On July 4, President Trump signed H.R. 1, the budget reconciliation bill—dubbed the “One Big Beautiful Bill Act”—into law, marking a historical and catastrophic turning point for the Medicaid program. This legislation is poised to decimate federal Medicaid funding over the next decade, with the nonpartisan Congressional Budget Office (CBO) estimating a staggering $1.02 trillion decrease in federal Medicaid and CHIP spending over the next 10 years, potentially leading to 12 million fewer Americans covered. These cuts are anticipated to have wide-scale, negative impacts across the healthcare landscape.
In Colorado alone, projections indicate that more than 300,000 residents could lose their health coverage over the next ten years, a direct result of the bill’s changes to Medicaid and Marketplace premium tax credits. Moreover, new provider tax moratoriums, increased Medicaid eligibility redeterminations, and stricter work requirements are expected to increase administrative burdens, deplete funding, and force countless otherwise eligible Medicaid enrollees off the program.
While the bill does offer some targeted relief, these provisions are not sufficient to offset its overall adverse effects. Notably, the law establishes a $50 billion Rural Health Transformation Program. This program is designed to assist eligible rural clinics and hospitals, including Certified Community Behavioral Health Clinics (CCBHCs), Community Mental Health Centers (CMHCs), Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), by allowing states to apply for funding to improve healthcare access and outcomes, promote technology, and enhance the rural workforce. Additionally, the bill includes extended cost-sharing exceptions for CCBHCs and FQHCs, aiming to preserve access to these vital services. However, the sheer scale of the overall funding reductions and the increased administrative hurdles eclipse these positive aspects, rendering them insufficient against the overall harms of the bill.
CBHC shared its concerns about the new law in this statement.
