How Trump Bill Medicaid cuts will affect our healthcare

President Donald Trump’s “Big Beautiful Bill” has transformed US health care significantly, leaving millions of vulnerable Americans without health insurance, threatening hospitals and centers that provide care to them.

The Senate on Tuesday voted 51-50 to pass the spending measure after an overnight voting session on the amendment. However, the bill faces another major test in the House. There, Republicans make up the majority of razors, with some members already opposing the law.

A recent change in the bill would cut health costs by around $1.1 trillion over the next decade, according to new estimates from the Non-Participation Congressional Budget Office.

More than $1 trillion in these cuts comes from Medicaid, a federal and state coinsurance program for disabled and low-income Americans, according to the CBO. Fund cuts exceed insurance coverage. That loss of funds could hinder many rural hospitals that are disproportionately dependent on federal spending.

The CBO estimates that the current version of the bill would have lost health insurance by 2034, with the majority of them losing Medicaid coverage.

But the meaning could be even greater. An estimated 17 million people could lose their health insurance, said Medicaid program director and uninsured at the health policy research organization KFF.

She said these other changes include new regulations that dramatically limit access to affordable care law market coverage and expire strengthening ACA taxes.

“If all of this happens, federal policy changes will represent the biggest health insurance backback to date,” Cynthia Cox, director of KFF’s ACA program, said in an analysis released Tuesday.

According to government data, around 72 million Americans currently exist in Medicaid, which is about a fifth of the US population. Medicaid is the main payer for most nursing home residents, paying about 40% of all births.

The Trump administration and its allies argue that the legislation cuts aim to eliminate waste, fraud and abuse. Democrats said they would break the president’s repeated promise not to touch the Medicaid program. Medicaid is one of the most divisive issues through negotiations in both rooms, with some House Republicans expressing reservations about how deep the cut is.

“They want to cut down on fraud, but swipe up won’t solve the problem,” said Jennifer Mensik Kennedy, president of the American Nurse Association.

She said the cuts could shutter rural hospitals and health centers, leading to unemployment for medical staff, including nurses.

The bill’s cuts come from several different provisions, but the lion’s share of Medicaid savings comes from two changes.

It will establish new strict national labor requirements for certain Medicaid beneficiaries between the ages of 19 and 64. Parents of children without disabilities and children over the age of 14 must attend school at least 80 hours a month, and at least 80 hours per month, to maintain insurance coverage, unless they qualify for the exception.

According to KFF, current law prohibits Medicaid eligibility based on work requirements or work reporting rules.

The bill’s new work requirements will not begin until 2026. It is projected to save about $325 billion over a decade, the CBO said.

An analysis published June 23rd by the UC Berkeley Labor Center states that work requirements have led to more people losing insurance, “substantially harsh barriers for older people.” The Centre said employment has been steadily declining since the age of 50. [people’s] Control, “including poor health, age discrimination, and increased responsibility for providing care to aging families.

“These same factors make older people particularly vulnerable to compensation losses under Medicaid work requirements,” the analysis states.

People living in rural communities such as seasonal farmers may also struggle to find some jobs this year, Menshik Kennedy said.

AARP, an advocacy group focusing on issues affecting people over the age of 50 in the United States, has been founded over the weekend, John Thune, Rs.D. and Senate Minority Leader Chuck Schumer, DN.Y., opposes people who are unable to meet Medicaid labor requirements fail to purchase coverage to receive insurance coverage through the ACA Marketplace.

“This creates a steep coverage cliff as there could be absolutely no affordable coverage options left for people in their 50s to early 60s, especially those who are retiring or working part-time,” the group said.

Another source of Medicaid savings comes from regulations that curb and gradually reduce taxes states can impose on hospitals, health plans and other health care providers. These provider taxes are designed to help fund the state’s Medicaid program, consistent with some of the state’s spending.

Some members of the Trump administration and conservative lawmakers argue that receiving disproportionately more federal funds than the state contributes is a loophole.

Another strategy called the bill’s provider tax restrictions and state-oriented payments would cut a total of $375 billion in spending, according to a CBO report.

However, some GOP senators and experts raised concerns that provider taxes threaten the critical funding flows for rural hospitals. Mensik Kennedy said rural healthcare providers, particularly Critical Access Hospitals, are more dependent on Medicaid funding to support Medicaid funding compared to urban people.

“You’re the backbone of their community and we’re going to see the closure of rural hospitals that are already struggling financially. You’ll see half a million unemployment,” Mensick Kennedy said.

She said pregnant women in rural areas could be forced to drive more than 30 or 40 miles to give birth to a baby, but emergency medical services had to drive for an hour to have a heart attack and reach a patient.

Patients in rural communities are already seeing higher chronic disease and mortality rates due to limited access to care, according to the Centers for Disease Control and Prevention.

Senate Republicans added $25 billion in funding to the bill to keep rural hospitals open in the face of Medicaid cuts.

However, Mensick Kennedy said the fund “put water into the fires of the house,” adding that it would not be enough to offset cuts from the provider tax and other provisional caps.

Overall Medicaid funding cuts for rural hospitals have exceeded 20% in more than half of the state, according to a report by the National Rural Health Association.

Senate Republicans handed the drugmakers the victory after adding provisions to the Inflation Reduction Act bill that would exempt more drugs from Medicare drug price negotiations.

Under the bill, drugs used to treat multiple rare diseases will be exempt from price associations between Medicare and manufacturers. The Senate initially ruled out the provisions known as the Orphan Reduction Act in the first draft of the bill last month.

The pharmaceutical industry argues that exclusion of these drugs from negotiations will increase investment in treatments in rare circumstances. Currently, only drugs treating a single rare disease or condition may be exempt from price consultations.

“The Orphanage Act allows for more options for Americans with unusual illnesses,” the trade group’s biotechnology innovation organization wrote in a post on X on Wednesday. The group also said that only 5% of rare diseases are receiving approved treatments, but the economic cost of rare conditions in the US exceeded $99.7 billion in 2019.

However, on Tuesday, patients with affordable drug drug pricing group urged the home to remove orphan treatment from the bill and allow Medicare drug price negotiations to provide more savings to patients.

In a statement, Melis Basley, executive director of the group, said in a statement that the decision to include it in the law “moved us in the wrong direction and reduced difficult progress to drug prices.”

“Pharma lobbyists don’t stop anything to maintain the profits of the industry. It’s about reminding Americans why they’re paying the highest drug prices in the world when the majority of Senate caves reach their profits.

She calls it a “completely unnecessary $5 billion giveaway” for the pharmaceutical industry, referring to the CBO’s estimates of how much taxpayer costs over the next decade.