OBBB: A Budget Built to Fail

Medicaid cuts, ballooning deficits, and a Congress playing the blame game while Americans face the fallout.

When the House passed its version of the One Big Beautiful Bill (OBBB), critics hoped the Senate would step in with a more tempered approach, something closer to reality, if not compassion. However, instead of mitigating the damage, the Senate Finance Committee's version, released last week, made the bill even more extreme. The cuts go deeper, the tax giveaways grow fatter, and the deficit rises even higher.

This isn’t budgeting. It’s branding. And if, by some improbable twist, this bill actually passes both chambers, the people who can afford it least will pay the highest price.

“The proposal … would ‘defund’ Planned Parenthood, deny people birth control, cancer and STI screenings … It’s no exaggeration to say that lives will be lost,” warns Deirdre Schifeling, ACLU, who further called the OBBB “a pernicious bill.”

The impacts are far-reaching and disproportionately impact the most vulnerable. “This bill would take away health insurance coverage for millions of beneficiaries … and jeopardize the health and economic stability of our communities,” says Bruce Siegel, President & CEO, America’s Essential Hospitals.

The Medicaid Squeeze Tightens

Medicaid, already on the chopping block in the House version, takes an even bigger hit under the Senate plan—up to $1 trillion in cuts. But it’s not just the dollar amount. The Senate bill limits how states can even try to make up the shortfall. It shrinks the amount states can raise from healthcare providers and sets strict federal limits on what they can pay out, tying reimbursement to Medicare rates regardless of local needs or inflation.

Sen. Josh Hawley (R‑MO) has voiced his opposition, saying, “This is a whole new system that is going to defund rural hospitals effectively in order to what? … this needs a lot of work.”

The message to states is simple: you’re on your own, and we’ll make sure you can’t do much about it. For low-income seniors in nursing homes, people with disabilities who rely on daily support services, or working families using Medicaid for basic healthcare, the implications are devastating.

For a refresher on the OBBB up to it’s entry into the Senate, see our reporting here:

What Did We Just Vote For Again? Inside the Quiet Reconfirmation of the OBBB

ICYMI: The One Big Beautiful Budget Breakdown

Tax Cuts Get Lock-In, But the Deficit Grows

If you’re thinking all these cuts are in service of reducing the federal deficit, think again. The Senate version actually increases the deficit more than the House bill. That’s largely because it locks in the Trump-era tax cuts permanently and adds new deductions, including a larger one for seniors. But it doesn’t offset any of this with real revenue increases. Corporate tax breaks and high-earner loopholes remain untouched.

So, while Medicaid is gutted, the wealthy are rewarded. It’s a brutal inversion of priorities, and it blows up any pretense of fiscal responsibility.

Senator Ron Johnson (R‑WI) is not having it, saying, “We’re not doing anything to significantly alter the course of the past and future in this country … you’ll just see why I’m not particularly uplifting on the legislation.”

Senate Democrats are voicing similar concerns, releasing a statement that says in part, “This bill will massively increase the already gigantic budget deficit … burden America’s citizens with crushingly unsustainable debt.”

The SALT Trap and a House That’s Ready to Revolt

The Senate also walked back one of the few sweeteners that kept moderate House Republicans on board: the higher cap on state and local tax (SALT) deductions. The House version raised the SALT cap to $40,000 to appease Republicans from high-tax states, such as New York, New Jersey, and California. The Senate dropped it back to $10,000.

That move alone could fracture the fragile coalition that passed the bill in the House. Add in the larger deficit, and you risk losing support from the hardline fiscal conservatives, too. It’s hard to see how a final version could pass both chambers unless leadership is willing to make brutal trade-offs or twist even more arms.

A Bill Built to Fail?

Here’s the uncomfortable truth: neither chamber seems to actually want this bill to pass in its current form. Instead of crafting something viable, they’ve created a piece of political theater. The House gets to say it acted. The Senate gets to say it tried. And when the bill collapses, both can blame each other.

It’s an illusion of action. But behind that illusion are real consequences. The uncertainty itself hurts people. States can't budget. Providers can't plan. Families on the edge have no idea if their care will disappear next year.

What’s at Stake

This was never about policy. It was about optics. A Medicaid overhaul was framed as “reform,” tax cuts were dressed up as “relief,” and the entire package was sold as “fiscal responsibility”, even as it added more to the national debt.

Ultimately, the OBBB may never become law, but the damage is already done. It reveals a party more interested in blame than governance, more committed to a narrative than to the needs of the people it claims to serve.

If this bill somehow does make it to the president’s desk, it won’t be a victory. It’ll be a warning: that political theater can become real policy, and that cruelty, when dressed up in budget numbers, is still cruelty.

What You Can Do: Don’t Let the OBBB Become Law

This bill isn’t just political theater. It’s a direct threat to Medicaid, seniors, disabled people, and working families across the country. Even if it seems doomed today, bad policy has a way of sneaking through when the public is silent. We can’t afford to let that happen.

Call the Congressional Switchboard

Tell your Senator and Representative: Vote NO on the OBBB.

Call: (202) 224-3121
You’ll be connected to your member of Congress based on your ZIP code.

Here’s a sample script:

"Hi, my name is [Your Name], and I’m a constituent from [Your City or ZIP].
I’m calling to urge [Senator/Representative’s Name] to vote NO on the One Big Beautiful Bill. This bill guts Medicaid, adds to the deficit, and hurts seniors, disabled people, and low-income families. Please stand up for your constituents, not partisan politics or tax cuts for the wealthy. Vote no on the OBBB.”

Make it personal if you can. Talk about your own healthcare, your family, your work, your fear of what these cuts will do.

Support the Organizations Fighting This

If you’re able, donate or volunteer with grassroots organizations working on the front lines to:

• Protect Medicaid

• Defend disability rights

• Provide care and support for seniors

• Fight budget injustice and corruption

Here are a few national and local groups to consider:

• National Health Law Program (NHeLP)

• Center on Budget and Policy Priorities (CBPP)

• Justice in Aging

• Disability Rights Education & Defense Fund (DREDF)

• Your local Medicaid expansion coalition or free clinic

Every dollar, every share, every voice helps push back against cruelty dressed as policy.

Let’s Be Loud

Congress is counting on public confusion and low turnout to slip this bill through. Don’t give them that silence. Call. Share. Donate. Speak out.

If this bill becomes law, millions will suffer; however, if we act, we can prevent it.

Bibliography:

• “Senate GOP’s Medicaid Cuts Mean New Trouble for Trump Megabill,” Wall Street Journal, June 17, 2025.

• “Senate Looks to Cut $1 Trillion from Medicaid. Here’s Who Would Be Hurt Most,” MarketWatch, June 17, 2025.

• “Senate Republicans Cool to Finance Committee’s Tax Plan,” Politico, June 16, 2025.

• “The ‘Legalized Fraud’ Keeping Rural Hospitals Afloat,” Washington Post, June 13, 2025.

• “The GOP’s Big Bill Would Bring Changes to Medicaid for Millions,” AP News, June 15, 2025.

• Anousha Sakoui, “Republican Senator Ron Johnson Warns on Opposition to Trump Tax Bill,” Financial Times, June 11, 2025.

• “US Senate Republicans Change Trump Tax-Cut Bill, Setting Conflict,” Reuters, June 16, 2025.

• American Civil Liberties Union, “ACLU Responds to Senate Finance Committee Bill That Will Kick Millions Off Medicaid,” press release, June 16, 2025.

• Josh Hawley (Sen.), quoted in St. Louis Public Radio, “Big Beautiful Bill Could Interfere with Missouri Medicaid Program,” June 17, 2025.

• Healthcare Finance News, “Senate Finance Committee Releases Its Version of ‘Big, Beautiful Bill’,” June 16, 2025.

• ABC News, “Senate Finance Committee’s Version of the ‘Big, Beautiful Bill’ Sets Up…,” June 17, 2025.

• CBS News, “Senate Republicans Unveil Long-Awaited Details on Trump Tax Bill,” June 16, 2025.

• Taiyangnews, “US Senate Finance Committee Proposal Risks Clean Energy Tax Credits,” June 17, 2025.

• Congress.gov, “H.R. 1 – One Big Beautiful Bill Act,” May 22, 2025.

• Wikipedia, “One Big Beautiful Bill Act,” updated June 2025.

• Senate Finance Committee, “Chairman Crapo Releases Finance Committee Reconciliation Text,” press release, June 16, 2025.

• Mike Crapo (Sen.), quoted in Newsmax, “All the Talk About How This Bill Is Going to Generate an Increase in Our Deficit Is Absolutely Wrong,” June 9, 2025.

• Wall Street Journal, “GOP Senator Draws Red Line on Trump Megabill,” June 3, 2025.