On July 4, the president signed the One Big Beautiful Bill Act (OBBBA, P.L. 119-21). While the law excludes sweeping changes to Medicaid—such as per capita caps or a rollback of funding for the Affordable Care Act (ACA) Medicaid expansion population—it includes numerous restrictions on financing, eligibility, benefits, and enrollment. Many of these disproportionately affect states that have adopted the ACA Medicaid expansion.
Of note, the Congressional Budget Office (CBO) has yet to release a score of the final legislation; federal savings reflect its score of the bill that was passed by the Senate Budget Committee. This Budget Brief summarizes Medicaid and related provisions in the OBBBA.