How Trump’s Megabill Would Change Medicaid

Here are the major provisions, why they matter, and when they go into effect.

U.S. Speaker of the House Mike Johnson (R-LA) speaks to the media at the U.S. Capitol in Washington on May 22, 2025. Kevin Dietsch/Getty Images

The One Big Beautiful Bill Act contains changes to Medicaid that Republicans say will reduce fraud, waste, and abuse, making the program more sustainable for the future.

Democrats, however, have objected to the potential loss of coverage by several million enrollees, as forecast by the Congressional Budget Office (CBO), and the potential financial impact on small rural hospitals.