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flag The 2025 One Big Beautiful Bill cuts Medicaid by $900B, leaving 10M uninsured and straining county health systems.

flag The Republican-backed One Big Beautiful Bill Act, enacted in 2025, is projected to leave 10 million Americans uninsured over the next decade and cut Medicaid funding by over $900 billion, straining counties across the U.S. States like California, New Mexico, and Texas—where local governments are legally responsible for indigent care—are facing rising costs and eroded infrastructure after years of relying on federal support. flag Counties such as Placer in California and Doña Ana in New Mexico are exploring regional health coalitions or risk cutting benefits as federal funds decline. flag California, already grappling with an $18 billion budget shortfall, has paused new Medi-Cal enrollments and cut benefits, while Illinois and Minnesota are scaling back programs for undocumented immigrants due to fiscal pressures. flag Experts warn that without federal support, more people will delay care, increasing strain on emergency rooms and community health centers.

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