On July 4, 2025, Congress and President Trump signed into law the H.R.1 One Big Beautiful Bill Act (OBBBA). The law is a broad budget reconciliation package that touches multiple sectors including tax policy, energy, defense, immigration, and healthcare. While wide-ranging, the bill introduces the largest federal healthcare funding reduction in history.
Coverage Loss
The Committee for a Responsible Federal Budget estimates the bill’s healthcare provisions could result in approximately 10 million fewer insured individuals over the next 10 years (CRFB, www.crfb.org).
Medicaid-Dependent Populations
According to the Medicaid and CHIP Payment and Access Commission, 39 percent of Medicaid enrollees are children (MACPAC, www.macpac.gov). The Children’s Hospital Association reports that more than half of patient revenue at many children’s hospitals comes from Medicaid (Children’s Hospitals, www.childrenshospitals.org).
Rural and Safety-Net Providers
The Kaiser Family Foundation notes that rural areas have higher Medicaid enrollment rates and fewer alternative coverage options, making these regions especially sensitive to changes in public coverage programs (KFF, www.kff.org).
The Commonwealth Fund, using Congressional Budget Office modeling, estimates that changes to Medicaid and ACA subsidies in the Big Beautiful Bill could increase uncompensated care costs by up to $200 billion over the next decade (Commonwealth Fund, www.commonwealthfund.org).
Success in this changing environment will depend on more than just policy awareness. It will require healthcare organizations to take proactive, strategic action to adapt their operations for long-term sustainability. At symplr, we believe the path forward lies in strengthening the operational backbone of healthcare. That means focusing on four interconnected imperatives where operational improvements can have the greatest impact:
They align with the core purpose of the symplr Operations Platform: to help healthcare leaders reduce vendor sprawl, consolidate fragmented systems, and streamline operations across workforce, provider, quality, and spend management workflows. With a more connected and efficient infrastructure, organizations can better respond to disruption, protect access to care, and stay focused on delivering their mission.
Drive cost savings opportunities across operations by consolidating fragmented systems and reducing vendor sprawl with a scalable, secure platform that supports enterprise-wide visibility and efficiency gains.
Health systems must improve revenue by onboarding providers more quickly, driving revenue per bed, and maximizing incentive payments with quality improvements. Support high quality care while reducing costs by improving efficiency with automation across workflows that impact providers.
Every dollar counts and should go towards your mission. Gain greater control over operations with tools to manage vendors, contracts, spend, and facilities in a unified, compliant environment.
Optimize workforce strategy and strengthen recruitment, retention, development, and engagement by aligning staff planning with patient care needs. Enable precise, predictive scheduling and timekeeping to reduce premium labor spend and align staffing with real-time patient demand—critical in an environment where every hour and every dollar counts.
Improve provider network operations, ensure directory accuracy, and meet compliance requirements to deliver better member experiences.
Create exponential value with our first-of-its-kind symplr Operations Platform
The OBBBA is a budget reconciliation law signed on July 4, 2025, introducing wide-ranging policy and funding changes in healthcare.
Providers may see changes in reimbursement, reporting expectations, and administrative processes that affect daily operations.
The Commonwealth Fund, using Congressional Budget Office modeling, estimates that changes to Medicaid and ACA subsidies in the Big Beautiful Bill could increase uncompensated care costs by up to $200 billion over the next decade (Commonwealth Fund, www.commonwealthfund.org
It includes provisions that expand or modify coverage for patients, creating new requirements for payers and health systems.
The OBBBA includes adjustments to Medicare funding and reimbursement. While some programs may see reduced funding, the intent is to redirect resources to other healthcare priorities.
The law introduces changes to Medicaid eligibility and funding, which may vary by state. These adjustments could affect both access to care for patients and the financial obligations of states.
Overall, the OBBBA is expected to reshape coverage, reimbursement, and compliance requirements. Healthcare organizations will need to adapt operations to manage these changes while continuing to deliver care.
Hospitals may experience shifts in reimbursement models, potential increases in administrative requirements, and financial pressures tied to coverage changes. The impact will vary depending on size, location, and patient population.
