The One Big Beautiful Bill Act, signed July 4 by President Donald Trump, has a number of notable provisions that affect cardiovascular physicians, including student loan and Medicaid changes.
Here are 10 ways that the bill impacts the cardiovascular field, according to a July 10 news release from the American College of Cardiology:
- Up to 17 million individuals could have their health insurance impacted, which will lead to more patients relying on emergency services.
- The amount of federal unsubsidized loans that medical students can obtain in any academic year is capped at $50,000, and the maximum aggregate limit for unsubsidized loans for medical students at $200,000.
- Grad PLUS loans are being terminated, with an exception for students who already have an existing loan.
- New loans must be repaid either with a fixed monthly payment or an income-based repayment assistance plan.
- There are a number of provisions affecting Medicaid, including enrollment verification, eligibility and work requirements.
- The bill includes $50 billion in support to rural hospitals.
- Cost-sharing requirements, which go into effect Oct. 1, 2028, will require states to implement cost-sharing for up to $35 per service on ACA expansion adults who have incomes of 100-138% of the Federal Poverty Line, with an annual cap of 5% of family income.
- There are exceptions to the requirements for primary care, mental health and substance abuse services, as well as services provided by FQHCs, certified community behavioral health clinics or rural health clinics.
- A one-time, temporary payment increase of 2.5% for 2026 under the Medicare Physician Fee Schedule is included in the package, which goes into effect Jan. 1, 2026.
- The ACC is working to make Medicare telehealth flexibilities, which are set to expire Sept. 30, permanent.
