Nearly 11 million more people would be uninsured over the next decade if provisions that affect Medicaid and Obamacare health insurance plans are enacted under the Republican tax megabill, according to estimates released by the Congressional Budget Office on Wednesday.

House Republicans’ sweeping tax and spending cuts package would increase the deficit by $2.4 trillion over the next decade, according to the Congressional Budget Office’s analysis of the bill that GOP lawmakers narrowly approved last month.

Nearly 1.4 million medically fragile, low-income dual Medicare and Medicaid enrollees could find it harder to retain a valuable prescription drug subsidy if the Republican House reconciliation bill becomes law.