'One Big Beautiful Bill': How cuts will affect healthcare in 5 areas

Evan Walker
Evan Walker TheMediTary.Com |
An older adult rides on a mobility scooter with an American flag attached to the bagckon a sidewalk outside of a buildingShare on Pinterest
The “One Big Beautiful Bill”, signed by U.S. President Donald Trump last month, will cut about $1 trillion from health-related programs. Rebecca Noble for The Washington Post via Getty Images
  • The tax cut and spending bill, or the so-called “One Big Beautiful Bill Act”, recently approved by the United States Congress reduces federal spending on healthcare programs by $1 trillion over the next eight years.
  • Experts say older adults could be directly affected by cuts being made to Medicare and Medicaid programs.
  • They also note that the prices of some drugs, such as cancer and myeloma treatments, could increase and nursing homes could reduce services.

The One Big Beautiful Bill Act, signed by U.S. President Donald Trump on July 4, will impact a wide array of health-related programs in the United States.

The bill, officially known as House Resolution 1, is expected to reduce federal spending on Health-related programs by $1 trillion between now and 2034.

It’s estimated that those cuts will cause at least 10 million people to lose Health insurance coverage during the next nine years.

Medicaid, the health program for lower-income households, will be hardest hit by a $790 billion cut from its budget over the next decade.

The bill also reduces funding for food assistance programs, Planned Parenthood, and rural hospitals.

Many of these reductions will affect programs that serve older adults, including Medicare, which provides Health insurance for people 65 years and older.

Some of the impacts will take years to be felt. Other provisions, however, could directly affect people’s lives in the next year or two.

Here’s a look at five areas where older adults could be affected.

More than 66 million older Americans receive health insurance coverage under the Medicare program.

There isn’t any direct mention of Medicare cuts in the Trump bill, but there are measures that could impact people who are enrolled in the program.

Under a 2010 budget mechanism law known as PAYGO, which is tied to the national debt, the Congressional Budget Office estimates the Trump bill could trigger $500 billion in Medicare cuts between 2026 and 2034.

The Health Foundation for Western & Central New York states that these reimbursement reductions could cause healthcare providers, especially specialists and rural facilities, to stop accepting new Medicare patients or even discontinue Medicare altogether.

In addition, the Center for Medicare Advocacy reports the bill will also reduce the number of people eligible to receive Medicare. They say some non-citizens who meet Medicare eligibility requirements through work history or residency length will no longer be covered.

“This represents a major policy shift. While undocumented immigrants have never been eligible for Medicare, lawfully present individuals who worked and paid into the system have historically been able to qualify for Medicare benefits,” the center states.

The new eligibility requirements are scheduled to take effect on Jan. 1, 2027.

The bill also prohibits the implementation of two finalized rules until October 1, 2034. One of those rules imposes a nine-year ban on implementing improvements to Medicare Savings Programs that help lower-income Medicare beneficiaries pay for premiums and out-of-pocket costs.

The Kaiser Family Foundation reports that the $793 million in cuts to Medicaid services could affect 22 million people aged 50 and older who now use the low-income health program.

Kanwar Kelley, MD, a specialist in otolaryngology, head and neck surgery as well as obesity medicine and lifestyle medicine and the co-founder and chief executive officer of Side Health, says these reductions put older adults in a predicament.

“This bill boasts savings, but at the expense of decreasing access to care, especially in a population that is closest to retirement,” Kelley told Medical News Today. “The cuts in funding will restrict their access to care and cause changes in planning for retirement, due to budget constraints or the need to continue working to continue coverage into later life.”

Experts say the bill will reduce the number of people enrolled in Affordable Care Act (ACA) health insurance programs as well as increase premiums on those who kept their plans.

The foundation says the bill’s changes to shorten the enrollment period, impose new documentation requirements, and eliminate automatic re-enrollment will make it more difficult for older adults to sign up for ACA programs.

They also note that the bill does not extend enhanced ACA premium tax credits that are set to expire at the end of this year. That means enrollees with incomes more than four times the official poverty level would lose subsidy eligibility. Those with incomes between 100% and 400% of the poverty level will receive a smaller tax credit.

The foundation estimates that more than half of Obamacare enrollees with incomes above four times the poverty threshold are between the ages of 50 and 64. They note that premiums are generally higher for this age group because they need more medical attention.

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