“One Big Beautiful Bill”? More like One Big Cut
The 119th Congress and Senate recently passed H.R. 1—cynically titled the One Big Beautiful Bill Act—and no, I’m not joking when I say the name is almost unbearable irony. This 887-page package slashes nearly $1.2 trillion in healthcare and social safety nets over the next decade—including Medicaid cuts, work requirements, and limitations on nutrition assistance, SNAP, utility support, and even internet subsidies.
Who’s Covered—Who’s Cut
According to the Congressional Budget Office and confirmed by the American Hospital Association, H.R. 1 includes approximately $940 billion in Medicaid cuts over 10 years, and is projected to push nearly 12 million people off health insurance by 2034 (American Hospital Association, 2025) (Health Management Associates, 2025). States could see Medicaid funding drop by 10–21%, with rural hospitals losing up to $50 billion—leading to closures and workforce reductions (American Hospital Association, 2025) (Business Insider, 2025).
Real-World Consequences
These cuts aren’t just numbers—they’re lives. In states like Louisiana, 11.8 million people risk losing health insurance, and potentially 3 million more could be dropped from SNAP (AP News, 2025). In rural areas, hospitals that rely heavily on Medicaid for patient volume and funding may shut down—driving up ER crowding, worsening health outcomes, and further straining provider resources (CT Insider, 2025) (The Commonwealth Fund, 2025).
Budget: For Whom?
While Medicaid coverage shrinks, the legislation pours $4.5 trillion in tax breaks to the wealthy and corporate sector (AP News, 2025) (TIME, 2025). This betrays the bill’s ironic name—it feels like a celebration of cutting lifelines for peoples survival while protecting profits of the rich.
Why This Worries Me—And Should Worry You
As a physician, I’ve watched my colleagues walk away, clinics close, and patients suffer when we prioritize “efficiency” over human value. Now, with even basic supports in jeopardy, caregiving becomes harder—not just for doctors but for every family across the country.
$1.2 trillion in cuts means fewer doctors willing to serve, fewer clinics staying open, and poorer health for entire communities. It doesn’t matter how good your intentions are; if your safety net is gone, care collapses, and people die.
Where Do We Go from Here?
I don’t have all the answers. But here are small actions we can take—together:
- Advocate: Call or write your representatives about protecting Medicaid & SNAP.
- Share stories: Tell your community what this means in real life—real pain, not just policy.
- Support locally: Whether you’re a doctor or not, financially or volunteer-wise support clinics and mental health providers in your area.
Because when policies break the system, we have two choices: accept it—or fight to fix it.
Sources:
- American Hospital Association. (2025). Analysis highlights impact of proposed Medicaid cuts on rural patients and hospitals. https://www.aha.org/news/headline/2025-06-16-analysis-highlights-impact-proposed-medicaid-cuts-rural-patients-and-hospitals.
- The Commonwealth Fund. (2025). “How Medicaid and SNAP Cutbacks in the “One Big Beautiful Bill” Would Trigger Big and Bigger Job Losses Across States.” https://www.commonwealthfund.org/publications/issue-briefs/2025/jun/how-medicaid-snap-cutbacks-one-big-beautiful-bill-trigger-job-losses-states.
- Health Management Associates (HMA). (2025). What the Senate’s Budget Approval Means for the Future. https://www.healthmanagement.com/insights/weekly-roundup/july-2-2025/.
- The Associated Press (AP). (2025). Democratic leader Jeffries heads to Speaker Johnson’s home state to decry cuts in Trump’s tax law. https://apnews.com/article/democrats-johnson-louisiana-health-town-hall-jeffries-ba2510481af6098cdacd2e7faa73e320.
- Business Insider. (2025). How Trump’s Medicaid changes could affect every state. https://www.businessinsider.com/map-which-states-trump-medicaid-changes-could-impact-most-2025-7.
- CT Insider. (2025). Johnson Memorial Hospital chief warns of impact of federal Medicaid cuts: ‘very devastating.’ https://www.ctinsider.com/journalinquirer/article/ct-johnson-memorial-hospital-medicaid-stafford-20762717.php.
- TIME. (2025). The Big Budget Bill Could Make Your ER a Mess. https://time.com/7300067/budget-bill-effects-emergency-rooms-hospitals/.
