Resources on the One Big Beautiful Bill Act Signed Into Law July 4, 2025
President Trump July 4 signed into law the OBBBA; Public Law No. 119-21, a sweeping package that enacts many of the administration’s legislative priorities on taxes, border security and energy. The bill includes significant policy changes to Medicaid and the Health Insurance Marketplaces.
According to the Congressional Budget Office (CBO) score of a draft version of the Senate bill, the OBBBA will lead to nearly $1 trillion in Medicaid cuts and more than 11.8 million people losing Medicaid and Health Insurance Marketplace coverage. A significant portion of the savings will result from new limits on the use of Medicaid provider taxes and state-directed payments (SDPs), which have historically allowed hospitals to bridge the chronic underpayments for the care they deliver to Medicaid enrollees. The CBO estimates that the policy changes related to SDPs and provider taxes will save $340 billion and result in direct decreases in provider payments.
Chair File: Leadership Dialogue — Continuing the Work to Strengthen Health in America With AHA President and CEO Rick Pollack
In this episode, 2025 AHA Board Chair Tina Freese Decker talks with AHA President and CEO Rick Pollack about the legislation’s key provisions that apply to health care. Freese Decker and Pollack discuss how the AHA is helping the field prepare for some of the law’s changes, as well as ongoing efforts to mitigate some of the policies.