On May 22, 2025, the House of Representatives passed H.R. 1 One Big Beautiful Bill Act, which contained disconcerting provisions aimed at cutting Medicaid funding by almost $700 billion over the next decade. Medicaid has been a central fixture for 83 million Americans, providing essential healthcare and long-term care for children, seniors, people with disabilities, and low-income adults. The Affordable Care Act’s Medicaid expansion to adults who earn up to 138% of the federal poverty level ($21,597 for a single adult) has insured millions of Americans with health coverage. These potential changes will deprive over 10 million Americans from healthcare coverage through Medicaid and disproportionately affect communities of color.

Medicaid has been linked to increased access in rural and disadvantaged areas and improved health outcomes like decreasing all-cause mortality by almost 2% and lowering maternal mortality. In a recent report authored by the Asian & Pacific Islander American Health Forum, the National Association for the Advancement of Colored People, the Leadership Conference on Civil and Human Rights and other national health organizations, Medicaid is the primary source of healthcare for almost 30% of people of color. 

Medicaid has consistently enjoyed broad bipartisan support. A recent poll demonstrates that most Americans—Democrats, Republicans, and independents alike—favor maintaining and increasing spending on Medicaid access. Forty states across the political spectrum have opted into Medicaid expansion, recognizing the program’s role in improving health outcomes, supporting rural hospitals, and reducing uncompensated care. Despite the overwhelming evidence that Medicaid is extremely popular across the political spectrum and saves lives, House Republicans have moved to sacrifice public health in favor of funding tax cuts that primarily benefit the wealthy. The harmful provisions in H.R. 1 stand in contrast to the values shared by voters of all political backgrounds who believe Americans should not be denied care due to their income.

The bill will attempt to cut costs by

1. Reducing the incentives and federal subsidies given to states for expanding Medicaid, specifically punishing any state that provides any health benefits or assistance to undocumented immigrants with lower expansion matches,
2. Establish cost-sharing and copays of $35 for services provided to anyone above the federal poverty level ($15,650 for a single adult),
3. Instituting stringent work requirements and eligibility verifications that burdens Medicaid recipients and state governments with more paperwork,
4. Prohibiting Medicaid payment to nonprofits and providers that focus on reproductive health, family planning, and abortion services like Planned Parenthood,
5. Removing gender affirming care as an Essential Health Benefit under the Affordable Care Act and prohibiting coverage for any Medicaid/CHIP recipient,
6. Suspending rules that streamline application and enrollment into Medicaid and for patients who qualify for the Medicare Savings Program (covers Medicare premiums and cost-sharing for low-income Medicare beneficiaries).

We strongly condemn any legislation aimed at limiting equitable access to Medicaid or attacking access to abortion services and gender affirming care. Among the many destructive changes also embedded in H.R. 1, the elimination of federal student loans and loan forgiveness programs will severely limit access for students from all backgrounds to pursue careers in medicine. This bill proposes a lifetime cap of $150,000 for federal graduate student borrowing, specifically for those enrolled in professional programs. This will potentially force students to rely on private loans with less favorable terms and fewer protections, undoubtedly compounding the physician shortages in the very communities that rely on us. 

At the heart of these proposed cuts lies an uncomfortable truth – healthcare is not a human right if equal access is not afforded to everyone regardless of socioeconomic class and immigration status. These actions go against the principles set by other nations, the World Health Organization, and the EU among others, highlighting the precarious path that the U.S. government is currently steering the country down. If passed in the Senate as is, the “One Big Beautiful Bill” will greatly harm patients across the United States and hamper the ability for physicians and other healthcare providers to serve their communities. 

Call to Action:

To Senators – We call on all senators to reject this bill to protect the American public’s interest and maintain our great nation’s founding principles of “Life, Liberty and the pursuit of happiness” 

To Medical Students – we urge all medical students to contact their Senators in Congress and demand a No vote on the “One Big Beautiful Bill.”

Signed,

Asian Pacific American Medical Student Association (APAMSA)

Student National Medical Association (SNMA)

Latino Medical Student Association (LMSA)

American Medical Student Association (AMSA)

Student Osteopathic Medical Association (SOMA) 

Medical Students with Disabilities and Chronic Illness (MSDCI)

Additional Resources:

Contact your Congressional Representatives: https://www.congress.gov/contact-us 

More information about federal student loans changes: Official Statement and infographic

Call or email your Representative today with a call script from our partner organization, Vot-ER: https://go.vot-er.org/0mAQQu