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Several provisions of President Trump’s “One Big Beautiful Bill” (OBBB) have been worrying lawmakers on both sides of the aisle (particularly the proposed cuts to Medicaid spending), but there’s so much in OBBB beyond Medicaid. OBBB is still in flux; we expect the Senate to release their version of the proposed bill very soon—potentially this weekend. While legislators were given a July 4th deadline to bring the bill to the President, it’s uncertain whether that deadline will be met. According to the Congressional Budget Office, the House-passed OBBB bill would add roughly $3 trillion through 2034 to the federal deficit. As a result, many fiscal conservatives are seeking deeper cuts. For a more detailed summary of OBBB, click here.  Here’s what else health care leaders need to know about the House-passed OBBB:  

• “Trump Savings Accounts” (also called a “Baby Bonus”) would encourage Americans to have children by offering $1,000, with the intention of increasing it to $5,000 from the federal government. Although the policy idea is sound, experts warn the proposal in OBBB needs guardrails. Additionally, the potential Baby Bonus is offset by so many other cuts to programs important to lower-income families that its effect could be negated.     

• Some of the cuts proposed include up to 30% reductions to the State Nutrition Assistance Program (SNAP) budget. If adopted, families and their children could lose access to the program. It would also require states to pay as much as 25% of the cost of nutrition assistance for the first time in 50 years. 

• OBBB includes language terminating the Grad PLUS loan program, increasing the requirements for PELL Grants, and changing the maximum lending limits for graduate students. Professional programs would cap at $100,000; medical schools would cap at $150,00—a fraction of the cost of this education. The bill would also prohibit any new Grad PLUS loans from being issued during the 2026-2027 academic year. Many graduate students at Adventist universities rely on these loans for funding. 

Last Friday, President Trump also issued an Executive Order requiring HHS to make Medicaid rates equal to Medicare rates for all states. The House-passed OBBB calls for caps on state-directed payment rates for Medicaid non-expansion states at 110% of Medicare rates.  It’s unclear whether Congress will adjust the OBBB’s language to align with the President’s goal. Government Advocacy leaders across AHPA systems are currently mobilizing to ensure adequate payment as this policy is being developed.    

AHPA extends our gratitude to Jenna Wilson, guest co-author of this article.  Jenna is a graduate student in the School of Global Health Management and Informatics program at the University of Central Florida.