Medicaid & the One Big Beautiful Bill Act
H.R.1 Medicaid Impact, state by state
Estimated 10-year effects of the Senate-passed budget reconciliation bill — the version tracking the law enacted July 4, 2025 — on Medicaid coverage and funding across the country (federal fiscal years 2025–2034).
8.7M
fewer people enrolled in Medicaid — about 1 in 10 current enrollees
$1.25T
total cut to Medicaid funding, counting both federal and state dollars
$665B
stripped from hospitals’ Medicaid funding — 18% of the national total
Shade map by
Not modeled
Source. Manatt Health, “Senate-Passed H.R. 1: Updated Estimates on Impact to State Medicaid
Coverage and Expenditures, Hospital Expenditures,” July 1, 2025 — prepared with State Health
and Value Strategies, a program of the Robert Wood Johnson Foundation. Figures come from Manatt’s
Medicaid Financing model and cover FFY 2025–2034.
Notes. Coverage-loss figures are identical under the House and Senate bills; expenditure figures
shown reflect the Senate-passed bill, which tracks the enacted law. Tennessee is excluded by
Manatt due to data limitations and is shown as “not modeled.” These estimates predate later
CMS implementation guidance (including the January 2026 provider-tax rule and February 2026 state
directed payment guidance) and are an acknowledged underestimate — not every provision of
H.R.1 was modeled. Estimates are projections, not counts.