In a controversial move with far-reaching health consequences, the U.S. House passed the Trump administration’s sweeping domestic agenda legislation—dubbed the “Big Beautiful Bill”—just before the July 4 deadline set by the president. While its proponents claim it will make the country “stronger, safer and more prosperous,” leading health experts warn the bill is a dangerous and unethical setback for public health in the U.S.With major cuts to Medicaid, significant changes to the Affordable Care Act (ACA), and reduced access to basic nutrition and reproductive services, the legislation’s health implications are vast and immediate.What’s at StakeAt the heart of the bill is a $930 billion cut to Medicaid funding over the next decade—the deepest reduction to the program in its history. In addition, for the first time, work requirements will be imposed on certain able-bodied adults aged 19 to 64 to retain their Medicaid benefits. Parents of children aged 14 and older must also meet this 80-hours-per-month rule through employment, training, volunteering, or school.Dr. Jason M. Goldman, president of the American College of Physicians (ACP), as reported in healio.com, called the cuts “devastating” and warned they would cripple the U.S. health care system and worsen public health outcomes. Similar concerns were echoed by the American Medical Association (AMA), the American College of Obstetricians and Gynecologists, and the Emergency Nurses Association, all of whom opposed the bill.Dr. Arthur L. Caplan, founding head of the Division of Medical Ethics at NYU Grossman School of Medicine, called the bill “immoral, unethical, and tragic,” also reported in healio.com.“Slashing Medicaid and imposing work requirements is punishing our poorest, most vulnerable, and mentally ill populations,” Dr. Caplan said. “It’s unconscionable that the solution to economic reform is to cut basic health care.”No Access To Affordable Care ActThe bill also weakens the Affordable Care Act (ACA), which could lower enrollment rates and disrupt access to care. One of the major changes is the elimination of automatic re-enrollment in ACA plans. Policyholders must now update their information annually, and the open enrollment window has been shortened by a month.For individuals applying outside the open enrollment period—due to life events like job loss or family additions—advance premium subsidies will no longer be available immediately. Under current rules, applicants get up to 90 days of help while their paperwork is processed. The new law forces applicants to wait for full documentation approval before receiving assistance.According to the Congressional Budget Office (CBO), the result will be catastrophic: an estimated 11.8 million more uninsured Americans by 2034.“These patients don’t disappear,” Dr. Caplan said. “They flood emergency rooms with preventable issues—headaches, infections, chest pain—overburdening a system already stretched thin.”Emergency Rooms on the BrinkWith millions projected to lose insurance, ERs may become the default safety net—a role they are not equipped to handle.“Hospitals will close. Services will shrink. Waiting times will skyrocket,” Dr. Caplan warned. “And it won’t just affect the poor—it will affect everyone.”He also criticized the bill for ignoring the root cause of health care costs in the U.S.“We have the most expensive, inefficient system in the world. Yet instead of tackling pricing, this bill cuts access,” he said.SNAP Benefits, Nutrition & Health ImpactThe bill also drastically alters the Supplemental Nutrition Assistance Program (SNAP), affecting roughly 42 million Americans. The age for work requirements has been raised from 54 to 64, and overall benefits will be reduced. Many families will now receive less support—$292 for an individual and $975 for a family of four.Nutrition is a cornerstone of preventive health, and public health experts say this rollback will contribute to higher rates of malnutrition, particularly among older adults and low-income families.Reproductive Health and Planned Parenthood DefundedIn another blow to health access, the bill defunds Planned Parenthood, making it ineligible to serve Medicaid patients. According to the Contraceptive Access Initiative, 10% of Medicaid-covered women who received family planning services in 2021 did so through Planned Parenthood.The move will severely limit access to contraception, STD testing, cancer screenings, and reproductive counseling, particularly in underserved areas.Physician Payments, Rural Hospitals, and moreTo soften the backlash, the bill includes a 2.5% temporary increase to Medicare Physician Fee Schedule rates in 2026, and reinstates certain telehealth flexibilities, as noted by the American Telemedicine Association.However, experts like Dr. Caplan argue that these are inadequate responses to a much deeper crisis.“That’s like saying the ship is sinking, but we’ve added two lifeboats,” he said. “Increased reimbursement won’t matter if your patient population loses coverage.”