Those who presently control our government would have you believe that “The Big Beautiful Bill” (TBBB) just passed is in our best interest as a nation. Is it? My Op-ed today will focus on the healthcare aspects of this bill and the ripple effect throughout our state and country.
As Larry Levitt, Executive Vice President for health policy at KFF explained, “it is the biggest rollback in federal support for health coverage ever.” The bill dramatically cuts benefits of Medicaid and the Affordable Care Act (ACA) to counteract huge tax cuts for the rich. Understand that the final bill passed by the Senate and then rubber-stamped by the House causes even greater cuts to funding of Medicaid than the original House version.
The version passed by the Senate will cut more than $ 1 trillion from Medicaid and ACA benefits over 10 years while cutting at least $295 billion from the Supplemental Nutrition Assistance Program (SNAP) over 10 years (2025-2034). A recent study released by The Commonwealth Fund (regarding the bill originally passed by the House) utilized Congressional Budget Office (CBO) projections and the IMPLAN modeling program to estimate outcomes for each state in the United States. As a result of the passage of this bill, the study predicts a loss in 2029’s gross domestic product (GDP) of $154 billion, 1.22 million jobs lost, and drops in state and local tax revenues of $12 billion. Seventeen million Americans will have lost their health insurance by 2034. Those losing their health insurance will include people who could only afford their health insurance on the Affordable Care Act Marketplace with the assistance of subsidies provided during President Biden’s term in office. These tax credit subsidies will expire at the end of this year.
In addition, 4.7 million Americans will lose their SNAP benefits completely, while most others who qualify for benefits will see their nutrition allotments reduced.
The CBO warns that because of The Big Beautiful Bill’s projected $3.3 trillion increase in the federal deficit (CBO estimate) over the next decade, sequestration may be triggered, which would legally require that $500 billion be cut from Medicare. The Commonwealth Fund’s authors point out that the lowest 10% of household incomes will lose on average $1600 of services per year, while the top 10% of household incomes will gain $12,000 per year due to the bill’s projected cuts in both services and taxes. This is Robinhood in reverse, stealing from the poor to further enrich the wealthy!
A recent study published in the Annals of Internal Medicine projected that the implementation of this bill (House version) will cause 16,642 more preventable deaths a year. This result is due to the uninsured who delay care or do not seek care because they cannot afford it. The study estimates that 2 million people will lose their primary doctor, 1.3 million will not be able to fill their medically necessary prescriptions, and 380,270 women will skip their mammograms. Some of those who lose their insurance and therefore their healthcare will develop chronic diseases which will haunt them the rest of their lives.
A major feature of the Medicaid cut in TBBB is the work requirement. The House-passed version stipulates that each recipient, age 19 to 64 years old must document 80 hours per month of work or service unless they are a caregiver or are disabled. The Senate Finance Committee’s version is more rigorous. To be considered a caretaker, you must have a child less than 14 years of age in the household. These details must be verified every 6 months, down from every 12 months. This will cause loss of insurance for those who are seasonal workers, those between jobs, and those who are unable or do not comply with the additional required documentation, not because of “waste, fraud, and abuse.”
The effects of “The Big Beautiful Bill” will be catastrophic for states, their businesses, and their people. Pennsylvania Health Access Network (PHAN) recently published a position paper entitled, “47 Pennsylvania Hospitals Rely on Medicaid to Stay Open”. The cutbacks in funding will deepen over time. In 2029, SNAP will receive 38% less funding and Medicaid will receive 11% less throughout Pennsylvania.
When adding the cuts to both Medicaid and SNAP, The Commonwealth Fund estimates that in 2029 alone, Pennsylvania will lose $5.346 billion in federal funding of Medicaid and SNAP, a total loss of $6.346 billion in our state’s GDP, 50,900 less state jobs, and $477 million less in state tax revenue. These are just the financial losses for 2029. Can you imagine the human suffering that will accompany this? And for what? Tax cuts that will overwhelmingly go to the richest 1% of Americans.
As Robin Stelly of PHAN recently stated, “The bill will take away healthcare from 600,000+ Pennsylvanians, including people fighting serious illnesses like cancer and diabetes, hardworking families, seniors in nursing homes, children, veterans, and people with disabilities. It will also put 1 in 4 PA hospitals at risk and throw our state budget into crisis, all to pay for tax cuts for wealthy Americans and corporations.”
Dwight Michael, M.D., a retired primary care physician, is a member of the Gettysburg DFA Health Care Task Force. He lives in Gettysburg.