State of the Pod

703: The $10 Billion Question: How OBBBA Is Reshaping Healthcare


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$10 billion is cut from Medicaid each year, leaving around 10 million people uninsured. These outcomes correlate with the passing of the One Big Beautiful Bill Act, or OBBBA. What are the policy changes enacted by OBBBA, and how are these policy changes affecting millions of people insured on the publicly-funded Medicaid? What will happen if the reforms are put into practice too late? This episode will dive into the details of these policy changes, emphasizing potential pros and cons of OBBBA on the U.S. healthcare system – as well as how they affect both Medicaid beneficiaries and private insurees alike. Listeners will walk away with a newfound understanding of the interconnectedness of the U.S. healthcare system – how even the smallest policy alterations can have a widespread, indirect impact on everyone. 

Written by Shane Douglas, Rma Polce, Ayrina Lopez & Skye Romo.

Produced and Edited by Ayrina Lopez, Shane Douglas & Rma Polce. 

Special thanks to the Investigative Biology Lab @ Cornell University for our recording equipment 

Music from Karl Casey @ White Bat Audio 

References:

Baldwin CPAs. “Understanding the impact of the One Big Beautiful Bill Act on healthcare taxation and business planning,” Baldwin CPAs, September 9, 2025, https://www.baldwincpas.com/insights/how-the-one-big-beautiful-bill-act-impacts-healthcare-taxes.

CDC. “Preventing chronic diseases and promoting health in rural communities,” Centers for Disease Control, December 19, 2024, https://www.cdc.gov/health-equity-chronic-disease/health-equity-rural-communities/index.html

FOX 5 Washington DC. “How does the Big Beautiful Bill affect Medicare,” FOX 5 Washington DC, July 6, 2025, https://www.youtube.com/watch?v=8Vtk7G5Ov0g.

Gorman L. “Variations in public and private insurers’ hospital reimbursements,” National Bureau of Economic Research, September 1, 2025, https://www.nber.org/digest/sep20/variation-public-and-private-insurers-hospital-reimbursements?page=1&perPage=50.

Haley MJ, et al. “Medicaid work requirements could threaten parents’ and children’s coverage and well-being,” Georgetown University McCourt School of Public Policy, May 19, 2025, https://ccf.georgetown.edu/2025/05/19/medicaid-work-requirements-could-threaten-parents-and-childrens-coverage-and-well-being/.

Morrisey AM. Health Insurance, Second Edition. Health Administration Press; 2013. https://account.ache.org/iweb/upload/Morrisey2253_Chapter_1-3b5f4e08.pdf.

NAMD Staff. “OBBBA Medicaid Policy Timeline,” National Association of Medicaid Directors, August 12, 2025, https://medicaiddirectors.org/resource/obbba-medicaid-policy-timeline/.

Pillai D, et al. “1.4 million lawfully present immigrants are expected to lose health expected to lose health coverage due to the 2025 tax and budget law,” KFF, September 25, 2025, https://www.kff.org/immigrant-health/1-4-million-lawfully-present-immigrants-are-expected-to-lose-health-coverage-due-to-the-2025-tax-and-budget-law/.

The Board of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. “2025 Medicare Trustees Report,” 2025 Medicare Trustees Report, June 18, 2025, https://www.cms.gov/oact/tr/2025.

The Committee for Responsible Federal Budget. “OBBBA would accelerate social security & Medicare insolvency,” The Committee for Responsible Federal Budget, June 27, 2025, https://www.crfb.org/blogs/obbba-would-accelerate-social-security-medicare-insolvency#:~:text=According%20to%20the%20Social%20Security%20and%20Medicare,benefits%20by%20roughly%20$30%20billion%20per%20year.

Tolbert J & Chidambaram P. “Cost sharing requirements could have implications for Medicaid expansion enrollees with higher health care needs,” KFF, June 27, 2025, https://www.kff.org/medicaid/cost-sharing-requirements-could-have-implications-for-medicaid-expansion-enrollees-with-higher-health-care-needs/#:~:text=The%20bill%20would%2C%20for%20the,enrollee%20is%20unable%20to%20pay.

McGough, M., Wager , E., Winger, A., Panchal, N., & Cotter, L. (2024, December 20). How has U.S. spending on healthcare changed over time? Peterson-KFF Health System Tracker. https://www.healthsystemtracker.org/chart-collection/u-s-spending-healthcare-changed-time/

Brook, R. H., Keeler, E. B., Lohr, K. N., Newhouse, J. P., Ware, J. E., Rogers, W. H., Davies, A. R., Sherbourne, C. D., Goldberg, G. A., Camp, P., Kamberg, C., Leibowitz, A., Keesey, J., & Reboussin, D. (2006). The health insurance experiment: A classic rand study speaks to the current health care reform debate. https://www.rand.org/pubs/research_briefs/RB9174.html

Fact sheet: Hospital mergers and acquisitions can expand and preserve access to care | aha. (2025, October 21). https://www.aha.org/fact-sheets/2023-03-16-fact-sheet-hospital-mergers-and-acquisitions-can-expand-and-preserve-access-care

Nocera, S., & Zweifel, P. (1998). The demand for health: An empirical test of the grossman model using panel data. In P. Zweifel (Ed.), Health, the Medical Profession, and Regulation (pp. 35–49). Springer US. https://doi.org/10.1007/978-1-4615-5681-7_2

Goodman-Bacon, Andrew. 2021. “The Long-Run Effects of Childhood Insurance Coverage: Medicaid Implementation, Adult Health, and Labor Market Outcomes.” American Economic Review 111 (8): 2550–93. DOI: 10.1257/aer.20171671

Sommers, Benjamin D., et al. “Medicaid Work Requirements In Arkansas: Two-Year Impacts On Coverage, Employment, And Affordability Of Care.” Health Affairs, vol. 39, no. 9, Sep. 2020, pp. 1522–30, https://doi.org/10.1377/hlthaff.2020.00538.

“How Medicaid Built Community Health Centers And Health Centers Returned The Favor”, Health Affairs Forefront, July 31, 2025 . DOI: 10.1377/forefront.20250729.523547

The post 703: The $10 Billion Question: How OBBBA Is Reshaping Healthcare  first appeared on State of the Pod.

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