Trump Administration Legislation H.R.1 Proposed to Change Medicare and Medicaid Coverage

Proposed legislation H.R.1, also known as the One Big Beautiful Bill Act, was signed by Donald Trump in July 2025. The bill reduces federal Medicaid spending and alters eligibility requirements, including adding work requirements and requiring more frequent eligibility checks for some adults. Changes to Medicaid eligibility are scheduled to take effect on January 1, 2027.

The legislation is projected to have significant impacts on public health coverage. Reports indicate that up to 10 million people may lose health insurance over the next decade due to changes to Medicare and Medicaid. For example, one hospital projects that between 1,000 and 2,000 residents could lose Medicaid coverage, potentially leading to a $7 to $10 million revenue reduction for the facility.

A report analyzes policy changes under the Trump administration affecting healthcare and Medicare.