The healthcare spending debate continues as the controversial bill proposing significant Medicaid cuts has moved one step closer to becoming law. On May 22, the House of Representatives narrowly passed the “One Big Beautiful Bill Act” in a 217-215 vote. We know that the bill, a key legislative priority of President Donald Trump, includes deep cuts to Medicaid along with other federal budget adjustments to reduce spending.
What the House Just Did:
The House version of the bill includes:
- Over $1.5 trillion in cuts to Medicaid over 10 years.
- Decreasing funding for block grants, which will shift costs and potentially create financial burdens on individual states.
- Work requirements for certain Medicaid recipients.
- Cuts to other safety-net programs like SNAP (food stamps), TANF (Temporary Assistance for Needy Families), and WIC (Special Supplemental Nutrition Program for Women, Infants and Children).
This legislation would dramatically alter the structure of Medicaid, the largest public health insurance program in the U.S., which currently covers more than 70 million Americans. Transitional Resources relies heavily on Medicaid funding to support our clients and programs. When people do not get the care they need, they end up on the streets for longer and seek crisis care at places like emergency rooms and hospitals, who are under-equipped and unable to provide appropriate care. The long-term stability of people living with serious mental illness affects not only TR and our clients, but our entire community as folks from all over lose access to the care they need to be healthy and stable community members.
If enacted into law, the bill could:
- Strip coverage from millions of Americans who gained Medicaid through state expansions. This means folks will no longer receive the benefits they need to remain stable and will likely return to the streets and overwhelm our limited healthcare system resources, such has emergency rooms and hospitals.
- Threaten rural hospitals and healthcare providers that rely heavily on Medicaid payments. TR serves all of King County, and we have people who started in rural areas where care was inadequate or entirely unavailable. This blow could devastate an already underserved and underdiagnosed group, meaning their conditions will likely worsen as they lack access to the care they need.
- Create a patchwork of access, where care availability and quality could vary widely between states, counties, or even cities. Inadequate and inconsistent access to care weakens the entire infrastructure of healthcare, leading to higher barriers for vulnerable populations to access care, higher industry costs, and increased burnout among providers and staff.
- Increase financial pressure on states, forcing many to reduce eligibility or services.This could limit the services of TR and other providers, leading to increased homelessness and greater instances of serious mental health symptoms, as people will not have access to the care they need to remain stable.
- It will not save on costs. In fact, things will get more expensive as people will delay care until it is an emergency. What could have been a simple health care visit covered by Medicaid is now an emergency room visit with all the added labs, imaging, and other expensive work ups. We end up paying more in the long run.
It’s not only TR who will be affected; organizations across Seattle and King County–including many in our very own West Seattle community–will feel direct effects of these cuts as demands for various services increase from places like food banks, clothing donations, childcare assistance, and many more as people begin to lose coverage.
What Happens Next in the Senate:
After narrowly passing the House of Representatives, the bill now heads to the Senate, where it faces a tougher path. Several Republican senators have voiced serious concerns over the bill at large, especially over the Medicaid provisions.
The Senate will begin reviewing the bill in committee over the next few days. If passed in its current form, the bill could result in millions losing coverage, particularly affecting low-income families, seniors, and people with disabilities. The Congressional Budget Office is expected to release its analysis in early-June, which will give insight to what issues will be important as the debate takes shape.
With only a slim majority, (53 – 47) Senate Republicans can’t afford too many defections. This means we should be prepared for intense negotiations, possible amendments, or even possibly a full rewrite of the bill if things get really heated.
What You Can Do:
This bill has massive implications for healthcare access. TR and other providers are mobilizing to protect these funds, and you can help! Now is a critical time to:
- Contact your senator — especially if they’re on the fence. If your Senator has pledged to vote no and protect Medicaid, thank them for their support and ask them to help rally their colleagues and do what they can to ensure Medicaid stays protected.
- Share your story if Medicaid has impacted your life. You can read more about sharing your story in this guide from The Association of University Centers on Disabilities. Send your story to your Senator–even if they have pledged to save Medicaid! Every story your Senator shares helps make an impact by reminding folks that real people are affected by this.
- Stay informed as this bill heads to committee review in the coming weeks.
We’ll continue tracking developments as the bill progresses through the Senate.