Trump’s Large Lousy Law will harm 24 million Americans who receive health care through the Affordable Care Act.https://t.co/kbK6OJvjC2
— Congressman Raja Krishnamoorthi (@CongressmanRaja) June 16, 2025
President Trump’s proposed “One Big Beautiful Bill” and other changes could significantly impact access to health insurance for millions of Americans. The bill, which passed the House in May, aims to prevent alleged fraud and abuse in the Affordable Care Act (ACA) system. Under the proposed legislation, ACA policyholders would be required to provide detailed information on income, household size, immigration status, and more every year starting in 2028.
Failure to do so could result in losing premium tax credits, making coverage unaffordable for some.
It’s hard to believe that the Senate Republicans would put forward a bill that’s even worse than the House bill on Medicaid, but they did.
Even more people will lose health care
Even more hospitals will close
Even more people will have their health insurance costs skyrocket— Chuck Schumer (@SenSchumer) June 16, 2025
Sabrina Corlette, a research professor at Georgetown University, expressed concerns that these requirements could lead to many becoming uninsured due to the complexity and burden of the paperwork. The bill would also eliminate provisional eligibility for tax credits during major life changes, such as job loss or having a baby.
The Senate version of OBBB doubles down on Medicaid cuts + threatens rural hospitals esp those in ACA expansion states
52% of rural hospitals already have no labor + delivery
⬇️Top 20 rural counties in the country w/ 1/2 or more of women of reproductive age covered by Medicaid pic.twitter.com/rlbZmgz1Fd
— Joan Alker (@JoanAlker1) June 17, 2025
This could cause delays in coverage, particularly for new parents, as babies can’t be confirmed eligible for subsidies until they receive Social Security numbers. Additionally, the bill proposes shortening the ACA open enrollment period and eliminating a special enrollment period for lower-income individuals.
Healthcare coverage hurdles under new bill
Critics argue that this could lead to increased premiums and out-of-pocket costs for enrollees. The Congressional Budget Office estimates that these changes could increase the uninsured population by 700,000 by 2034.
The Senate text DOUBLES down on provisions that undercut the ACA Medicaid expansion.
As @AdamSearing and I blogged about last week the "One Big Beautiful Bill" is a clear attack on the ACA's vision that everyone deserves health care. https://t.co/bFwXQGlD2P
— Joan Alker (@JoanAlker1) June 17, 2025
As the Senate deliberates on these proposals, the future of Obamacare and access to healthcare coverage for millions of Americans hangs in the balance.
Rural hospitals are also warning that the proposed $785 billion cut to Medicaid over a decade could result in severe service cuts or closures. Hospitals and healthcare providers in rural areas have launched a lobbying effort, urging lawmakers not to implement cuts that they say would “cut into the bone” of essential health services. The House tax-and-spending bill introduces new bureaucratic obstacles that could complicate Medicaid enrollment and retention, increasing the likelihood of many losing their coverage.
The most significant changes include work requirements for Medicaid recipients aged 19-64 and changing the frequency of Medicaid eligibility determination from once every 12 months to twice a year. If the bill becomes law, millions of low-income Americans may lose health insurance, while those retaining coverage could face restricted access to healthcare due to increased bureaucratic obstacles and higher costs. The overall effect could lead to more Americans foregoing necessary medical care, negatively impacting public health outcomes.