WASHINGTON — President Trump's One Big Beautiful Bill Act, signed July 4, imposes stricter eligibility requirements and slows the growth of federal Medicaid funding, sparking warnings that millions could lose coverage. By 2027, able-bodied adults must log 80 hours of work, training or volunteering each month to remain enrolled, and states face new administrative burdens to verify compliance.
Critics point to a nonpartisan CBO estimate that 10 million more Americans will be uninsured by 2034. Rural providers—from five hospitals in western Pennsylvania named in a June Dem senators' letter to South Dakota clinics—warn that reduced reimbursements and patient losses could force cutbacks or closures. Consumer advocates also highlight new copays of up to $35 for some doctor visits and the rollback of medical-debt protections as additional financial risks.
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