(C) Common Dreams
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Medicaid Cuts in the One Big Beautiful Bill Act Leave 3 in 10 Young Adults Vulnerable to Losing Health Care Access [1]
['Amelia Coffey', 'Heather Hahn']
Date: 2025-08-07
On July 4, 2025, President Trump signed the One Big Beautiful Bill Act (OBBBA) into law. To partially offset the cost of trillions of dollars in tax cuts, the legislation includes nearly $1 trillion in cuts to Medicaid.
Medicaid generally covers children younger than 18 from families with low and moderate incomes, pregnant women with low and moderate incomes, parents with very low incomes, and individuals with disabilities. In the 40 states that chose to expand Medicaid to adults with low incomes (at or below 138 percent of federal poverty guidelines) under the Affordable Care Act, young adults can qualify based on income alone. Otherwise, they must qualify in other ways, such as being pregnant or disabled.
Extensive research shows Medicaid covers lifesaving care for enrollees. It reduces mortality, can help establish healthy habits, and can lead to higher lifetime earnings. These benefits extend far beyond individuals.
But OBBBA leaves the roughly 3 in 10 young adults ages 18 to 24 insured through Medicaid vulnerable to losing coverage.
How will Medicaid changes reduce young adults’ access to health care?
OBBBA cuts Medicaid spending by changing the program in several ways that affect young adults. Notably, many of the changes target the Medicaid expansion population. Because Medicaid expansion is a key source of health coverage among young adults (PDF), they will likely be disproportionately affected by these changes.
Here are five ways the changes to Medicaid in OBBBA will likely affect young adults in the short and long terms:
What can states do to support young adults as they implement OBBBA Medicaid changes?
Taken together, evidence suggests changes to Medicaid in OBBBA will likely create new hurdles for young adults as they work to achieve self-sufficiency.
As states consider how they will implement OBBBA’s changes, they should prioritize access to coverage for as many of the young adults who rely on Medicaid as possible and take steps to mitigate some of the challenges young adults could experience.
For example, to mitigate hurdles young adults face in documenting their compliance with work requirements, states could ensure Medicaid administrators have access to data on school enrollment and develop user-friendly ways to report unstable work, such as allowing people to easily upload documents from a mobile phone. These and other improvements (PDF) to state data and reporting infrastructure may be an effective area to focus implementation resources to support health care access for young adults.
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[1] Url:
https://www.urban.org/urban-wire/medicaid-cuts-one-big-beautiful-bill-act-leave-3-10-young-adults-vulnerable-losing
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