Just before the holiday weekend the U.S. House passed the One Big Beautiful Bill Act as it’s been named. To pay for President Donald Trump’s major priorities like tax cuts and border security, lawmakers are targeting health care spending.
The legislation is expected to reduce federal health care spending by $700 billion over the next decade. That’s according to the Congressional Budget Office estimate.
Most of those savings come from Medicaid, which is funded by both the federal government and states. Alice Burns studies Medicaid for KFF, a nonpartisan national research group.
“Most of the Medicaid reductions in spending come because fewer people are going to be enrolled in the program,” Burns says.
Burns says the bill would reduce Medicaid enrollment by imposing work requirements, increasing how often people need to file eligibility paperwork and delaying rules that could simplify that process.
Over the next decade, federal health spending in Montana would drop about $300 million per year. About 50,000 people could lose Medicaid because it’s harder to keep up with paperwork requirements. The bill also doesn’t renew enhanced subsidies for the federal insurance marketplace. That means the number of uninsured Montanans could grow by 40,000.
All of this is according to KFF estimates. Burns says these numbers are hard to predict with certainty.
“It’s really hard to know. Are states going to do things to mitigate the losses or are they going to do things that amplify the effects?” Burns says.
The bill now moves to the Senate where it’s expected to receive more scrutiny.
