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  • New Resource on State-by-State Impacts of Budget Reconciliation Law

    On July 4, 2025, President Trump signed the Congressionally-passed budget reconciliation law, known as “One Big Beautiful Bill,” into law. As we have talked about extensively, this law 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…

  • Medicaid Managed Care: The Big Five in Q2 2025

    Q2 2025, which ended on June 30, is not just another quarter.  That’s because on July 4 the Budget Reconciliation Law (P.L. 119-21) was signed into law.  That law makes major cuts to Medicaid, reducing federal payments to states by $990 billion over the next ten years and leaving 7.5 million Americans uninsured in 2034.…

  • New CBO Health Coverage Estimates of Budget Reconciliation Law

    On August 11, 2025, the Congressional Budget Office (CBO) issued more detailed estimates of the impact of the budget reconciliation law (H.R. 1 or P.L. 119-21) on health coverage. Consistent with final cost estimates issued in July, CBO finds that the reconciliation law will increase the number of uninsured people by 10 million in 2034, relative…

  • What to Expect From States When They’re Expecting Big Changes Due to HR 1

    The passage of the recently enacted tax and budget law (HR1) will have major implications for state budgets, but the impact will be disproportionate. For example, Medicaid, expansion states (plus Wisconsin and Georgia) will be required to implement work requirements, increasing administrative costs while putting up barriers to enrollment and retention. Other states will be…

  • New Federal Budget Law Spells Trouble for Patients with Insulin-Requiring Diabetes

    By: Billy Dering, Amy Killelea, and Christine Monahan (Georgetown University Center on Health Insurance Reforms) The recently enacted federal budget law is set to significantly roll back critical provisions of the Affordable Care Act (ACA) that have expanded health insurance coverage to millions. The law takes aim at health care programs that primarily serve low- and moderate-…