The One Big Beautiful Bill Act (OBBBA), signed into law on July 4, 2025, includes over $1 trillion in cuts to federal healthcare programs. The law includes sweeping cuts across Medicaid, ACA Marketplace, and Medicare (through statutory trigger of sequestration due to deficit increases). Most of the financial impacts will likely come in the form of reimbursement cuts and reductions in enrollment through a variety of administrative restrictions and beneficiary affordability reductions.