President Donald Trump is touting what he calls a “big beautiful bill” as a landmark achievement in his second term, but critics say the legislation’s sweeping tax cuts for the wealthy come at a devastating cost: deep cuts to Medicaid that could leave millions of Americans without healthcare.
Signed into law this week, the Trump-backed legislation delivers hundreds of billions of dollars in tax breaks, mostly benefiting corporations and the top 1% of earners. At the same time, it slashes Medicaid funding by more than $1.2 trillion over the next decade, one of the largest rollbacks of a social safety net program in U.S. history.
“This bill is a gift to the ultra-rich, paid for by ripping healthcare away from working families, seniors in nursing homes, and children with disabilities,” said Senate Minority Leader Patty Murray. “It’s cruel. Plain and simple.”
Medicaid Gutted
The law effectively caps federal Medicaid funding, converting it into a block grant program that gives states a fixed amount of money—regardless of need. It also allows states to impose stricter eligibility requirements, work mandates, and even lifetime coverage limits.
The Congressional Budget Office estimates that 18 million people could lose coverage within the first three years.
In rural states like West Virginia and Kentucky, where Medicaid expansion under the Affordable Care Act dramatically reduced uninsured rates, hospitals are warning of an impending crisis.
“People will die,” said Dr. Ayesha Coleman, an emergency physician in Charleston, WV. “We’re already seeing patients delay care because they’re afraid they’ll get a bill they can’t pay.”
Tax Cuts Tilted to the Top
The bill slashes the top corporate tax rate from 21% to 15% and lowers the top individual income tax rate for millionaires. Provisions aimed at “super-charged investment incentives” also largely benefit hedge funds and private equity firms.
White House Press Secretary Hope Griffin defended the bill, calling it “an engine of prosperity that will lift all Americans.” But early analyses show the benefits are sharply skewed: the top 0.1% of earners are projected to receive an average tax break of $230,000 a year, while middle-class families would see minimal or even negative impacts due to healthcare losses.
Protests and Legal Challenges Mount
Health advocacy groups and civil rights organizations are already filing legal challenges, arguing that the bill violates federal protections under Medicaid law. Protests erupted in several cities Tuesday night, with demonstrators gathering outside the Capitol chanting “Healthcare is a right!”
Meanwhile, several governors—even some Republicans—have expressed concern. “This bill ties our hands,” said Ohio Governor Rachel Park (R). “We’ll be forced to make impossible choices between helping the elderly, the disabled, or low-income children.”
Meanwhile, Mitch McConnell dismissed the concerns, saying :
“I know a lot of us are hearing from people back home about Medicaid. But they’ll get over it.”