"One Big Beautiful Bill" enacts largest Medicaid cuts in history (July 4, 2025 )
July 4, 2025 — The One Big Beautiful Bill Act signed by President Trump includes nearly $1 trillion in cuts to Medicaid and CHIP over ten years — the largest rollback of federal health care support in American history, according to the Congressional Budget Office — and fails to extend the enhanced ACA premium tax credits that had driven record marketplace enrollment to 24.3 million people, setting up a coverage cliff at the end of 2025.
The law institutes work reporting requirements for Medicaid eligibility for the first time, restricts states' ability to use provider taxes to finance their Medicaid share, blocks Medicaid funds from reaching abortion providers for one year, and eliminates enforcement of minimum nurse staffing standards at long-term care facilities until 2034 — a rule that had been expected to save 13,000 lives annually. The American Medical Association said the law will cause an estimated 11.8 million people to lose health care coverage. Independent analyses put the figure as high as 15 million.
The law also includes a $50 billion Rural Health Transformation Program over five years, though analysts noted this only partially offsets a projected $155 billion reduction in Medicaid spending in rural areas under the same legislation — a net loss that threatens closure for the more than 300 rural hospitals already operating at immediate financial risk. The AMA issued a statement of "outrage" at passage, saying the law "will worsen patient access to care."
| https://www.americanprogress.org/article/the-truth-about-the-one-big-beautiful-bill-acts-cuts-to-medicaid-and-medicare/ |