算了，还是让AI 做。 according to gemini

Q: Does big beautiful bill cut medicaid?

A:

Yes, the term "big beautiful bill," also referred to as the "One Big Beautiful Bill Act" or a significant House-passed reconciliation bill, does contain provisions that would cut or restrict Medicaid. This legislation was notably passed by the House of Representatives around May 22, 2025.

According to multiple reports and analyses from sources like CBS News, NPR, Healthcare Dive, KFF (Kaiser Family Foundation), the American Hospital Association, the Center on Budget and Policy Priorities, and Investopedia, this bill includes several measures aimed at changing Medicaid:

 

• Significant Spending Cuts: Estimates of the proposed federal spending cuts to Medicaid vary slightly by analysis but range from approximately $625 billion to over $700 billion over the next 10 years.
• Work Requirements: The bill seeks to impose work requirements (often termed "community engagement requirements") for able-bodied adults without dependents to be eligible for Medicaid.
• Stricter Eligibility and Enrollment: It includes provisions for more frequent eligibility checks and other changes to enrollment and renewal processes, which could lead to coverage losses.
• Changes to State Funding: The legislation aims to limit states' ability to use certain financing mechanisms, such as provider taxes, to fund their share of Medicaid costs. It also proposes reducing federal matching funds for states that cover certain immigrant populations with state funds or that have expanded Medicaid under the Affordable Care Act (ACA).
• Potential for Coverage Losses: Analysts, including the Congressional Budget Office (CBO), estimate that these changes could lead to millions of people losing Medicaid coverage—with some estimates suggesting around 7.6 million to 10.3 million individuals could become uninsured.

This bill has passed the House and, as of late May 2025, is set to be considered by the Senate, where it may undergo further changes. Organizations like the American Hospital Association and the Medicare Rights Center have expressed concerns about the potential impact of these Medicaid changes on access to healthcare for vulnerable populations.