If you are among the many people confused about the One Big Beautiful Bill barreling through Congress and its implications for Medicaid, we have just the guy to walk you through it. Al Guida founded Guide Consulting Services, a 25-year-old consulting practice that helps corporate, government, and non-profit clients navigate Washington policy processes to achieve measurable goals. In this episode, Al breaks down Medicaid-related provisions in the BBB; we discuss the political outlook, potential impacts, and how continued advocacy can influence outcomes, even after the bill passes.

Key Takeaways:
Legislation Timeline:

• Medicaid provisions tied to tax cut bill likely to pass by early to mid-July.
• CBO projects rising deficits and major Medicaid cuts.

Medicaid Coverage Impact:

• Up to 10 million may lose coverage.
• Red states most affected due to high Medicaid reliance.
• Safety net providers face more uncompensated care.

Work Requirements:

• Mostly paperwork-related; 60% of recipients already work.
• Could disqualify 5.2 million due to admin burdens.
• Shorter retroactive coverage harms crisis mental health care.

Fraud Measures:

• Support for blocking deceased and fraudulent enrollees.
• Opposed to punitive cuts and eligibility restrictions.

Immigrant Coverage:

• Cuts affect refugees and undocumented populations.
• Could drive ER use and strain local budgets.

Provider Advocacy:

• Push for carve-outs to protect mental health/addiction providers.
• Urged listeners to contact senators and oppose cuts.
• Stressed advocacy potential during regulatory phase post-passage.