On July 3, 2025, the House of Representatives passed H.R. 1 One Big Beautiful Bill (OBBB) along mostly party lines following the Senate’s amendments earlier this week. President Donald Trump signed the bill into law on July 4, 2025. Over the next decade, the bill will extend $2.9 trillion for tax breaks for the wealthy at the expense and detriment of children, families, and hard-working Americans. Billions of dollars will be funneled toward federal agencies for detaining immigrants, constructing walls along the southern border, and military weapons manufacturing. 

Rather than reducing barriers in accessing healthcare and ensuring food security for Americans, this bill will require Medicaid patients to pay up to $35 copays for medical services and institute additional work requirements to qualify for Supplemental Nutrition Assistance Program (SNAP) benefits while simultaneously cutting funding for the SNAP by over $300 billion over the next decade. Rural communities and communities of color will be deeply affected by these cuts, severely limiting access to affordable care.

How will some of these changes affect you as medical students and physicians?

Medicaid
Medicare
  • Limit Medicare’s ability to negotiate on certain drugs (orphan drugs), leading to increased costs for patients
  • Increasing barriers in coordinating coverage between Medicare and Medicaid for low-income beneficiaries through Medicare Savings Programs by delaying implementation to 2034
Affordable Care Act (ACA)
  • Limiting access to subsidized healthcare by:
    • Shortening the enrollment period from November 1 to December 15 (prior policies started November 1 to January 15 the following year)
    • Eliminates year-round Special Enrollment Periods for individuals under 150% of Federal Poverty Level (FPL), or $23,475 for a single-person household 
      • This means anyone making 150% and under the FPL can only enroll during qualified life events or during enrollment period 
    • Require verification of eligibility prior to enrollment and renewals starting in 2028
      • Previous rules allowed 90 days to confirm eligibility while receiving premium tax credits
      • Ends auto-renewals 
    • Health plans will not automatically enroll you into a plan with lower cost-sharing, even if you qualify
Student loans
Abortion

National APAMSA strongly condemns the signing of this cruel bill that primarily benefits the wealthy while leaving millions of Americans without healthcare or food on the table. As expressed in our previous Joint Statement with SNMA, LMSA, AMSA, SOMA, and MSDCI, we are deeply disappointed by these decisions that will harm patients and exacerbate the physician shortage. OBBB will have lasting repercussions on American health and well-being, further deepening inequities in healthcare and socioeconomic success. These provisions represent a stark disconnect between national leaders and public interests despite polls that indicate almost two-third of Americans view this bill unfavorably. We urge policymakers to rectify and reverse these changes and work with constituents to produce new legislation that will strengthen our nation and alleviate health disparities.

Take action:

  1. Register to Vote: Exercise your privilege to vote and shape the future by electing officials that reflect your priorities. 
    1. The Medicaid cuts are not projected to be enacted until after the 2026 Midterms, which makes 2026 a crucial moment for voters to show their elected officials that voting against their constituents’ best interest will have consequences.
  2. Become civic engagement advocates through Vot-ER’s Healthy Democracy Campaign
  3. Please contact your members of Congress to express your opposition towards these policies. You can use 5 Calls to quickly locate your representatives’ numbers and be prepared with prompts that can help you discuss this particular bill and other issues at ease. 

For questions about this statement, please reach out to our Rapid Response Director, Brian Leung at rapidresponse@apamsa.org.