Contractors adapt to new tax policies and Medicaid changes under the One Big Beautiful Bill Act.
The One Big Beautiful Bill Act is poised to create substantial changes in the construction industry and healthcare coverage in the U.S. The new law extends tax benefits for contractors while enacting significant Medicaid cuts, including imposing new work requirements. This dual impact raises concerns among industry stakeholders about financial implications and necessary adaptations. Key discussions focus on potential amendments and the challenges faced by state Medicaid programs. As the act unfolds, vigilant navigation of these transformations will be crucial for affected parties.
The One Big Beautiful Bill Act (OBBBA), signed into law on July 4, 2025, is set to have sweeping implications for both the construction industry and the Medicaid program in the United States. The act introduces significant changes, particularly in tax policy that could reshape the landscape of health coverage.
One of the key aspects of the OBBBA is its extension of measures from the 2018 Tax Cuts and Jobs Act (TCJA). Many provisions that were set to expire in 2025 will now remain in effect, which has raised new considerations for tax planning among contractors. A presentation by CBIZ will discuss the implications of these extended provisions and help contractors adjust their tax planning strategies and manage their cash flow effectively. Key figures in the presentation include Joseph Natarelli, Barry Fischman, Marty McCarthy, Daniel Mauriello, and Steve Cerruto.
On a more concerning note, the OBBBA represents the largest cuts to Medicaid in its 60-year history, amounting to an astonishing $1 trillion. As part of these changes, new work requirements will take effect on January 1, 2027. Under these requirements, individuals who do not work at least 80 hours per month will be denied coverage. This could significantly affect many enrollees, leading to a predicted loss of coverage for numerous individuals due to complicated red tape. While some exemptions may apply to certain groups, the administrative burden associated with these new requirements is expected to impact state Medicaid programs adversely.
As states prepare for the financial pressure that the OBBBA will exert on their Medicaid systems, they are being urged to adapt quickly to these changes. Medicaid insurers, including Centene and Molina Healthcare, have already adjusted their earnings expectations for 2025, anticipating a slower growth trajectory due to the anticipated fallout from the bill. This has raised concerns among stakeholders about the sustainability of Medicaid coverage for countless individuals reliant on the program.
A recent poll reveals that 65% of Medicaid recipients under the age of 65 believe the OBBBA will negatively impact their families. This sentiment adds urgency to the ongoing legislative efforts to amend certain aspects of the law, particularly those concerning Medicaid funding and provider taxes. Some states, deemed particularly vulnerable to cuts, include Kentucky, Mississippi, Missouri, New Mexico, South Carolina, and West Virginia, where the implications of these changes could be grave.
Missouri Senator Josh Hawley has taken a proactive approach by introducing legislation aimed at repealing sections of the OBBBA that restrict states’ abilities to impose taxes on healthcare providers. The Federation of American Hospitals supports this legislative effort, underscoring the critical role that such taxes and directed payments play in funding essential healthcare services.
Despite the potential for legislative change, experts do not anticipate significant immediate relief for state Medicaid programs confronting substantial budget constraints due to the OBBBA. Many believe that substantial issues must worsen before any effective relief measures are introduced for these critical programs. As states scramble to find solutions amidst these sweeping changes, the OBBBA will undoubtedly continue to be a focal point of discussion among policymakers, healthcare providers, and recipients alike.
In summary, the OBBBA promises to reshape the health coverage landscape dramatically, introducing complicated requirements and significant funding cuts to essential services. As the fallout unfolds, stakeholders across industries will need to monitor developments closely, particularly concerning how Medicaid recipients will fare under the new regulations.
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