NEWSROOM

The “One Big Beautiful Bill” passed by Congress this summer and signed into law by President Trump on July 4, 2025, introduces some of the most sweeping changes to health care and federal safety net programs in the U.S. in decades.
 
The legislation will have a dramatic impact on premiums paid for health insurance purchased through the Affordable Care Act (ACA) public exchanges. This is especially true for those receiving enhanced ACA subsidies, which are set to expire at the end of 2025.
 
For Californians with ACA coverage, the combined impact of 10.3 percent higher premiums and the loss of federal premium tax credits could be devastating. More than 1.5 million enrollees face average net premium increases of 66 percent. That could drive many to forgo health insurance coverage in 2026, increasing the potential burden on hospitals if uninsured persons need emergency care.
 
Information on potential rates for individuals getting health insurance through Nevada Health in 2026 has not been made available yet. However, KFF is reporting, on average, an ACA plan premium increase of about 20 percent – more than double the seven percent increase last year.
 
Beyond its impact on ACA premiums, the OBBB will affect California and Nevada by reducing federal funding for social programs like Medicaid (Medi-Cal in California) and SNAP, the Supplemental Nutrition Assistance Program. SNAP assistance in California is called CalFresh.
 
Other key changes include new work requirements for under-age-65 Medicaid enrollees, more frequent validation of eligibility for assistance, new copays, and significantly reduced payments to hospitals, nursing homes, and other providers serving Medicaid recipients. Critics say these lower payments could mean fewer services or facility closures.
 
In California, about 15 million people – one in three residents – are covered by Medi-Cal. The state will see a 19 percent reduction ($164 billion) in Medi-Cal funding over the next decade, according to a KFF analysis.
 
For more information concerning the impact of the OBBB, read the latest column by Paul Roberts, REBC, Sr. Director of Education & Market Development.