The new federal budget law, the One Big Beautiful Bill Act (the Act), enacted on July 4, 2025, makes dramatic changes to the Medicaid program. Health care providers, plans, patients, and other stakeholders that work with Medicaid populations should prepare for these changes.

President Donald Trump’s “big, beautiful bill” includes major wins for business interests that carried out aggressive lobbying campaigns on Capitol Hill.

Rather than being transparent about sweeping changes they were proposing, lawmakers buried them in a massive legislative package that was rushed to a vote before anyone — including many of the senators and representatives voting on the bill — could fully grasp what was inside.