Advocacy - Lab Advocate
On July 4, 2025, President Donald Trump signed H.R. 1 –the One Big Beautiful Bill Act – into law. The legislation includes broad tax and healthcare reforms with several provisions that may affect clinical and public health laboratories.
The law reduces federal Medicaid funding by an estimated $800 billion to $1.1 trillion over the next decade, with phased implementation beginning in fiscal year 2027. It introduces new work requirements for Medicaid eligibility – mandating 80 hours of work or qualifying activity per month for certain adults—and applies immigration-related restrictions that delay or limit coverage eligibility for some legal residents.
Additional provisions include limits on retroactive Medicaid coverage, caps on provider taxes, and changes to state financing mechanisms, all of which may affect access to preventive and diagnostic services. The law also establishes a $50 billion Rural Health Transformation Fund to support healthcare infrastructure through state-directed grants, including laboratory services. At the same time, rural hospitals and clinics that depend on Medicaid reimbursement may experience financial strain due to projected funding reductions.
Independent estimates suggest that the combined effect of these provisions could lead to a loss of insurance coverage for approximately 10 to 12 million individuals. A decrease in the insured population may reduce the volume of routine and diagnostic testing, with potential implications for early detection, chronic disease management, and public health surveillance.
The legislation includes workforce-related measures such as expanded eligibility for Pell Grants for short-term training programs and new caps on graduate student loans. It also rescinds unspent pandemic-era funds and reduces CDC grant allocations, which could affect ongoing efforts to strengthen public health laboratory capacity.
ADLM will continue to monitor the implementation of H.R. 1 and continue advocating to support access to laboratory services, appropriate reimbursement, and long-term investment in the clinical and public health laboratory workforce and infrastructure.