The American Hospital Association has called passage of the One Big Beautiful Bill Act "an extremely disappointing and very difficult day for healthcare in America."
President Donald Trump on Friday signed into law the One Big Beautiful Bill Act, meeting a self-imposed deadline of July 4.
Congress has cut nearly a trillion dollars from Medicaid over a decade and has made enrollment in that program and in Affordable Care Act plans harder, according to AHA President and CEO Rick Pollack. The number of uninsured individuals is expected to increase by 11.8 million, he said.
"No matter how often repeated, the magnitude of these reductions – and the number of individuals who will lose health coverage – cannot be simply dismissed as waste, fraud, and abuse," Pollack said by statement.
ACA policyholders must now update their information annually and will no longer be able to automatically re-enroll during a shortened time period for open enrollment.
WHY THIS MATTERS
What this means for hospitals is more care at the ER level and more uncompensated care.
"It also will drive up uncompensated care for hospitals and health systems, which will affect their ability to serve all patients. It will force hospitals to make service line reductions and staff reductions, resulting in longer waiting times in emergency departments and for other essential services, and could ultimately lead to facility closures, especially in rural and underserved areas," Pollack said after the Senate passed the bill and before it moved back to the House.
Hospitals are getting a reduction in provider taxes, which are levied by states and then returned to hospitals, along with more federal dollars, to pay for Medicaid. The legislation includes a 3.5% cap for state provider taxes, but that's lower than a House proposed 6%.
TELEHEALTH
One winner in the legislation is telehealth.
"The final reconciliation package now approved by both the U.S. Senate and House reinstates and makes permanent first-dollar coverage for High-Deductible Health Plan-Health Savings Accounts (HDHP-HSAs)," according to ATA Action.
The legislation will give workers permanent access to coverage of telehealth services without jeopardizing their HSA eligibility, said Kyle Zebley, executive director of ATA Action and senior vice president, public policy at the ATA.
"Telehealth stands out as a bright spot in the final reconciliation package – a policy unicorn – achieving unwavering support from both sides of the aisle, in both chambers," Zebley said.
Email the writer: SMorse@himss.org