The proposed “One Big, Beautiful Bill Act” by Republicans poses a significant threat to approximately 11.8 million adults and children who may lose their health insurance over the next decade. The bill aims to cut nearly $1 trillion from Medicaid, the Affordable Care Act (ACA), and the Children’s Health Insurance Program (CHIP), potentially undoing years of progress in expanding healthcare coverage in the U.S.
Under the new legislation, states will be tasked with more stringent and frequent verification processes for Medicaid and ACA enrollees. Eligibility checks will shift to every six months, complicating the coverage retention for vulnerable groups, especially those who experience homelessness or transient living situations. These individuals may miss critical communication regarding re-enrollment paperwork, risking their health coverage. Historical data from Texas demonstrates that increased income checks led to thousands of children losing Medicaid coverage, highlighting the potential for significant negative consequences if the bill is enacted.
In addition, the bill will introduce new barriers for children obtaining CHIP coverage. States will have the discretion to delay enrollment for children whose parents are behind on premiums, with potential waiting periods imposed for those transitioning from private insurance to Medicaid. This changes the previous protections established by the Biden administration that aimed to ensure continuous coverage for children.
The legislation also restricts who qualifies for subsidies under the ACA, making it harder for refugees and asylum seekers to access health insurance. Moreover, it threatens funding for states that provide Medicaid to undocumented immigrants by reducing federal reimbursement rates.
One of the most contentious aspects of the proposal is the new work requirement mandated for able-bodied adults aged 19 to 64. Under these provisions, individuals will need to demonstrate 80 hours of work, volunteer activities, or educational involvement per month to maintain their Medicaid eligibility. Critics argue that this could lead to unfair coverage losses due to bureaucratic issues and challenges in providing verification documentation.
Enrollment complexities also extend to individuals eligible for both Medicare and Medicaid, as the GOP bill seeks to roll back certain enrollment streamlining measures. This could increase the paperwork burden on this vulnerable population, further jeopardizing their health coverage.
While the bill’s proponents argue that it could lead to decreased government spending on healthcare, experts caution that the impact on millions of Americans could be detrimental, leading to increased rates of uninsured individuals. Overall, these changes threaten the significant progress made in recent years to expand access to healthcare, underscoring the stark divide in approaches to health policy between parties.
With ongoing discussions in Congress about healthcare access, it remains crucial to closely monitor how these proposed cuts will affect millions of Americans—especially the most vulnerable populations— and to advocate for solutions that prioritize health security for all.