Tip: Click Print Flyer → choose "Save as PDF" in your print dialog to download. Set margins to None for best results.
Oh Snap! Truths — ohsnaptruths.com
What the "One Big Beautiful Bill" Does to Your Health Coverage
$911B
Cut from Medicaid over 10 years
CBO, July 2025
7.5M
More Americans uninsured by 2034
CBO, Oct 2025
Jan 1, 2027
Work requirements take effect
Public Law 119-21
| Provision | 10-Year Cut |
|---|---|
| Work requirements (ACA adults) | $326 billion |
| Provider tax moratorium | $191 billion |
| Limits on state-directed payments | $149 billion |
| Eligibility checks every 6 months | $63 billion |
| TOTAL | $911 billion |
Source: CBO — Estimated Budgetary Effects of Public Law 119-21 (July 21, 2025)
Starting January 1, 2027, adults on ACA Medicaid expansion must prove they work, volunteer, or attend school for at least 80 hours per month — or lose coverage.
"Would not have any meaningful impact on the number of Medicaid enrollees working."— CBO analysis of Medicaid work requirements
In Arkansas (2018), work requirements caused 18,000 people to lose coverage in months — not because they stopped working, but because they couldn't complete the paperwork.
| State | Extra Uninsured by 2034 |
|---|---|
| California | 1,600,000 |
| New York | 860,000 |
| Florida | 590,000 |
| Texas | 480,000 |
| Illinois | 470,000 |
Source: KFF analysis of CBO estimates (July 23, 2025)
20 states + D.C. will see uninsured rates rise by 3+ percentage points. 76% of cuts ($694B) hit in 2030–2034.
Update your contact info
Call your state Medicaid office and make sure your address, phone, and email are current. The #1 reason people lose coverage during eligibility checks: the state can't reach them.
Start saving work records
If you work, collect pay stubs, employer letters, or any proof of 80+ hours/month. You'll need this starting January 2027.
Document any health conditions
If a disability limits your ability to work, talk to your doctor now about getting it documented. Exemptions exist — but you must claim them with paperwork.
Call 211 for free help
Dial 211 from any phone, 24/7. Free, confidential help navigating coverage options, food, utilities, and more.
Verified Sources — Check Them Yourself
CBO — Budgetary Effects of Public Law 119-21 (July 21, 2025)
cbo.gov/publication/61570
CBO — Medicaid Supplemental Estimate (October 28, 2025)
cbo.gov/system/files/2025-10/PL-119-21-Medicaid_0.pdf
KFF — Health Provisions in the 2025 Reconciliation Law
kff.org/medicaid/health-provisions-in-the-2025-federal-budget-reconciliation-law/
KFF — How Will the Law Affect Uninsured Rates by State?
kff.org/uninsured/how-will-the-2025-reconciliation-law-affect-the-uninsured-rate-in-each-state/
KFF — Allocating CBO's Medicaid Spending Reductions Across States
kff.org/medicaid/allocating-cbos-estimates-of-federal-medicaid-spending-reductions-across-the-states-enacted-reconciliation-package/
KFF — A Closer Look at Work Requirement Provisions
kff.org/medicaid/a-closer-look-at-the-work-requirement-provisions-in-the-2025-federal-budget-reconciliation-law/
ohsnaptruths.com — Real Facts. No Fluff. No Spin. | Full article: ohsnaptruths.com/article/medicaid-cuts