
How Trump Bill Medicaid is influenced by the US health care that

An aerial absence of the Valley Health Hampshire Memorial Hospital on June 17, 2025 in Romney, WV
Ricky Carioti | The Washington Post | Getty pictures
“Big Beautiful Bill” by President Donald Trump would make the US health care comprehensive changes, leave millions of Americans in need of protection without health insurance and threaten the hospitals and centers that provide them.
The Senate voted 51: 50 for the expenditure measure after a marathon overnight on Tuesday. However, the legislation will be in the house with another large test in which the Republicans have a razor thin majority and some members have already raised objections to legislation.
According to the new estimates by the impartial congress budget office, the latest changes to the law would be reduced in the next decade in the next decade in the next decade.
According to CBO, more than $ 1 trillion of these cuts of Medicaid, a joint health insurance program for federal and state health insurance for disabled and low-income Americans. The financing cuts go beyond insurance cover: the loss of this financing could affect many rural hospitals that rely disproportionately on federal expenses.
The CBO estimates that the current version of the invoice would lead to 11.8 million people losing health insurance by 2034, with the majority of people lose medical coverage.
But the effects could be even greater. Trump's draft law In combination with separate changes in guidelines, an estimated 17 million people lose health insurance, said Robin Rudowitz, director of the Medicaid program and not insured with the KFF organization of health policy.
She said that these other changes include new regulations that dramatically restrict the market for the market for affordable care laws and runs dramatically and improved ACA tax credits.
“If all of this is done, this would be the greatest consideration of health insurance protection of all times due to changes in the federal guidelines,” said Cynthia Cox, KFF director of the program at the ACA, in an analysis published on Tuesday.
Around 72 million Americans are currently registered in Medicaid, such as a fifth of the entire US population. Medicaid is the main payer for the majority of the residents of the nursing home and pays around 40% of all births.
The Trump administration and its allies insist that the cuts in the legislative template will remove, fraud and abuse. The Democrats said they break the president's repeated promises not to touch the Medicaid program. Medicaid was one of the most split problems in both negotiations in both chambers, and some Republicans of the representatives have expressed reservations about how deep the cuts are.
“I understand that they want to shorten fraud, but to solve the problem, but Jennifer Mensik Kennedy, President of the American Nurses Association.
She said the cuts could stop hospitals and health centers in rural areas and lead to job losses for health care employees and nurses.
Millions of Americans will lose reports
The cuts in the invoice come from various provisions, but the proportion of the lion in Medicaid savings is due to two changes.
One would set up a new, strict national work requirement for certain Medicaid beneficiaries between the ages of 19 and 64. It would require childless adults without disabilities and parents of children who are older than 14 years at least 80 hours a month to keep their insurance cover, unless they qualify for an exception.
According to KFF, the current law prohibits the authorization of Medicaid's authorization on work requirements or job reporting rules.
The new work request in the invoice will not be received until 2026. It is expected to save around 325 billion US dollars over a decade, the CBO said.
An analysis published by the UC Berkeley Labor Center on June 23 said that the work requirement would lead to most people lose insurance and “a particularly draconian barrier for older adults”. The center indicated [people’s] Control, including deteriorated health, age discrimination and increasing responsibility for the care of aging family members.
“The same factors make older adults particularly susceptible to the loss of covers in accordance with the requirements for medical work requirements,” the analysis says.
People who live in rural communities such as seasonal farmers may also have difficulty finding employment for parts of the year, said Mensik Kennedy.
Aarp, a legal group that focused on topics that affect the United States from the age of 50, sent a letter to the majority leader of the Senate, John Thune, Rs.d., and Senate the Senate Guide Chuck Schumer, DN.Y., contradicted another provision, the people who do not meet the work of Medicaid, would not meet reporting on the ACA market regulations.
“This creates steep reporting for those in the 50s and early 60s, especially for those who are retiring or work part-time-who may not have an affordable cover option at all,” said the group.
Hospitals, health centers, patients in rural areas that are at risk
A surgeon will pass on June 17, 2025 in Romney, WV, in the operation of the Valley Health Hampshire Memorial Hospital
Ricky Carioti | The Washington Post | Getty pictures
Another source of driving for Medicaid is from a provision that the tax that states for hospitals, health plans and other medical providers can improve step and gradually reduces. These provider taxes are intended to help finance state medical programs, whereby the federal government corresponds to part of the state's expenditure.
Some members of the Trump administration and the conservative legislator argue that it is a gap for states to receive disproportionately more federal funds than they contribute.
According to the CBO report, the restrictions of the law about the providers and another strategy, which is referred to as state payments, would reduce the expenditure of $ 375 billion.
Some GOP senators and experts express concerns that the fulfillment of provider tax would endanger a critical financing current for rural hospitals what could force them and other health centers to close. According to the Mensik Kennedy, health service providers in rural areas, especially hospitals for critical access, are more dependent on Medicaid Financers in order to support them in comparison to urban areas.
“You will see closures of rural hospitals that are the backbone of your community and have already been to struggle financially. You will see half a million job losses,” said Mensik Kennedy.
She said pregnant women in rural areas could be forced to drive 30, 40 or more miles to deliver a baby while the medical emergency services had to drive an hour to reach a patient with heart attack.
Patients in rural communities already have higher rates of chronic diseases and mortality, since, according to the centers, they only have limited access to care for the control and prevention of diseases.
The Republicans of the Senate have added a fund of 25 billion US dollars to the draft law in order to remain open to rural hospitals in view of Medicaid.
Mensik Kennedy, however, said that the fund “put a bucket of water on the house fire”, and added that it was not enough to compensate for the cuts of the upper limit for provider taxes and other provisions.
According to a report by the National Rural Health Association, the entire Medicaid financing for rural hospitals would exceed over 20% for rural hospitals.
A victory for pharmaceutical
The Republicans of the Senate achieved a victory to drugmakers after returning a provision to the legislative template that would be more used by the Medicare drug price negotiations of inflation reduction act.
According to the law, medication for the treatment of several rare diseases are freed from these price discussions between Medicare and manufacturers. The Senate initially missed this provision, which was called Orphan Cures Act, in its first draft of the law last month.
The pharmaceutical industry argues that the exception of these drugs from the negotiations will promote more investments in treatments for rare diseases. Currently, only medication that treats a single rare disease or a single state can be freed from price discussions.
“The law on Orphan Cures will enable more options for Americans who live with rare diseases,” wrote the innovation organization of the BioTechnology trade group on Wednesday in a post about X. The group also said that only 5% of rare diseases have approved treatment, while the economic button rarely exceeded 997 billion US dollar in 2019.
But on Tuesday, patients with the pharmaceutical price group for affordable medication asked the house to remove the orphanage law from the invoice and enable negotiations of Medicare medication in order to achieve more patients.
The decision to include it in legislation “moves us in the wrong direction and undermines the highly competitive progress towards lower drug prices,” said Merith Basey, Executive Director of the group.
“Pharmaceutical lobbyists will not persist to maintain the industry gains, and if a large part of the Senate keeps their interests, it is a memory of the Americans why they pay the highest drug prices in the world.
She called it “completely unnecessarily 5 billion US dollars for the pharmaceutical industry” and referred to CBO estimates how much orphanage should cost over taxpayers in the next decade.