The One Big Beautiful Bill Act (OBBBA) introduces major Medicaid and Marketplace program changes that could reduce coverage for millions and impose operational and financial challenges on states.

House Republicans propose Medicaid funding caps that could reduce federal support, impacting state budgets and Medicaid coverage for millions, particularly in expansion states like California.

Proposed Medicaid budget cuts totaling $880 billion over a decade could reduce coverage for 11 million Americans and strain state health budgets, impacting rural hospitals and long-term care services.