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25 Ways the New One Big Beautiful Bill Act Impacts Everyday Americans
- Tahitia Timmons MSN, RN,CDP®,CDE® CPDC,PCC
- Jul 1
- 6 min read
Updated: Jul 1
Introduction
The Social Determinants of Health (SDOH) shape nearly every aspect of life and health in America.
According to the CDC, SDOH include the conditions where people are born, grow, live, work, and age—like jobs, education, housing, healthcare, and safe environments. Policies that change access to healthcare, food, housing, or education impact much more than a family’s budget—they affect life expectancy, well-being, and community stability.
The new One Big Beautiful Bill Act (OBBBA) is poised to bring major changes to all of these areas and impact everyday Americans.
Supporters say the bill helps the middle class and those in poverty, but a close look at the evidence shows the most direct effects—positive and negative—will be felt by individuals and families making less than $125,000 to $150,000 a year (about 400% of the federal poverty level for a family of four). For those earning less than $75,000, the risk of losing critical supports like Medicaid, SNAP, or affordable insurance is even higher.
While households with higher incomes may experience indirect impacts (like higher hospital or local taxes, or community clinic closures), the bill’s most significant consequences—lost coverage, increased food and housing insecurity, and limited access to preventive care—are concentrated among those with low to moderate incomes.
Understanding how OBBBA interacts with the SDOH is crucial for everyone.Not just policy junkies (like me), but for parents, educators, employers, and communities across the country. The following lays out 25 ways OBBA impacts average Americans, what’s changing, who’s affected, and what we can all do to navigate the road ahead.
25 Ways the One Big Beautiful Bill Act Could Impact Everyday Americans
1. Healthcare Access Shrinks:
OBBA could result in over 10 million people losing Medicaid by 2034, directly impacting access to affordable healthcare.
2. Work Requirements May Exclude Many:
Medicaid’s new 80-hour monthly work rule risks cutting off coverage for people with disabilities, caregivers, and those in unstable jobs.
3. More Uninsured Families:
The bill could increase the number of uninsured Americans by 16 million, including many children.
4. Mental Health Support Gaps Widen:
Cuts to Medicaid and ACA plans could force rural and BIPOC communities to travel farther—or wait longer—for mental health care.
5. Gender-Affirming Care Blocked:
OBBA prohibits federal funds for gender-affirming care, affecting thousands who rely on Medicaid and CHIP.
6. SNAP Food Aid Reductions:
Stricter SNAP eligibility rules may cut food support for over 2 million people, increasing food insecurity in low-income communities.
7. Rising Medical Debt:
As more lose coverage, families face higher out-of-pocket costs and are at greater risk for medical debt.
8. Impact on Working Parents:
New work rules don’t account for unpaid caregivers (like parents or adult children), risking coverage loss for millions.
9. Reduced Support for People with Disabilities:
Work requirements and eligibility changes will likely reduce access for people with disabilities, despite the ADA’s protections.
10. Potential Job Losses in Healthcare:
Cuts to federal funding may force clinics and hospitals—especially in rural areas—to reduce staff or close.
11. Threats to School-Based Health Services:
Schools in low-income districts often use Medicaid to fund nurses and counselors. Budget cuts may mean fewer support staff for students.
12. Affordable Housing Becomes Harder:
Families facing higher health costs or lost benefits may struggle to keep up with rent or mortgage payments, risking housing instability.
13. Greater Hunger Among Children:
Cuts to SNAP and Medicaid hit children hardest, as hunger and illness often go hand-in-hand.
14. Less Support for Mental Health Parity:
Mental health coverage is often first to go with insurance losses, worsening crises for those with anxiety, depression, or substance use disorders.
15. Strain on Community Clinics:
As insurance rates drop, more people turn to safety-net clinics, straining already limited resources.
16. Fewer Job Training Programs:
Eligibility changes in SNAP and Medicaid may eliminate employment and training programs that help people move out of poverty.
17. Increased Costs for Prescription Drugs:
Without insurance, Americans pay full price for medications, leading many to skip doses or abandon treatment.
18. Racial Disparities May Widen:
Black, Latino, and Native American communities are overrepresented in Medicaid and SNAP. OBBA’s cuts could deepen inequities.
19. Safe Environments Threatened:
Reduced access to preventive care and food support can increase homelessness, food insecurity, and unsafe living conditions.
20. Telehealth Expansion Uncertain:
OBBA doesn’t guarantee funding for telehealth, which has become vital for rural and disabled Americans.
21. Housing Stability on the Line:
Losing health or food benefits can force families into choosing between rent and groceries—a key driver of homelessness.
22. Young Adults Most At Risk:
Young people aging out of parents’ plans or public aid will face new gaps in coverage and support.
23. Fewer Preventive Screenings:
Loss of insurance coverage means fewer cancer screenings, vaccines, and preventive services, especially for marginalized groups.
24. Community Health Will Suffer:
OBBA’s broad cuts mean less community investment in parks, healthy food, clean air, and safe spaces—critical to well-being.
25. Economic Ripple Effects Will Be Felt Locally
As families lose benefits and clinics face cuts, local economies may suffer—from higher uncompensated hospital care to lost jobs and less consumer spending. Research shows every $1 cut from SNAP or Medicaid can result in up to $1.70 lost in local economic activity.
Navigating Change—What You Can Do:
Stay informed about what’s changing and how it might impact you or your community. If you work in HR, care management, or support roles, be ready to help others understand the bill and connect them to resources. Everyone can advocate for smarter, more compassionate policy—one conversation at a time.
Learn about SDOH and OBBA from trusted sources (CDC, Kaiser Family Foundation, local public health).
Share this information with your network—awareness is a powerful first step.
Support those around you—especially if you’re in a position to answer questions or guide people through these changes.
Advocate for policies that protect and expand SDOH—not just for yourself, but for your whole community.
References and Sources for Each Fact
Medicaid Coverage Losses
Kaiser Family Foundation (KFF). How Will the 2025 Budget Reconciliation Affect the ACA, Medicaid, and the Uninsured Rate?
Work Requirements May Exclude Many
Center on Budget and Policy Priorities (CBPP). Medicaid Work Requirements Will Reduce Coverage Without Increasing Employment
More Uninsured Families
Kaiser Family Foundation. How Will the 2025 Budget Reconciliation Affect the ACA, Medicaid, and the Uninsured Rate?
Mental Health Support Gaps Widen
Substance Abuse and Mental Health Services Administration (SAMHSA). 2023 National Survey on Drug Use and Health
National Rural Health Association. Mental Health in Rural America
Gender-Affirming Care Blocked
Politifact. Fact-check on gender-affirming care and Medicaid
KFF. Medicaid’s Role in Covering Transgender People
SNAP Food Aid Reductions
Center on Budget and Policy Priorities. SNAP Works for America's Children
Rising Medical Debt
American Journal of Public Health. Medical Bankruptcy in the United States, 2019
Kaiser Family Foundation. Medical Debt in the U.S.
Impact on Working Parents
Kaiser Family Foundation. Medicaid Work Requirements Including Parents Would Lead to Large Coverage Losses
Reduced Support for People with Disabilities
National Disability Rights Network. Medicaid Work Requirements Threaten Health and Independence
Potential Job Losses in Healthcare
Health Affairs. Potential Effects of Medicaid Cuts on Rural Hospitals
National Association of Community Health Centers (NACHC). America’s Health Centers
Threats to School-Based Health Services
Healthy Schools Campaign. The Role of Medicaid in School-Based Health
Affordable Housing Becomes Harder
Urban Institute. The Link Between Housing and Health
Greater Hunger Among Children
Feeding America. Child Hunger Facts
Less Support for Mental Health Parity
Mental Health America. Mental Health Parity
Strain on Community Clinics
National Association of Community Health Centers. America’s Health Centers
Fewer Job Training Programs
Center for Law and Social Policy (CLASP). Job Training and Public Assistance
Increased Costs for Prescription Drugs
Commonwealth Fund. When Out-of-Pocket Drug Costs Lead to Nonadherence
Racial Disparities May Widen
Kaiser Family Foundation. Key Facts on Health and Health Care by Race and Ethnicity
Safe Environments Threatened
Telehealth Expansion Uncertain
National Conference of State Legislatures. Telehealth Policy Trends and Considerations
Housing Stability on the Line
National Low Income Housing Coalition. NLIHC Research
Young Adults Most At Risk
Georgetown University Center for Children and Families. Medicaid Unwinding Data
Fewer Preventive Screenings
Centers for Disease Control and Prevention (CDC). Prevention
Community Health Will Suffer
Robert Wood Johnson Foundation. Social Determinants of Health: The Solid Facts
Local Economic Ripple Effects
USDA Economic Research Service. The Supplemental Nutrition Assistance Program (SNAP) and the Economy
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