Commonwealth Fund December 19, 2025
TOPLINES
H.R. 1’s Medicaid provider tax changes are projected to reduce federal investments by nearly $226 billion over 10 years and cause 2.4 million people to lose coverage, with 1.1 million likely unable to find another source of affordable insurance
While limits on Medicaid provider taxes will save billions in federal dollars, the funding drop will strain state budgets and lead to decreased coverage for people with disabilities, diminished benefits, and reduced long-term services and supports
Congress authorized more than $900 billion in Medicaid cuts, the largest in the program’s 60-year history, when it passed its budget reconciliation bill in July 2025. The tax and spending law, known as H.R. 1 or the One Big Beautiful Bill Act, significantly limits...
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