MAKING SENSE OF IT ALL FOR MINNESOTA PHYSICIANS
On July 4, 2025, President Trump signed into law Public Law 119-21, a congressional reconciliation bill known as the One Big Beautiful Bill Act (OBBBA). According to the nonpartisan Congressional Budget Office’s official analysis, the law is expected to result in a net increase in the budget deficit of $3.4 trillion over 10 years (2025-2034) due to a decrease in direct spending of $1.1 trillion (of which $911 billion is associated with reduced Medicaid spending) and a decrease in revenues of $4.5 trillion.
Please note:
- Anxieties about the OBBBA’s effects are valid. In the next 10 years, the policy is expected to lead to as many as 220,000 Minnesotans losing insurance coverage (and up to 10 million nationally) and a loss of approximately $19 billion in federal Medicaid spending.
- State implementation work is needed. Some of the OBBBA’s most consequential Medicaid provisions don’t take effect until after the 2026 midterm elections. In the meantime, Minnesota leaders will need to address the state budget impact; develop new eligibility and reporting systems; make difficult decisions about payment rates, coverage and benefits; and inform Minnesotans of the changes.
The MMA has created this guide to help Minnesota physicians understand how key provisions of the law will affect your practice and your patients.
To begin reading the guide, please click on one of the linked sections below.
- Medicaid (Medical Assistance)
- ACA Subsidies & MinnesotaCare
- Medicare
- Health Savings Accounts
- Medical School Loan Access
The guide pulls heavily from a KFF OBBBA summary, a CBO letter sent to Senator Wyden (Sen. Ron Wyden) on June 4, and a final CBO estimate published on July 21.
The MMA will regularly update this guide as more information becomes available. Please contact Adrian Uphoff, manager of health policy and regulatory affairs, with questions.