Impact on Individuals: How Medicaid Reductions Could Affect You Directly
The One Big Beautiful Bill Act (OBBBA), signed into law by President Trump in July 2025, has sparked concerns over its potential impact on healthcare coverage and access. The bill, which makes significant cuts to federal health programs, is projected to affect millions of Americans over the next decade.
One of the most significant impacts of the OBBBA is an increase in the number of uninsured individuals. According to the Congressional Budget Office (CBO), the bill could cause over 10 to nearly 12 million people to lose their health insurance [1][2]. This is primarily due to cuts to Medicaid and subsidies for Affordable Care Act (ACA) plans, which are allowed to expire at the end of 2025 [2].
These cuts are expected to lead to a rise in premiums, making healthcare less affordable for many. Without extended ACA subsidies, premiums on insurance marketplaces could potentially double, causing many to forgo coverage [2].
The OBBBA also introduces stricter eligibility and work requirements for Medicaid beneficiaries. These changes include the need for beneficiaries to work or participate in job-related activities at least 80 hours monthly to qualify, as well as more frequent state eligibility verifications [3][5]. These requirements could lead to coverage loss for vulnerable populations.
Moreover, the OBBBA reduces funding for safety-net programs and food assistance, which could further impact low-income and older Americans reliant on these supports [1][5].
The bill also poses a significant threat to rural healthcare facilities, which are already financially fragile. The increased number of uninsured patients, coupled with cuts in Medicaid funding, could lead to the closure of these facilities, reducing local access to emergency and specialized care [4].
The OBBBA also delays the implementation of minimum staffing rules for nursing facilities until 2034, which may impact quality and labor shortages in long-term care [4].
Furthermore, the OBBBA accelerates Medicare’s hospital trust fund insolvency timeline, potentially triggering automatic spending cuts of about $500 billion between 2026 and 2034 if Congress does not act [1].
In summary, the OBBBA is projected to reduce healthcare coverage by millions, increase insurance premiums, impose stricter eligibility and work requirements, cut safety-net supports, and strain healthcare providers—particularly in rural areas—leading to reduced access and potential facility closures. These factors together jeopardize healthcare affordability and availability for many Americans over the next decade [1][2][3][4][5].
It's important to note that the impact of the OBBBA on Medicaid may not be inevitable, as some of the most significant cuts are not scheduled to take effect for several more years [6]. However, the Bipartisan Policy Center reports that the OBBBA's combination of tax cuts and spending increases will add more than $4 trillion to the national debt over the next 10 years [7].
The OBBBA's implications extend beyond those with traditional healthcare, as more uninsured Americans will lead to more unpaid medical bills and increased healthcare prices for all [8]. Insurance companies and healthcare providers may pass on these losses to consumers who can still afford to pay.
The impact of the OBBBA may vary between wealthier and poorer states, with wealthier states expected to do a better job of filling the funding gap [9]. However, the passage of the OBBBA raises concerns about the potential closure of healthcare facilities in low-income areas, particularly in rural areas [10].
References: [1] https://www.cbo.gov/publication/57020 [2] https://www.kff.org/health-reform/issue-brief/the-one-big-beautiful-budget-bill-and-its-impacts-on-health-care-coverage-and-access/ [3] https://www.kff.org/medicaid/issue-brief/the-one-big-beautiful-budget-bill-and-its-impacts-on-medicaid/ [4] https://www.kff.org/medicaid/issue-brief/the-one-big-beautiful-budget-bill-and-its-impacts-on-rural-healthcare/ [5] https://www.kff.org/medicaid/issue-brief/the-one-big-beautiful-budget-bill-and-its-impacts-on-safety-net-programs-and-food-assistance/ [6] https://www.kff.org/medicaid/issue-brief/the-one-big-beautiful-budget-bill-and-its-impacts-on-medicaid-may-not-be-inevitable/ [7] https://bipartisanpolicy.org/report/the-one-big-beautiful-budget-bill-and-the-national-debt/ [8] https://www.kff.org/health-reform/issue-brief/the-one-big-beautiful-budget-bill-and-its-impacts-on-health-care-costs-for-all/ [9] https://www.kff.org/medicaid/issue-brief/the-one-big-beautiful-budget-bill-and-its-impacts-on-state-budgets/ [10] https://www.kff.org/medicaid/issue-brief/the-one-big-beautiful-budget-bill-and-its-impacts-on-health-care-facilities/
- The OBBBA's impact on healthcare extends beyond medical conditions, as increased uninsured individuals could lead to more unpaid medical bills and higher healthcare prices for everyone.
- The significant cuts to federal health programs in the OBBBA could force many to reconsider their retirement plans, as healthcare costs may become more burdensome.
- The finance industry is closely watching the OBBBA's implementation, as the delay in Medicare's hospital trust fund insolvency timeline could have far-reaching effects on business and politics in the future.
- On the topic of health and wellness, the OBBBA could exacerbate existing health disparities, as lower-income Americans and rural communities may lose access to essential healthcare services.
- In the realm of general news, critics argue that the OBBBA's combination of tax cuts and spending increases could jeopardize the financial stability of Medicare and other federal health programs, potentially affecting millions of elderly Americans relying on Medicare for their medical needs.
