Not Just a Budget Cut: How 17 Million Lives Are Being Harmed by “One Big Beautiful Bill”

Earlier this month, President Trump and Republican lawmakers’ big budget bill that guts Medicaid and threatens access to health care for 17 million Americans was signed into law. Now, families brace for impact.

With the new law’s $1 trillion in cuts to health care, the largest ever, families are preparing for the worst. Whether consumers rely on Medicaid for insurance or get coverage from a private or other source, they could see critical services cut, premiums spike and bureaucratic barriers to care force millions of Americans off their health coverage. Hospitals and health clinics are already making adjustments in anticipation of implementation of the bill. Curtis Medical Center, a rural health clinic operated by Community Hospital in Curtis, Nebraska announced it will be closing, with their CEO citing, “anticipated federal budget cuts to Medicaid” as the reason.

Just a few hours from Curtis, in Lincoln, Nebraska, Mellissa Ely, known to many as Missy, a 51-year-old mom to two boys and a grandmother to four grandkids has been navigating the health care system for years with the help of Medicaid expansion. She is also a registered Republican, a supporter of Donald Trump.

Missy’s ability to spend time with her family has been shaped in large part by her access to care. Before gaining access to Medicaid through expansion, Missy was uninsured. During that time, she had a heart attack but could only afford to take a very limited number of her prescribed medications.

Reflecting candidly on what her life might look like today if she continued down a path without health coverage, Missy shares, “Without Medicaid expansion, unfortunately, I think I would be dead.”

Missy’s story shows that Medicaid isn’t a partisan issue — it’s a lifeline. Her experience is not unique and underscores how access to affordable care can mean the difference between life and death, no matter your politics. Just across the border in the neighboring state of Kansas, one in seven residents uses Medicaid, 283,000 of those are children, and thousands of families are facing similar fears about what these cuts will mean for their futures.

One proud Kansas resident, Ryan Jolly, describes herself as being at the center of many of the groups Medicaid serves. She is a daughter, mother, foster parent, health care provider and small business owner. “If the different constituencies that are affected by Medicaid were presented in a Venn diagram,” she said, “I’m that big circle in the middle where they all overlap.”

Now that the severe cuts to Medicaid have been signed into law, Ryan is terrified, not just for her own family and small business, but for children across the state.

Ryan has served as a foster parent for 15 years, specializing in medically complex children. “In our state, there are roughly 5,000 children in foster care who rely on Medicaid for their health insurance,” she explained. Thousands more adopted from foster care also rely on Medicaid for their medical needs. She warns that cuts will put these children at risk. “I don’t know how many families will be able to open their doors to children that are abused and neglected if those families are expected to carry the full financial burden of their medical care,” she said.

With severe cuts to Medicaid, states now have to make impossible choices and could choose to cut optional benefits such as home- and community-based services (HCBS) first.

One family in Pennsylvania is particularly worried about losing access to HCBS. Colleen Tomko of Coopersburg, Pennsylvania is the mother of Shaun, a now 35-year-old adult who has coverage through Medicaid because of developmental disabilities diagnosed at birth.

Shaun’s day-to-day life is rich and meaningful — he works at a law firm, volunteers at a local library and PBS, and finds joy helping at music festivals. Whether he’s at the gym, out shopping, enjoying a movie, or participating in community events, Shaun is not only present, he is known, valued, and included.

“Everywhere he goes out in the community, somebody knows him,” shares his mother, Colleen. “He has this sense of independence, contribution, and a life that’s very worth living and has a great deal of meaning.”

But that life is fragile. Medicaid doesn’t just support what Shaun does, it supports who he is.

“If somehow Medicaid benefits are cut or eliminated, it would be very drastic to his life. It would…dash all our hopes of trying to plan for the future.”

For families like the Tomko’s, losing home and community-based services would be devastating. Without those services, the primary fallback for people like Shaun is institutional care.

“The irony with that is that it’s more costly and it’s more detrimental to people’s overall quality of life.” Institutionalization would mean the loss of everything Shaun has built — his autonomy, his community, and his voice. Shaun’s mother said, “Without Medicaid, that life is a nightmare.”

These stories are just a snapshot of what’s at stake. The “big, beautiful bill” doesn’t just threaten Medicaid; it puts the foundation of our health care system on unstable ground, and the impacts will continue to ripple. Small business owners, rural communities, foster parents, seniors, people with disabilities, and even those of us with private insurance will experience the fallout.

The consequences of this bill won’t be felt in headlines or spreadsheets. They’ll be felt in emergency rooms, in school nurse offices, at kitchen tables where families are forced to choose between rent and medicine.

For Missy, Ryan, Colleen, Shaun, and for 17 million Americans with stories just like theirs, the stakes couldn’t be higher. This isn’t just about numbers on a page. It’s about lives.

If you have a story to tell, visit Share Your Story.