"One Big Beautiful Bill" Projected to Uninsure Nearly 12 Million Americans

A recent tweet from The New Yorker has amplified a pediatrician's grave concerns that the "One Big Beautiful budget bill," recently signed into law, will lead to a national increase in sick children suffering from healthcare cuts, mirroring challenges already observed by Texas pediatricians. The comprehensive legislation, championed by the Trump administration, aims to solidify tax cuts and bolster national security, but relies on substantial reductions to social safety net programs.

The "One Big Beautiful Bill," a sprawling legislative package nearing 900 pages, was signed into law on July 3, 2025. It makes permanent tax cuts from the Trump administration's first term and allocates billions to border security and defense. To offset these expenditures, the bill implements deep cuts to programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP).

A primary component of the bill involves significant changes to Medicaid, including new work requirements for able-bodied adults and a shift of financial burden to states. The nonpartisan Congressional Budget Office (CBO) estimates that these changes could result in 11.8 million more Americans becoming uninsured by 2034.

Pediatricians warn that these Medicaid cuts will severely strain healthcare providers, particularly pediatric practices and rural hospitals, which often rely heavily on Medicaid reimbursements. "I fear that what Texas pediatricians are encountering now will grow more common nationally, as Trump’s cuts are enacted over the next decade," stated the pediatrician quoted in The New Yorker's tweet, highlighting concerns about reduced services and exacerbated shortages in child-specific care.

Beyond healthcare, the bill enacts the largest cuts in SNAP's history, expanding work requirements and mandating states to shoulder a portion of the benefit costs. This shift could push thousands of Texans into poverty and increase food insecurity for vulnerable families, as states may be forced to reduce benefits or implement stricter eligibility rules.

Experts contend that the bill's changes extend far beyond merely targeting "waste, fraud, and abuse" in these programs, as claimed by the administration. Analysts from organizations like KFF and the Urban Institute project that states like Texas could face billions in new costs or be compelled to drastically cut essential services. While the bill includes some provisions like increased child tax credits and "Trump Accounts" for newborns, advocates argue these do not offset the profound impact of the social safety net reductions on low-income families and children.