Kathrine Frich
You might not even know if you or your family will be affected.
You might not even know if you or your family will be affected.
Insurance Programs Affected by the OBBBA
The “One Big Beautiful Bill Act” (OBBBA), signed into law in July 2025, enacts significant changes to various U.S. health insurance programs, including Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), and Affordable Care Act (ACA) marketplace plans.
These changes are projected to result in approximately 11 to 17 million Americans losing health coverage.
Medicaid
Medicaid provides health coverage to low-income individuals, including children, pregnant women, elderly adults, and people with disabilities.
Changes:
- Introduction of work requirements: Adults aged 19–64 must work at least 80 hours per month, with certain exemptions.
- Increased eligibility verifications: States must conduct eligibility checks every six months.
- Reduction in federal funding: Over $1 trillion cut over the next decade.
- Restrictions on funding for certain services, including gender-affirming care and services provided by organizations like Planned Parenthood.
Medicare
Medicare is a Ffederal health insurance program for people aged 65 and older, and some younger individuals with disabilities.
Changes:
- Automatic spending cuts amounting to approximately $500 billion over eight years.
- Exclusion of undocumented immigrants from eligibility.
- Introduction of a $35 monthly insulin cap and expanded vaccine coverage under Medicare Part D.
Children’s Health Insurance Program (CHIP)
Chip Provides low-cost health coverage to children in families that earn too much to qualify for Medicaid but cannot afford private coverage.
Changes:
- Restrictions on federal funding for certain services, including gender-affirming care.
- Potential impact due to broader Medicaid funding cuts and policy changes.
Affordable Care Act (ACA) Marketplace Plans
ACA Provides health insurance options for individuals and families through federal and state exchanges.
Changes:
- Elimination of enhanced premium tax credits, leading to increased premiums.
- Shortened enrollment periods and elimination of automatic re-enrollment.
- Estimated 4.2 million individuals losing coverage due to these changes.
State-Specific Program Names
While Medicaid and CHIP are federal programs, they are administered by individual states and often have unique names. Here are some examples:
- California: Medi-Cal
- New York: Medicaid
- Texas: Texas Medicaid
- Florida: Florida Medicaid
- Illinois: Illinois Medicaid
- Pennsylvania: Medical Assistance
- Ohio: Ohio Medicaid
- Georgia: Georgia Medicaid
- North Carolina: NC Medicaid
- Michigan: Medicaid Health Plans
These state-specific programs are all subject to the changes enacted by the OBBBA
