Congress has passed it. The President has signed it. Our work has become even more critical.
The federal budget reconciliation legislation finalized this summer delivers much of the damage we feared: deep cuts and new restrictions on Medicaid and coverage under the ACA. These changes threaten access to life-saving care and disproportionately harm people with low incomes, people of color, immigrants, people with disabilities, and LGBTQ+ communities.
Among the most harmful changes imposed by the so-called “One Big Beautiful Bill” Act are new work requirements, more frequent and burdensome redeterminations, increased cost-sharing, bans on trusted family planning providers, cuts to federal funding to states in the form of reduced provider taxes, the exclusion of immigrants from coverage, and rollbacks to essential services like gender-affirming care and sexual and reproductive health.
Access all of our analysis of the bill and its impacts at www.healthlaw.org/medicaid-defense.
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Our Response: Rapid + Coordinated
Even while we were actively fighting to stop this legislation, NHeLP was quietly preparing for the possibility that it could become law. We are now putting that preparation into action with a broad, coordinated, and multi-pronged strategy. This effort stretches across federal and state levels and includes legal, policy, and advocacy interventions to protect access to care and limit harm.
At the federal level, we are prepared to respond to new policies and regulations from CMS and push for guardrails, oversight, and protections. We are using our deep understanding of federal law to inform implementation strategies that work for people, not against them. At the state level, our approach is grounded in our knowledge of and experience in that state. We consider whether a state expanded Medicaid, supports work requirements, operates its own marketplace, or is navigating other unique policy dynamics.
We are working directly with state advocates and partners on the ground, coordinating legal strategies, monitoring implementation, and preparing for litigation where necessary.
How Our Resources Can Help Advocates
Navigating these changes will be difficult. You do not have to do it alone. NHeLP’s team of legal and policy experts will continue to develop a wide array of materials to help advocates, policymakers, health care providers, and community leaders respond effectively.
These resources explain what the new law means, how it is being implemented, and what you can do to protect the people most at risk. Whether you are drafting comments on a proposed rule, educating communities about their rights, advocating for policy fixes at the state level, or coordinating a media response, our tools are designed to support you.
We will also provide guidance on state-specific challenges, tailored technical assistance, and in-depth analysis to help you navigate uncertainty and make informed decisions. If you are working to keep people covered and connected to care, NHeLP is here to back you up every step of the way.
Health Access – Resources
Blogs and Analysis
Upcoming Webinars and Events
What We Know and What Happens Next: OBBBA and its Impact on Health Care Coverage is a new webinar series from the National Health Law Program. It helps advocates prepare for the harmful provisions in the so-called “One Big Beautiful Bill” Act by offering legal and policy analysis on key topics, including work requirements, due process, automation, and barriers to care like cost-sharing and attacks on sexual and reproductive health. The opening session covers overarching themes and ways to engage. Each webinar offers tools and strategies to support advocates in protecting coverage and advancing health equity.
Registration links will be added to the calendar below as they become available. A tentative list of topics and dates is provided here:
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OBBBA Overview and Implementation Timeline – Watch recording
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How to Prepare for Work Requirements – Watch recording
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How Automated Eligibility Systems Can Harm or Help Applicants and Enrollees – Watch recording
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The Role of Due Process – Watch recording
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Access to Care: Cost Sharing, Premiums, and Retroactive Eligibility – Watch recording
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The Impact on People with Disabilities – Watch recording
