Healthcare Impacts of the One Big Beautiful Bill Act

This document is a technical report that outlines the healthcare impacts of the One Big Beautiful Bill Act (OBBBA), signed into law on July 4, 2025. The report details projected effects on healthcare coverage, payment structures, and enrollment processes over the next decade. It highlights anticipated coverage losses and payment cuts, with a projected increase of 14.2 million uninsured individuals due to various provisions within the act. The report documents significant cuts to federal healthcare programs, including Medicaid, Medicare, and the ACA Marketplace, amounting to over $1 trillion. Key changes include the implementation of Medicaid work requirements, stricter eligibility verification processes, and cost-sharing mandates. The report also discusses the potential consequences of these changes, such as increased administrative burdens, reduced affordability, and exacerbated health conditions. Additionally, it presents a timeline for the implementation of major provisions and their expected impact on health system margins, emphasizing the long-term financial implications for healthcare providers.