Trump Signs 2025 Budget Reconciliation Bill, Enacting Sweeping Changes to Health Programs

President Donald Trump signed the fiscal year 2025 budget reconciliation bill (H.R. 1), called the “One Big Beautiful Bill Act,” on July 4, enacting major changes to federal tax policy and federal health programs.

The law makes significant changes to Medicaid, which covers more than 71 million low-income and disabled Americans. The legislation modifies eligibility rules and introduces new work, reporting and cost-sharing requirements for Medicaid enrollees. It also changes laws related to Medicaid financing. To help offset the impact of these policies, the bill establishes a $50 billion Rural Health Transformation Program to assist states in supporting rural health care providers.

The changes to the Medicaid program will impact hospitals and other health care providers throughout the country.