On July 4, 2025, President Trump signed the Congressionally-passed budget reconciliation law, known as “One Big Beautiful Bill,” into law, which will drastically cut federal funding for Medicaid and hamstring states’ ability to fund their portion of the federal-state partnership. Many of the law’s provisions target Medicaid expansion adults with work reporting requirements and required cost-sharing for many services. It also takes away eligibility for some lawfully present immigrants in Medicaid, Medicare, and the Marketplaces.
This resource from the Center for Children and Families at the Georgetown details each of the law’s provisions that pertain to Medicaid, Medicare or the Marketplace and which states are affected by each provision. Additionally, CCF researchers have included pertinent information about the implementation date, affected populations, and exemptions allowed. The document buckets the provisions into the following categories:
- Immigrant Provisions
- Medicaid Financing
- Eligibility, Enrollment, and Renewal-Related Provisions
- Marketplace Provisions
- Administrative Actions and Penalties
- Medicaid Longterm Services & Supports (LTSS) and Medicare
- CHIP Provisions Excluded in Moratorium on E&E Rule
Over the next few months (and years), CCF will continue to detail the different effects this law will have on individuals living across the country. For now, we hope that advocates and stakeholders will find this a helpful resource alongside thisexplainer to determine what will impact folks in their state, and when.
Author: Center for Children and Families at the Georgetown Center for Children and Families at the Georgetown