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The provisions of the federal 2025 budget reconciliation bill, the One Big Beautiful Bill Act (OBBBA), signed on July 4, 2025, are projected to cut federal Medicaid spending by $911 billion between 2025 and 2034. About 76% of the Medicaid funding cuts in the OBBBA are scheduled to go live between 2030 and 2034. 

The bulk of the Medicaid cuts, $851 billion, are linked to the following five OBBBA provisions:

$326 billion in projected federal spending cuts due to new federal work requirements for the Medicaid expansion population. Beneficiaries who fail to meet the hours requirement or who fail to . . .

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