“One Big Beautiful Bill” Passes: What It Means for Healthcare
On July 4, 2025, President Trump signed into law a sweeping legislative package titled the “One Big Beautiful Bill.” Passed along party lines in both the House (218–214) and Senate (51–50, with Vice President J.D. Vance casting the tie-breaking vote), the bill makes permanent the 2017 Trump-era tax cuts while implementing major reforms to healthcare, social safety nets, and rural infrastructure funding.
Key Provisions:
- Tax Policy: Permanently extends the 2017 tax cuts, including reductions in individual tax rates and a doubled standard deduction. While popular among business advocates, the legislation is projected to increase the federal deficit by over $2.8 trillion over 10 years.
- Medicaid & Medicare Changes: The bill includes up to $1 trillion in cuts to Medicaid over the next decade. An estimated 11 million Americans could lose coverage by 2034. Medicare is also affected, with reduced reimbursements and altered eligibility criteria.
- Work Requirements: Enforces 80-hour monthly work requirements for non-disabled adults receiving Medicaid and SNAP benefits. These changes could disqualify millions of recipients, particularly in low-income and rural areas.
- Rural Health Investment: Allocates $50 billion over five years for rural hospital infrastructure and stabilization. However, critics argue this is unlikely to offset losses caused by reduced Medicaid revenue.
- Food Assistance: Stricter SNAP requirements could remove access for millions, with health policy analysts warning of increased food insecurity and avoidable medical complications.
Healthcare Implications:
- Increased pressure on emergency departments and charity clinics.
- Potential surge in uncompensated wound care and post-operative services, especially in non-Medicaid expansion states.
- Likely closure of additional rural hospitals, particularly those operating on thin margins.
Public and Political Response:
- Public opinion polling shows 55% of Americans oppose the bill, while only 29% support it.
- Healthcare and patient advocacy groups have criticized the bill for reducing access and overburdening safety-net providers.
- Democrats plan to use the bill’s unpopularity as a campaign issue ahead of the 2026 midterm elections.
Keywords:
One Big Beautiful Bill,
Medicaid cuts,
SNAP eligibility,
rural hospitals,
healthcare policy