Senate passage of Big Beautiful Bill prompts another round health care warnings

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There will be severe consequences for health care in the One Big Beautiful Bill Act that codifies President Donald J. Trump’s financial plan for the nation, health organizations said.

On July 1, Vice President J.D. Vance broke a tie in the Senate to vote 51-50 for the One Big Beautiful Bill Act, according to news reports. By early afternoon, health organizations were repeating their warnings about extreme consequences looming across the health care system largely due to cuts to Medicaid.

Contact your lawmaker

News reports have stated lawmakers have a goal to get the bill to the president’s desk by Independence Day. The House of Representatives could vote on the legislation as early as today, according to Vot-ER, which emailed a letter asking supporters to in turn email their congressperson. Vot-ER, an advocacy group that supports physicians and other clinicians in helping patients get registered to vote, estimated up to 17 million people will lose health coverage. As of 2 p.m., the House Rules Committee had begun deliberations before the legislation goes to the full House for a vote.

Bad for physicians, bad for health care

Susan Dentzer, president and chief executive officer of America’s Physician Groups, published a statement with seven key reasons the bill will have “serious negative consequences” for millions of Americans, physician groups, hospitals, “and the entire stressed U.S. health care system.”

“America’s Physician Groups greatly regrets passage of the Senate reconciliation bill adopted today and is concerned that it will be accepted without major modifications by the House of Representatives and ultimately signed into law by President Trump,” Dentzer said.

“APG is shocked that so many of the nation’s lawmakers would voluntarily inflict so much damage on the citizenry and the health sector,” she said. “The roughly one in four U.S. patients whom our physicians serve deserved a far better deal.”

Hospital outlook is grim

For weeks, advocates for rural hospitals have been warning about serious financial constraints that would get worse if Medicaid is cut. The Senate version of the bill has a $50 billion fund to assist rural hospitals, but Dentzer said that “will not be sufficient over time to ameliorate the damage and will do nothing to help the large number of more urban-based health care providers caring for the vast majority of Medicaid enrollees who stand to lose coverage.”

American Hospital Association (AHA) President and CEO Rick Pollack said that organization’s members are “deeply disappointed” in the Senate vote.

“The real-life consequences of these nearly $1 trillion in Medicaid cuts — the largest ever proposed by Congress — will result in irreparable harm to our health care system, reducing access to care for all Americans and severely undermining the ability of hospitals and health systems to care for our most vulnerable patients,” Pollack said in a statement.

“This legislation will cause 11.8 million Americans to be displaced from their health care coverage as they move from insured to uninsured status,” Pollack said. “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.”

AHA urged lawmakers in the House of Representatives to mitigate the legislation and protect access to health care for patients and communities.

Health insurer perspectives

AHIP, the trade group for America’s health insurance plans, put its estimate at 11.8 million for the people who will lose coverage over the next 10 years. AHIP noted the looming cuts to Medicaid, and with APG cited the loss of subsidies that help some patients pay for insurance through the Affordable Care Act Marketplaces.

“The combined impact of the policies in the bill will destabilize state Medicaid programs and undermine countless local health care systems,” the AHIP statement said. “Due to new red tape and barriers to enrollment and re-enrollment, people losing eligibility for Medicaid will find an individual market with less choice and higher premiums. The potential expiration of the current health care tax credits later this year would compound the disruption.

“Taken together, these policies could result in the biggest rollback in health care coverage in the country’s history,” according to AHIP. “That would mean millions of American families lose affordable access to primary care and pharmacies. The emergency room — the costliest and least coordinated site of care — would become the front door of the health care system for millions of people. The bulk of these costs would simply shift to uncompensated care payments and to those who are insured.”

Making the country sicker?

Ironically, the Senate approval happened the same week communities across the country are preparing to celebrate the best of America, said Robert Wood Johnson Foundation President and CEO Richard E. Besser, MD.

“As communities prepare this week to celebrate American rights of life, liberty, and the pursuit of happiness, the Senate has decided to reverse generations of progress on all three,” Besser said in a statement. “America is at its best when all families and communities have what they need to be healthy and thrive. By contrast, the Senate’s bill takes those things away, stripping people’s ability to live with dignity, security, and the assurance of having their basic needs met.”

Besser noted the cuts to public programs approach $1 trillion, including Medicaid and the Supplemental Nutrition Assistance Program. What won’t be cut: punitive governmental red tape, he said.

“By its very design, the bill will make our country sicker, put children at risk of going hungry, and make it harder for families to afford basic necessities — all to further enrich wealthy individuals and corporations,” Besser said. “Seniors will struggle to afford long-term care. People with disabilities will lose critical health care 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.”

Women’s health

The One Big Beautiful Bill Act will defund Planned Parenthood, which removes provider choice for patients, said American College of Obstetricians and Gynecologists (ACOG) President Steven J. Fleischman, MD, MBA, FACOG. He called the Senate vote “a devastating blow to the health and dignity of all Americans.”

“There is no shortage of damage done to health care access by this bill,” Fleischman said. “This legislation jeopardizes the lives of millions and makes it harder for people to access essential care and for physicians to provide that care. As a physician, I urge the House to reject this harmful legislation.”