Health Care

States brace for sweeping health care cuts under Trump’s new law

Analysts say the One Big Beautiful Bill Act could lead to millions losing coverage.
President Donald Trump and first lady Melania Trump watch fireworks from the Truman Balcony of the White House Friday, July 4, 2025, in Washington. (AP Photo/Julia Demaree Nikhinson)

States are preparing for major changes to health care delivery under the budget reconciliation bill President Trump signed Friday — changes that affect all residents, not only Medicaid recipients.

The biggest budget impact of the law, known as the One Big Beautiful Bill Act, comes from new Medicaid restrictions, which analysts say could lead to millions losing coverage, though the effects will vary by state. The legislation is structured so the brunt of the federal budget cuts will fall on the 40 states that expanded Medicaid under the 2010 Affordable Care Act. 

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