lose.