Did Donald Trump’s signature 2025 legislation cut Medicaid spending by $1 trillion over a decade?

Federal legislation known as the “One Big Beautiful Bill Act” included an estimated $1 trillion in cuts to Medicaid spending over the next decade. 

Passed in 2025, the bill included tax cuts and increased spending on immigration enforcement and the military, offset by nearly $1 trillion in cuts to Medicaid, according to the Congressional Budget Office. 

Provisions included mandating able-bodied adults to work 80 hours per month to qualify for Medicaid benefits, known as BadgerCare in Wisconsin. That’s estimated to reduce spending by $326 billion through reduced enrollment. 

It also freezes provider taxes in states like Wisconsin that have not expanded Medicaid, and it gradually lowers the provider tax rates in expansion states from 6% to 3.5%, saving the federal government $226 billion. States have used taxes on providers such as hospitals to draw federal matching funds.