Both the U.S. House of Representatives and the Senate have passed the Republican-led “One Big Beautiful Bill” and sent it to the White House for signature. The bill contains Medicaid cuts totalling $1 trillion over the next 10 years.
This amounts to 15% of total federal Medicaid spending during that time period, according to the Kaiser Family Foundation. The reductions vary by state, with Louisiana and Virginia hit the hardest.
The cuts could have a long-term detrimental impact on home-based care, according Dr. Steven Landers, CEO of the National Alliance for Care at Home.
“The Alliance is deeply troubled by the Medicaid provisions within the One Big Beautiful Bill Act, which has passed both chambers of Congress and now awaits President Trump’s signature,” Landers said in a statement. “These provisions — including work requirements, reduced provider taxes, and new cost-sharing mandates — prioritize short-sighted budget savings over the health and wellbeing of our most vulnerable citizens who rely on home and community-based services (HCBS).”
The legislation aims to reduce fraud, prevent “wasteful spending” and stop “abusive financing practices” within the Medicaid reimbursement realm, according to the bill’s language.
The legislation could lead to a 4% reduction in household resources among populations with the lowest socioeconomic status, largely from the Medicaid cuts and food aid, according to the Congressional Budget Office (CBO). An estimated 17 million Americans could lose their health insurance, Kaiser reported. This will likely include millions of serious and terminally ill individuals dually eligible for Medicare who rely on Medicaid coverage, according to CBO.
Rural hospitals and other health care organizations may be hit hard by the loss of Medicaid revenue and may even be shut down as a result, according to the National Rural Health Association.
“Medicaid cuts would place significant financial pressure on hospitals in rural states, where many hospitals are already at risk of closure. In more than half of states, reductions in Medicaid funding for rural hospitals would exceed 20%,” according to a statement from the association.
The consequences of the bill will “not be pretty,” according to Katie Smith Sloan, president of the nonprofit senior care advocacy organization LeadingAge.
“This legislation deals a significant blow to a core element of our country’s social safety net: Medicaid. The consequences will not be pretty. Millions of Americans will lose health insurance coverage resulting from cuts to Medicaid and to Affordable Care Act Marketplace coverage. Due to the level of deficit this bill will create, Medicare payments to providers may be reduced by 4% for the next ten years …” Smith Sloan said in a statement. “And, as states respond to OBBB-created craters in their budgets due to reduced federal Medicaid contributions, the suffering will begin.”
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