17 Million May Lose Health Insurance, Millions More Face Cuts to Basic Aid

President Donald Trump signed the One Big Beautiful Bill Act into law on July 4, delivering $4.5 trillion in tax cuts (mostly for the wealthy) that will be financed by major cuts to the country’s social safety net programs, particularly Medicaid. 

The federal government jointly funds Medicaid with states (including the District of Columbia. and U.S. territories) to ensure low-income people, children, older individuals and people with disabilities are able to access healthcare. The GOP-passed budget includes nearly $1 trillion in cuts to Medicaid, mainly through work requirements as a new condition of Medicaid eligibility as well as reduced federal funding, which are slated to take effect in 2027 or 2028. 

These cuts, along with the rollback of enhanced premiums for the Affordable Care Act’s public marketplaces, will kick an estimated 17 million Americans off their health insurance over the next 10 years. Experts anticipate the number of uninsured Americans will increase to pre-ACA levels, leaving people sicker and driving up healthcare costs. 

For example, an uninsured person may not be able to afford primary or specialty care, which will worsen their symptoms and lead to a costly emergency room visit. Hospitals generally have to bear the costs of treating those patients through what’s called uncompensated care, adding to financial strain to their operating budgets. With fewer insured individuals, hospitals will lose patient volume and reimbursement, which could lead to more closures. 

Rural hospitals and Planned Parenthood are providers that will see serious financial and operational impacts from the budget. A July research paper published in JAMA Health Forum found that more than 100 rural hospitals could be at risk of closure by 2034, with the potential of losing more than 300,000 jobs and shrinking the economy by $135 billion. 

Meanwhile, the One Big Beautiful Bill Act imposed a yearlong moratorium on funding for any organization that uses federal Medicaid dollars and provides abortion services. This provision is aimed at Planned Parenthood (though unnamed in the law), which offers services beyond abortion that include gender-affirming care, LGBTQIA+ services like PrEP and HIV testing, access to birth control and overall wellness exams; other providers of these services also will  be affected. 

A federal district judge in Massachusetts on July 7 temporarily halted the Trump administration from pulling Medicaid funding from Planned Parenthood, which sued. It has long been enshrined in statute that federal Medicaid dollars can’t be used for abortion, except in cases of rape, incest or risk to the pregnant person’s life, but Planned Parenthood argued in its suit that patients will struggle to receive care overall from these cuts. 

The budget also includes cuts to the Department of Education and public schools and universities, which will strain district funding and make it harder to feed and educate kids. More than 22.3 million families nationwide are expected to lose some or all of their Supplemental Nutrition Assistance Program, or SNAP, benefits. 

What other concerns do you have about the GOP-passed budget? Comment below.