On July 4th, 2025, President Trump signed a sweeping new law, the "One Big Beautiful Bill," into law. The name might sound hopeful, but the impact on healthcare could mean higher costs or lost coverage for millions of families.
At ClearCover Health, we believe everyone should have clear information about how policies impact their care. Here is a straightforward guide on what this law changes and how it could affect your coverage and your costs.
What is the One Big Beautiful Bill?
The "One Big Beautiful Bill" is a new law that changes how the government spends money on important programs like immigration, homeland security, and healthcare.
Here is how the bill impacts healthcare directly:
- Less money for Medicaid funding
- New work rules to keep Medicaid coverage
- Help for rural hospitals
- Medicare stays the same (for now)
Let's dive a little deeper below to explore each of the four changes.
Medicaid Cuts
This law cuts about $930 billion from Medicaid over the next 10 years. These cuts will limit the ability of states to cover as many people or to provide the same level of services as before.
Impact: States may not be able to offer as much help
Who's affected: People who use Medicaid for doctor visits, prescriptions, or hospital care. Fewer people will qualify, and some services may no longer be covered
Projected Loss: About 11.8 million people could lose Medicaid by 2034
New Work Requirements To Keep Coverage
With this law, adults on Medicaid must prove they are working, looking for work, or have a valid reason for why they can't work, like a disability or being a caregiver, to stay covered.
Impact: People might lose coverage even if they still qualify because of confusing paperwork or system errors.
In 2023, Arkansas tried something similar — a Medicaid work requirement program where individuals had to report their work to maintain coverage. Thousands lost coverage because of paperwork errors, confusion, and system glitches, even if they qualified.
Projected Loss: Millions of people could lose coverage due to paperwork mistakes rather than actual ineligibility.
Help for Rural Hospitals
This law gives $50 billion to rural hospitals that are struggling, especially in places where Medicaid cuts may hit the hardest.
Goal: Keep small-town hospitals open so people in those areas can still get care.
Caveat: This funding is helpful, but it may not be enough. Some rural hospitals could still struggle to stay open or keep all services and staff, especially in areas with high need.
Medicare Stays the Same (for now)
If you have Medicare, which is an insurance program for seniors and people with disabilities, there are no changes for now.
Note: This law doesn't touch Medicare today, but there are discussions of future changes. We are keeping an eye on it.
What's Changing vs. What's Staying the Same
| Area | What's Changing? | What's Staying the Same? |
|---|---|---|
| Medicaid Funding | $930B in cuts over 10 years. Fewer people qualify or get full services. Work requirements of 80 hours/month. | No changes for elderly or disabled Medicaid recipients |
| Work Requirements | Adults on Medicaid must show proof of work or a reason for an exemption | No changes for children or seniors on Medicaid |
| Rural Hospitals | $50 billion fund to support small-town hospitals that will struggle with changes to Medicaid | Urban hospitals get no new direct funding from the government |
| Medicare | No cuts or changes to benefits or coverage | All current Medicare benefits stay intact |
| ACA Subsidies | ACA subsidies are scheduled to expire soon, which will likely increase premiums | No subsidy extension is included in this bill |
| Essential Health Benefits | Possible loosening of Medicaid benefit rules | Medicare benefits unchanged |
What Can You Do?
If you have Medicaid:
- Check your mail and your state's health website for new rules or paperwork
- Make sure you report your work status or income if required
- Look into Marketplace insurance options in case your coverage ends
If you don't have Medicaid:
- Expect that healthcare might get more expensive overall
- Be prepared for longer waits or fewer services in some areas
ClearCover's Takeaway
While the One Big Beautiful Bill provides support to some hospitals, it puts many families at risk of losing access to affordable coverage.
ClearCover Health is here to break it down, so you don't have to navigate these changes alone.
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