On Monday, the U.S. Senate passed its own version of the One Big Beautiful Bill Act, President Donald Trump’s signature legislation. The bill contains heavy cuts to the Medicaid program and other changes to U.S. healthcare infrastructure and government payment systems, but the bill must be reconciled in the House before it can go to the president.
The Senate bill offers a $4.5 trillion tax cut in exchange for major cuts to Medicaid. STAT reports that Senator Susan Collins (R-Maine) withheld her vote out of concern for the healthcare changes that constitute $1.1 trillion in health care spending reductions that help float the tax cuts, although the Congressional Budget Office (CBO) estimates that the bill will increase the federal deficit by $3.3 trillion over a decade.
Collins was joined in her no vote by Senators Thom Tillis (N.C.) and Rand Paul (Ky.), and Vice President J.D. Vance was required to cast a tie-breaking vote. Despite heavy cuts to funding for hospitals, the Republicans were able to win the support of Senator Lisa Murkowski (R-Alaska) by including a $50 billion relief fund for rural healthcare providers, Modern Healthcare reports.
No one seems especially thrilled with the bill. In a statement to the Hill, President and CEO of the Robert Wood Johnson Foundation and former acting director of the Centers for Disease Control and Prevention Richard Besser warned of the potential fallout from the sweeping legislation.
Seniors will struggle to afford long-term care. People with disabilities will lose critical healthcare coverage that allows them to work and live independently. Rural communities across America will be decimated from hospital closures, and people will lose their lives. It is unfathomable to see policymakers intentionally inflict so much damage on the people they represent.
The American Hospital Association’s President and CEO Rick Pollack also offered a word of warning:
This legislation will cause 11.8 million Americans to be displaced from their health care coverage as they move from insured to uninsured status. It also will drive up uncompensated care for hospitals and health systems, which will affect their ability to serve all patients. It will force hospitals to make service line reductions and staff reductions, resulting in longer waiting times in emergency departments and for other essential services, and could ultimately lead to facility closures, especially in rural and underserved areas.
The Arizona Chamber of Commerce appealed to the Republican Party’s ostensible interest in economic stability and the security of the business community:
The potential fallout is significant. According to the Chamber Foundation’s research, a $1 billion reduction in Medicaid spending would cost Arizona over 36,000 jobs, cut $1.7 billion in labor income, reduce economic output by $3.7 billion, and slash $138 million from state and local tax collections.
The impacts would be felt statewide, particularly in rural communities where Medicaid enrollees make up a large portion of the population. In counties like Apache, Graham, and Santa Cruz, more than 40% of residents are enrolled in AHCCCS.
The business community is also sounding the alarm about rising costs for employers. A reduction in Medicaid coverage would increase the number of uninsured residents, leading to more uncompensated care and cost-shifting to private insurance plans. For small businesses, that could mean higher premiums or difficult decisions about whether to continue offering coverage.
KFF is tracking the differences between the House and Senate passed bills as the House deliberates on the final product to be sent to the president’s desk.
To add your voice to the process, click below to easily contact Arizona’s Congressional Delegation
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