Trump Budget Law Cuts Medicaid, Risks 16 Million Uninsured by 2034

President Donald Trump's 2025 healthcare and tax legislation, including the "One Big Beautiful Bill Act" (OBBBA), significantly restructures federal healthcare funding by cutting over $1 trillion from Medicaid and ending enhanced premium tax credits for ACA marketplace coverage. These changes introduce stringent work requirements and eligibility verifications that are expected to reduce Medicaid enrollment by over 10 million and increase the uninsured population by 16 million by 2034. The new policies impose additional administrative burdens on ACA enrollees, particularly impacting states that have not expanded Medicaid, such as Georgia, Florida, and Texas, where the reduction in coverage and support services like navigators will be particularly severe. Hospitals, especially in rural and underserved areas, face rising uncompensated care costs and potential closures, despite targeted investments aimed at rural hospital stabilization. Meanwhile, states like Colorado and Oregon are enacting laws to improve healthcare workforce mobility and limit corporate control over medical practices, aiming to enhance access and maintain local decision-making in healthcare delivery. These reforms collectively threaten to reverse many gains in healthcare coverage and accessibility achieved over the past decade under the Affordable Care Act.