What Are The Medicaid Cuts 2025 And What Does It Mean?
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The One Big Beautiful Bill Act includes some of the most sweeping changes to Medicaid in decades. The Medicaid cuts could place a heavier burden on family caregivers by limiting access to health care for both caregivers and those they support.
1. What’s the 2025 One Big Beautiful Bill Act?
Signed into law by President Trump during a Fourth of July celebration, the 2025 One Big Beautiful Bill Act (OBBBA) is a sweeping tax cut and spending package that makes major changes to federal priorities. The legislation boosts funding for defense and border wall construction while making Trump’s 2017 tax cuts permanent.
To help pay for these changes, the law includes deep cuts to programs such as Medicaid, food assistance, student loans, and clean energy initiatives. According to the Congressional Budget Office, the Medicaid cuts alone will reduce federal spending by about $911 billion over the next decade.
While some provisions of the law will take effect later this year, others are scheduled to roll out after the 2026 midterm elections.
2. What Are the Medicaid Cuts? Key Medicaid Policy Changes
Among the most significant changes are new work requirements for some able-bodied adults and more frequent eligibility checks.
Adults ages 19 to 64 who do not have disabilities or young children will be required to work, volunteer, or attend school for at least 80 hours per month to remain eligible for Medicaid coverage. The requirement applies to childless adults and parents whose youngest child is over age 14, unless they qualify for an exemption.
In addition to the work rules, according to AARP analysis, the law mandates more frequent eligibility checks, moving from annual to twice-a-year reviews for Medicaid Expansion enrollees.
Other changes include limiting retroactive coverage, reducing it from three months to as little as one month before application, and allowing states to charge up to $35 for certain services for individuals just above the poverty line.
The complexity of verifying work hours and determining eligibility could leave many without coverage, particularly those in unstable jobs or caregiving roles. While states await implementation guidance, concerns remain about whether data systems can be updated in time to handle the new requirements.
3. Why It’s a Big Deal
The One Big Beautiful Bill Act came at a time when more than 71 million Americans rely on Medicaid for health care.
The Congressional Budget Office projects that the changes included in the new law will result in 11.8 million people losing Medicaid coverage over the next decade.
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