Trump’s One Big Beautiful Bill Act Cuts $1 Trillion From Medicaid, Expected to Deepen Access and Affordability Strains

Trump Medicaid cuts One Big Beautiful Bill Act (OBBBA), signed in July, brings extensive changes to Medicaid, altering eligibility, funding, and access to care across the United States. The law reduces federal Medicaid spending by more than $1 trillion over the next decade. According to the nonpartisan Congressional Budget Office (CBO), the measure will lead to 10 million people losing coverage due to the Trump Medicaid cuts within that time. Medicaid currently serves more than 71 million Americans with low incomes or disabilities. The CBO also projects that hospital uncompensated care costs could rise by $63 billion over the same period.

The impact of the Trump Medicaid cuts is already evident in many healthcare systems.

These reductions come amid widespread concerns about healthcare affordability. To help address the expected challenges, health-technology company Cedar has introduced a digital platform called Cedar Cover to support patients in identifying, securing, and maintaining health coverage. The solution integrates directly with hospital billing systems and assists with Medicaid enrollment, renewal, denials resolution, and medication assistance in one interface.

According to Cedar executives, Cedar Cover helps hospitals connect patients to unclaimed medication co-pay assistance and adapt to rapid policy changes. Nearly a dozen health systems, including Novant Health, Baystate Health, ApolloMD, and The Iowa Clinic, have implemented the platform.

Seth Cohen, president of Cedar, said, “The OBBBA is only going to further increase self-pay and make it even harder to get people enrolled in insurance, so you need a technology solution to help.” He added that Cedar’s data, drawn from 30,000 patients across 55 health systems, showed an 8% increase in unpaid balances from uninsured patients in 2024. These balances now represent about 30% to 35% of all hospital debt.

Cohen noted that uninsured or underinsured patients facing large medical bills require access to financial support rather than improved billing functions. He said Cedar’s approach evolved toward linking patients with existing aid programs that are often overlooked.

The OBBBA also includes new work requirements for Medicaid recipients and verification rules for applicants. Supporters described these as reforms intended to reduce taxpayer spending, while hospitals are preparing for increased financial strain as more patients transition to self-pay. Cohen said this shift could raise operating losses by as much as 60% for some facilities and substantially increase charity care demand. Florian Otto, CEO and co-founder of Cedar, added that each missed enrollment or aid opportunity could lead to patients delaying care and hospitals facing unrecoverable costs.

As the Trump Medicaid cuts take effect, many healthcare providers are bracing for the consequences.

Early adopters of Cedar Cover have reported quantifiable outcomes. A large Western health system saw a 30% increase in insurance reimbursement from overturned denials, generating $8 million in annual value recovery. Another reported a 97% Medicaid application approval rate, while Novant Health recorded average medication assistance grants exceeding $12,000 per approved application during a six-month pilot.

Cedar developed the platform in collaboration with Fortuna Health and TailorMed. Fortuna Health provides a digital tool for Medicaid enrollment and renewal, integrated within Cedar’s system to identify and guide eligible patients. CEO Nikita Singareddy described Fortuna as the “Turbo Tax of healthcare.” TailorMed, which partners with 900 hospitals, 3,000 clinics, and 1,500 pharmacies, specializes in connecting patients with financial assistance for costly medications. CEO Srulik Dvorsky said the collaboration enables a streamlined financial experience that helps patients manage expenses while supporting hospitals in reducing bad debt.

Healthcare experts are concerned about the long-term effects of the Trump Medicaid cuts on vulnerable populations.

Trump Medicaid Cuts Transform Medicaid Landscape

The One Big Beautiful Bill Act (OBBBA), signed in July, brings sweeping changes to Medicaid, altering eligibility, funding, and access to care across the United States. The law introduces Trump Medicaid cuts totaling more than $1 trillion over the next decade.

According to the nonpartisan Congressional Budget Office (CBO), the measure will result in 10 million Americans losing Medicaid coverage, as federal funding decreases. Currently, Medicaid serves more than 71 million low-income or disabled individuals. The CBO also predicts hospital uncompensated care costs could rise by $63 billion during the same period.