The recent passage of the One Big Beautiful Bill (OBBB) has triggered significant concern throughout the healthcare and Medicaid communities. With nearly $1 trillion in projected Medicaid cuts, many agencies are preparing for difficult adjustments. But this change also presents an opportunity. Agencies that focus on accuracy, preparation, and responsiveness can move forward with stability.
The One Big Beautiful Bill is a legislative initiative aimed at tax reform and federal spending cuts. Among its major features is a large-scale reduction in Medicaid funding. Passed by the Senate on July 1, 2025, the bill includes over $4 trillion in tax cuts and between $930 billion and $1 trillion in Medicaid reductions across the next decade.
Key changes include:
For service providers, these changes will likely mean fewer clients qualify for coverage, compliance expectations will increase, and payments may slow or become more difficult to secure.
These policy shifts are more than just numbers on a budget. Stricter eligibility rules mean fewer individuals will qualify for Medicaid, which could reduce client volume. This will particularly affect underserved populations, and agencies will need to adapt in order to continue providing care effectively.
In addition, agencies face growing administrative responsibilities. They must now track client work requirements, confirm eligibility more often, and stay prepared for audits. For organizations already managing limited resources, these changes create real strain.
The financial pressure is equally significant. Reimbursement delays, denials, and the demand for complete documentation will put even more stress on tight margins. Every mistake in billing could result in a payment delay or outright denial. Agencies must improve accuracy and strengthen their processes to avoid financial risk.
Despite these difficulties, agencies can use this moment to improve. A commitment to better systems and stronger oversight will help organizations respond more effectively and build resilience.
Although the challenges are serious, they are not insurmountable. Agencies that are willing to examine and revise their processes now will be better equipped for what lies ahead.
Start by reviewing how tasks are completed. Remove unnecessary steps, reduce manual tasks, and update systems to ensure claims and documentation are processed accurately and quickly.
Strong internal policies, staff training, and regular audits can also help reduce the chance of errors or failed compliance checks. These improvements aren’t just about staying within the rules—they protect revenue and help maintain service quality.
Importantly, this isn’t just about meeting today’s demands. Agencies that invest in better tools and training now will have an easier time adapting to future changes. A well-prepared agency is less vulnerable to shifting policies.
Carefully review all claims before submitting them. Create review checkpoints to find and fix issues early. Keep staff up to date on current Medicaid rules to avoid unnecessary errors.
Use available data to track denial trends and identify where issues occur. If certain codes or services frequently lead to problems, look deeper and adjust practices accordingly.
Keep records complete and accessible. Time logs, eligibility checks, and service details should be accurate and up to date. Regular internal audits can help catch issues before they become problems.
Prepare for multiple scenarios—best case, worst case, and middle ground—when building your budget. This will make it easier to stay flexible as funding levels change.
Build relationships with Medicaid offices, policy groups, and other providers. These connections can help clarify rules, provide support, and keep your agency aware of best practices.
Some providers are already making changes that help. Agencies that conduct early claim reviews and track denials more closely report fewer issues and faster payments. These are not dramatic overhauls, but practical improvements that show strong results.
The One Big Beautiful Bill and its Medicaid changes present real obstacles, but also an opportunity to strengthen systems and prepare for the future. Agencies that focus on accuracy, policy awareness, and financial responsibility will be best positioned to continue delivering care.
These are challenging times, but they are also a chance to build something more stable and effective. The steps taken now will determine how well agencies can respond—not just to today’s cuts, but to whatever changes come next.