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    On Saturday, July 4, 2025, President Trump signed the One Big Beautiful Bill Act (OBBBA) budget reconciliation package into law. Reconciliation is an expedited process used to pass fiscal legislation through a 50-vote majority, avoiding the Senate filibuster. OBBBA contains many of President Trump’s top policy priorities, including extending the Trump tax cuts from his first administration. It also includes many health-related provisions, with the potential to impact medical groups. Most importantly, the bill changes eligibility, enrollment, and funding policies for Medicaid, Medicare, and the ACA marketplace. The Congressional Budget Office (CBO) estimates these changes will result in 11.8 million beneficiaries losing coverage. The table below provides a non-exhaustive overview of specific provisions most relevant to medical groups, highlighting their potential impact and implementation timeframe. MGMA will continue to monitor the implementation of these provisions and advocate for policies that support the long-term sustainability of medical groups.

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