As reported in KFF Health News, the reconciliation bill recently signed into law by President Trump reduces federal health spending by about $1 trillion. That might be good news for the government (although the tax cuts passed will reduce revenue by significantly more than the spending cuts in the bill), but it’s bad news for Americans who have been helped by this government spending.

“The bill, passed in both the House and the Senate without a single Democratic vote, is expected to reverse many of the health coverage gains of the Biden and Obama administrations. Their policies made it easier for millions of people to access health care and reduced the U.S. uninsured rate to record lows, though Republicans say the trade-off was far higher costs borne by taxpayers and increased fraud.” — KFF Health News, July 3, 2025

Most of the cuts impact Medicaid, including work requirements for beneficiaries and provider taxes that increase reimbursements to hospitals and other institutions to make up for low Medicaid reimbursements. This will have a particularly acute effect on rural hospitals with high Medicaid populations.

Many of the provisions in this bill roll back provisions in the Patient Protection and Affordable Care Act (also known as Obamacare) that expanded Medicaid eligibility and reduced the number of uninsured Americans.