By skyforbes 
Healthcare Psychology Philosophy
Branded as a patriotic masterstroke, the “One Big Beautiful Bill Act” promises to cut waste and restore dignity — by emptying Medicaid’s coffers, hiking costs for low-income seniors, and tossing millions off coverage.
It is, in essence, a tax-cut triumph draped in a flag, with the healthcare safety net left to fray in the name of fiscal virtue.
I remember the day they passed the “One Big Beautiful Bill Act,” which was July 4, 2025. Of course, Independence Day. Nothing says “I’m a patriot” like taking away health insurance from millions of Americans.
Congress passed it with a very small margin, which makes you wonder if they even read the 940 pages. Then President Trump signed it with a flourish, probably between fireworks and a victory lap.
They said this was about cutting down on waste, making the borders safer, and starting a “Blue-Collar BOOM.” Doesn’t that sound nice? Like a Norman Rockwell painting, but with people filling out eleven forms to show they still qualify for Medicaid before getting kicked off anyway.
The White House said it would cut the deficit by cutting down on fraud. The Congressional Budget Office, which is bad at math, politely told us that it will add $3.3 trillion to the deficit over the next ten years.
It looks like $4.5 trillion in tax cuts and $1.2 trillion in spending cuts add up to a fiscal chasm, but come on, spreadsheets are so negative.
The real fireworks weren’t in the sky; they were in Medicaid. We’re talking about the biggest cuts since the program started: $1 trillion over ten years.
If I want to keep my coverage under the ACA expansion, I have to work, train, or volunteer for 80 hours a month. If you’re young, healthy, and have a free calendar, it’s not hard at all.
But if you’re one of the 2.6 million adults with disabilities who don’t qualify for federal disability benefits, you’re out of luck. Even if your lungs or joints don’t agree, you’ll meet “the dignity of work.”
That’s the main change. The supporting acts include biannual eligibility checks (because once a year wasn’t enough fun), the end of provisional coverage (great for parents of newborns who are waiting for their Social Security numbers), and copays of up to $35 for people who make more than the poverty line.
On paper, the copay stunt probably seems small. But if your income is just high enough to not get full assistance and just low enough that $35 feels like rent or groceries, it can be a big deal.
Things aren’t much better for states. The law basically says, “Get money from somewhere else and give it to Medicaid.” Goodbye taxes for providers, hello budget crisis. Taxes go up? Cut back on schools and roads? Or keep cutting Medicaid until it dies? Choose your poison.
Then there’s Medicare, the victim that no one thinks about. That “improvement” that would automatically sign up low-income seniors for programs to help with their premiums and deductibles?
On hold. In other words, 1.3 million seniors will happily pay thousands more each year while the government pats itself on the back. Some legal immigrants, even those who have been paying into the system for decades, will be politely told they are no longer eligible.
And if that $3.3 trillion deficit spike leads to automatic cuts in 2026, Medicare will lose $500 billion over the next eight years.
America’s rural areas? Yes, the land of golden waves of grain and closing hospitals. They added a $50 billion “Rural Health Transformation” fund that would be spread out over five years. It’s like giving a drowning man a spoon and telling him to bail out the Titanic.
When everything is said and done, 16 million of us will lose our health insurance. The ones who were hurt the most? The usual suspects are the poor, children, disabled people, and people who live in rural areas.
People who are “dually eligible,” meaning they have both Medicare and Medicaid, will be hit twice. CHIP will put millions of kids in danger.
What if you work in a hospital or clinic that gets money from Medicaid? Expect layoffs, instability, and services that aren’t as good.
But don’t worry, the (Wasteful and Inappropriate Service Reduction) (“WISeR”) Model is an AI project that will deny “wasteful” services.
Imagine it as a robot that controls access between you and your doctor, programmed to save money in ways that a person wouldn’t have the guts to do.
Twenty million people got health insurance because of the Affordable Care Act. This law will take away 16 million. That’s what real, effective symmetry looks like: one step forward and most of a step back.
I guess it’s my fault for thinking that “One Big Beautiful Bill” was for us, the people. It turns out it’s more like a gift basket for people who like tax cuts, with a card that says, “Here’s to dignity, discipline, and doing without.”