Speakers<\/b><\/b><\/h2>\n
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- \n
- Larry Levitt<\/b>, Executive Vice President for Health Policy at KFF<\/li>\n
- Bill McKibben<\/b>, writer, environmentalist, and founder of Third Act, which organizes older adults to act on climate change<\/li>\n
- Natasha Sarin<\/b>, Professor, Yale Law School and Yale School of Management<\/li>\n
- Richard Prisinzano<\/b>, Director of Policy Analysis at The Budget Lab at Yale<\/li>\n<\/ul>\n
\n\u201cThis bill wasn\u2019t labeled healthcare reform,\u201d said Larry Levitt, \u201cbut that\u2019s exactly what it is. It amounts to a partial repeal of the ACA, cutting more federal support for coverage than any legislation we\u2019ve seen before.\u201d<\/p>\n
According to Congressional Budget Office estimates, the law will slash over $1 trillion from federal healthcare spending \u2014 primarily by reducing Medicaid funding and eliminating insurance subsidies. As a result, 11.8 million Americans could lose coverage within the first year, with that number rising to 16 million once ACA tax credits expire later this year.<\/p>\n
Red Tape, Lost Coverage<\/b><\/h3>\n
Among the most controversial changes is a new Medicaid work requirement for adults covered under ACA expansion. Though nearly 90% of those individuals are already working or exempt, administrative hurdles are projected to strip 4.8 million people of coverage simply due to compliance failures.<\/p>\n
Other provisions include:<\/p>\n
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- Requiring Medicaid recipients to re-enroll every six months instead of annually;<\/li>\n
- Authorizing co-pays up to $35 for low-income individuals above the poverty line;<\/li>\n
- Tightening restrictions on how states fund their share of Medicaid, likely leading to reduced provider payments.<\/li>\n<\/ul>\n
Rural hospitals are especially vulnerable. While the bill includes a one-time $50 billion rural health fund to soften the blow, experts warn that temporary funding won\u2019t match the permanent nature of Medicaid cuts.<\/p>\n
\u201cHospitals won\u2019t close overnight,\u201d Levitt said. \u201cBut as payments shrink, closures will accelerate \u2014 and in some communities, healthcare access could vanish entirely.\u201d<\/p>\n
Immigrant Communities Targeted<\/b><\/h3>\n
Major changes to ACA marketplace rules are also on the horizon. Tighter income verification requirements will make enrollment more difficult and eliminate automatic renewals. In a particularly controversial move, many legally present immigrants \u2014 including refugees, asylees, and individuals with Temporary Protected Status \u2014 will no longer be eligible for ACA coverage, Medicare, or Medicaid.<\/p>\n
\u201cThese are not undocumented immigrants. These are legal residents,\u201d Levitt emphasized. \u201cAnd they\u2019re being excluded from programs they\u2019ve long relied on.\u201d<\/p>\n
Real Human Cost<\/b><\/h3>\n
The stakes are life and death, according to Natasha Sarin, a health and economic policy expert.<\/p>\n
\u201cPrevious expansions saved an estimated 28,000 lives over ten years,\u201d she said. \u201cThis rollback could result in 100,000 to 200,000 additional preventable deaths over the next decade.\u201d<\/p>\n
The impacts will fall hardest on vulnerable groups \u2014 the elderly, chronically ill, and immigrant communities already on the fringes of the healthcare system.<\/p>\n
A Fiscal Time Bomb<\/b><\/h3>\n
Despite promises of deficit reduction, the bill\u2019s tax provisions tell a different story. If temporary tax cuts are extended \u2014 as they often are \u2014 the bill could add $4 trillion to the national debt, pushing the debt-to-GDP ratio from 100% to 135% by 2035.<\/p>\n
\u201cIt\u2019s a massive expansion of the deficit,\u201d Sarin warned. \u201cAnd as the government borrows more, everyday interest rates \u2014 for mortgages, student loans, business lending \u2014 will rise. That will slow economic growth for everyone.\u201d<\/p>\n
Wealth Gains at the Top<\/b><\/h3>\n
The bill delivers substantial tax breaks to the wealthiest Americans, extending Trump-era tax cuts and creating new deductions for tip and overtime income. Meanwhile, the lowest-income households face major losses due to cuts in Medicaid, SNAP, and other safety net programs.<\/p>\n
\u201cThe bottom 40% of earners are losing around $700 a year,\u201d Sarin said. \u201cThe top 1%? They\u2019re gaining $30,000. This is a reverse Robin Hood bill \u2014 it redistributes wealth upward.\u201d<\/p>\n
Even benefits touted by Republicans, like the expanded child tax credit and a tax break for seniors, fall short: the child tax credit increase excludes families too poor to qualify, and the senior tax cut is modest and temporary.<\/p>\n
Rural Fallout<\/b><\/h3>\n
Though most cuts phase in after the 2026 midterms, rural communities are already feeling the effects. In places like Bakersfield, California \u2014 where over 60% of residents depend on Medicaid \u2014 local hospitals are on edge.<\/p>\n
Levitt pointed to recent closures in Nebraska and warned more will follow. \u201cNot every closure will have a direct line to this bill. But many will.\u201d<\/p>\n
More Than a Budget<\/b><\/h3>\n
\u201cThis isn\u2019t just a fiscal policy,\u201d Sarin said. \u201cIt\u2019s a redefinition of who is protected in America \u2014 and who is left behind.\u201d<\/p>\n
FEMA\u2019s Faltering Response Raises Alarm<\/b><\/h3>\n
As the nation grapples with the health and economic fallout of the \u201cBig, Beautiful Bill,\u201d another crisis is testing federal capacity: disaster response. The Federal Emergency Management Agency (FEMA) is facing sharp criticism for its sluggish and uneven handling of the recent Texas floods \u2014 the worst in the state\u2019s history \u2014 which killed 132 people, including children at a summer camp, and left more than 400 families displaced.<\/p>\n
\u201cThe FEMA director hasn\u2019t even bothered to show up in Texas yet,\u201d said Bill McKibben. \u201cEvery state and local official is now in suspense about whether there will be FEMA funding when the next disaster strikes.\u201d<\/p>\n
As of July 15, over 100 people remained missing. And in the wake of mounting frustration, many states are questioning whether they can still rely on FEMA at all.<\/p>\n
Can States Handle Disaster Relief Alone?<\/b><\/h3>\n
The Trump administration has floated the idea that disaster response should fall to individual states \u2014 a notion McKibben dismissed as unrealistic.<\/p>\n
\u201cThere are disasters every year in the U.S., but not in every state. It makes no sense for each state to fund and maintain its own disaster response core,\u201d he said. \u201cThis is something we should be doing together as a country.\u201d<\/p>\n
McKibben warned that the emerging pattern suggests federal disaster aid may now be granted based on political favoritism. \u201cThat may sound strange and un-American, but it seems to be the path we\u2019re on.\u201d<\/p>\n
FEMA\u2019s Call Center Collapse<\/b><\/h3>\n
According to a New York Times<\/i> investigation, FEMA initially answered 99.7% of calls from flood survivors on July 5. But just hours later, the agency terminated contracts with four major call center contractors, resulting in the immediate firing of hundreds of workers.<\/p>\n
The next day, FEMA\u2019s response rate dropped to just 35.8%. By July 7, only 15.9% of over 16,000 calls were answered.<\/p>\n
While President Trump has previously threatened to eliminate FEMA entirely, Department of Homeland Security Secretary Kristi Noem said on July 13 that the administration now plans to \u201cremake\u201d the agency \u2014 dismissing the Times<\/i>report as \u201cfake news.\u201d<\/p>\n
Climate Change Accelerates Disasters<\/b><\/h3>\n
McKibben emphasized that disasters like the Texas floods are not isolated events but symptoms of a warming planet. \u201cWarm air holds more water vapor, which increases the frequency and severity of floods. What we\u2019re seeing in Texas is the new normal,\u201d he said.<\/p>\n
To prevent further damage, McKibben called for a rapid transition away from fossil fuels, the primary driver of climate change. Carbon emissions from oil and gas also release deadly particulate pollution, which contributes to 1 in 5 global deaths annually.<\/p>\n
Clean Energy on the Chopping Block<\/b><\/h3>\n
Despite global momentum toward renewable energy, McKibben warned that the U.S. is moving in the opposite direction. The \u201cBig, Beautiful Bill\u201d includes sweeping rollbacks of clean energy incentives, cutting short tax credits for solar, wind, and electric vehicles that were included in the Inflation Reduction Act.<\/p>\n
\u201cThese credits were supposed to last a decade. Now many will disappear by the end of the year, and some as early as September,\u201d said McKibben. The outcome, he said, will be job losses in the clean energy sector and halted investment in renewable projects.<\/p>\n
The effects will also hit consumers. \u201cSolar power is now the cheapest way to produce electricity \u2014 that\u2019s why even red states like Texas have embraced it,\u201d he noted. \u201cBut under this bill, families will end up paying hundreds more on their utility bills.\u201d<\/p>\n
\u2018Sun Day\u2019 and the Road Ahead<\/b><\/h3>\n
McKibben announced plans for a national day of action called \u201cSun Day,\u201d to be held on September 21, the fall equinox.<\/p>\n
\u201cIt will be a celebration and a protest \u2014 a way to emphasize that solar and wind aren\u2019t alternative energy anymore. They\u2019re common sense. They\u2019re cheap. And they\u2019re the best path forward for this country and the planet.\u201d<\/p>\n
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All images provided by ACoM.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"
Yep\u2026 it\u2019s a law now. The newly passed federal legislation, branded by Republicans as the \u201cBig, Beautiful Bill,\u201d promises broad tax cuts but delivers sweeping rollbacks to healthcare access \u2014 changes experts warn could leave millions uninsured and balloon the national deficit by trillions. While the bill is touted as a tax relief package, health…<\/p>\n
- Bill McKibben<\/b>, writer, environmentalist, and founder of Third Act, which organizes older adults to act on climate change<\/li>\n