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Newsletter

Medicare - July 2025

IN THIS ISSUE...



This month’s newsletter summarizes the current status of healthcare legislation included in the “One Big Beautiful Bill.” 


Not only will any passed legislation significantly reduce Medicaid and food-stamp funding, but Affordable Care Act plans will be significantly impacted due to the failure to extend the enhanced tax subsidies that were introduced during the Biden Administation, shortening of the open enrollment period, and provisions intended to reduce fraud and abuse in ACA plans.


Primarily as a result of some of the Medicaid proposals and poor financial performance of insurance companies, the Fitch credit ratings agency has lowered its outlook from “neutral” to “deteriorating.” All of these factors, in addition to the reductions hospitals, physicians, and prescription drugs will incur, would have a negative impact on healthcare plans, costs, and plan designs in all sectors: Medicare, Medicaid, individual and family plans, and group insurance coverage.

 

We hope to learn more during July about what changes will occur and impact 2026 and future plans, and our hope and intent is to summarize the changes in the August newsletter.


  • CBO AFFIRMS TAX BILL CUTS HEALTHCARE $1T, RAISES DEFICIT $2.8T


  • WHERE THE ONE BIG BEAUTIFUL BILL’S CUTS WILL HIT, STATE BY STATE


  • ONE BIG BEAUTIFUL BILL HAS 35% APPROVAL RATING: KFF POLL


  • FITCH: HEALTH SECTOR IS “DETERIORATING”

CBO AFFIRMS TAX BILL CUTS HEALTHCARE $1T, RAISES DEFICIT $2.8T

According to an article written by Michael McAuliff and published in Modern Healthcare on June 17, according to the Congressional Budget Office and the Joint Committee on Taxation the House version of the “One Big Beautiful Bill” over the next ten years will cause a $1 trillion loss to the healthcare sector and increase the federal budget deficit by $2.8 trillion over ten years. 

 

Although there are many differences among individual Senators, the Senate is attempting to reduce the cost of healthcare and other programs further to help lower the projected budget deficit.

 

According to McAuliff, Senate Republicans are eying even deeper Medicaid cuts and stricter limits on the provider taxes states use to finance the program under legislation introduced June 16. The House-passed version of the One Big Beautiful Bill Act of 2025 would establish a moratorium on new provider taxes. The Senate Finance Committee portion of the upper chamber’s bill would go further by ordering the District of Columbia and the 40 states that expanded Medicaid under the Affordable Care Act of 2010 to reduce their provider taxes.

 

And on June 11 the Senate Health, Education, Labor, and Pensions Committee introduced legislation that would end what is called “silver loading.” If this change is contained in the final legislation the effect will be to increase the cost of Affordable Care Act Silver cost sharing reduction plans, and it's estimated that up to 300,000 participants won't be able to afford Affordable Care Act plans due to this change. (This is in addition to the much larger number of participants who will leave Affordable Care Act plans because of the failure to extend enchanced tax subsidies which were introduced during the Biden administration and which sunset December 31, 2025.)


The President has established a timetable of July 4 for passage of the “One Big Beautiful Bill.” This is a very aggressive timetable that we think is not likely to be met. This newsletter is being written on June 25, and the Senate still needs to pass its version of the legislation, the House-Senate Conference Committee needs to iron out differences between the House and Senate versions or the Bill, both chambers of Congress need to pass the final Bill, Republican majorities in both Houses of Congress are razor thin, and the President needs to sign the legislation.


WHERE THE ONE BIG BEAUTIFUL BILL’S CUTS WILL HIT, STATE BY STATE

(MH Illustration/Adobe Stock)

This article by Tim Broderick that appeared in the June 19 issue of Modern Healthcare projects that healthcare spending would be cut by almost $800 billion over the next 10 years, with hospitals bearing the brunt of the reductions if the House-passed version of the One Big Beautiful Bill Act of 2025 becomes law. Over the next decade, the Bill would decrease spending by $321 billion in hospitals, $81 billion among physicians and $191 billion for prescription drugs. Spending for other healthcare services would decline by $205 billion. All sectors—Medicare, Medicaid, individual and family plans, and group Insurance—would be affected by these changes.


The article also includes a state-by-state-analysis of how individual states will be impacted. The most highly impacted states would be CA ($100B), TX ($ 67.5B), NY ($61.6B), and FL ($55.8 B).  


ONE BIG BEAUTIFUL BILL HAS 35% APPROVAL RATING: KFF POLL

Nearly two-thirds of the public view President Donald Trump’s “One Big Beautiful Bill” unfavorably, according to a Kaiser Family Foundation KFF Health Tracking poll released June 17. The following analysis was prepared by Hayley DeSilva for Modern Healthcare.

 

Here are three key takeaways from the survey:

 

Many bill supporters changed their mind once cuts were explained

 

Of those who viewed the House bill favorably, 72% were MAGA Republicans, while 66% of Republicans and Republican-leaning independents opposed the bill.

 

MAGA support dropped by more than 20 percentage points after survey respondents were told about cuts to local hospital funding and that an estimated 10 million people would be without health insurance.

 

ACA support hits a new high

 

Support for the Affordable Care Act has been growing since 2017, during Trump’s first term, when Congressional Republicans attempted to repeal the law.

 

The survey found that 66% of people view the healthcare law favorably, the highest level of support received in a KFF poll since the law was enacted in 2010.

 

The level of support changes depending on political leanings — 63% of Republicans oppose it while 94% of Democrats and 71% of independents support it.

 

The Medicaid program was viewed favorably by 83% of those surveyed, compared with 77% in January.

 

Most support Medicaid work requirements, until care access comes into play

 

Two-thirds of participants said they supported work requirements for Medicaid, including 88% of Republicans, 93% of MAGA Republicans and 51% of Democrats.

 

When participants were told that most adults with Medicaid are working or unable to work and could lose coverage due to challenges with filing the necessary paperwork to prove they are employed, half of survey respondents changed their views and 64% opposed work requirements.

 

Overall support for work requirements increased to 79% when opponents were told that money saved could be used to fund Medicaid benefits for the elderly, people with disabilities and children in low-income households.


FITCH: HEALTH SECTOR IS “DETERIORATING”

Medicaid funding cuts outlined in the “One Big Beautiful Bill Act” could lead to financial challenges for the insurance sector, according to a June 17 report from Fitch Ratings.

 

The credit rating agency lowered its outlook from “neutral” to “deteriorating” after the Senate released its proposed changes to the legislation on June 16, which called for more healthcare funding cuts than the House-passed version.

 

Diminished interest in Congress to extend enhanced Affordable Care Act premium tax credits — which were expected to offset Medicaid enrollment losses — also contributed to Fitch’s lowered outlook. If not extended, the enhanced premium tax credits will expire at the end of 2025.

 

Ending the tax credits will lead to “adverse consequences to premium revenue” for health insurers over the next year, the report said.


About Paul Cholak


Paul is a licensed, independent health and life insurance agent and has over forty years of benefits experience and specializes in helping Medicare beneficiaries obtain health insurance. However, he offers a complete array of life and health insurance products to individuals of all ages.


He guides Medicare beneficiaries through the steps of getting insurance and is available to help clients both BEFORE and AFTER they've made their purchase decision.


Disclaimer for Part C and D plans: "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY: 1-877-2048) to get information on all your options."

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Enrollment in a Medicare Advantage, Medicare Advantage Prescription Drug, or stand-alone Part D Drug plan can now occur ONLY if a Medicare beneficiary is eligible for another election period [e.g., the Individual/Individual Coverage Election Period (ICP or ICEP)] when first becoming eligible for Medicare; a Special Election Period (for those who experience qualifying life events like an involuntary termination of their existing plan, moving outside of the plan’s service area, losing or becoming entitled to Medicare or Extra Help, declaration of a weather related emergency, etc.), or the Open Enrollment Period. Except for individuals desiring to enroll in a Chronic Special Needs Plan, there are no health questions to qualify.

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