On August 9, 2025, the ongoing debate over America’s healthcare future took a dramatic turn as President Donald Trump’s administration unveiled sweeping proposals to overhaul federal health spending and reshape Medicaid and Medicare. These changes, encapsulated in the administration’s so-called ‘One Big Beautiful’ bill and a series of new federal rules, have sent ripples across the nation—affecting not only millions of low-income Americans and immigrants, but also the fate of innovative state programs and the everyday lives of seniors, veterans, and people with disabilities.
At the heart of the controversy is the Trump administration’s proposed $1 trillion cut to the healthcare sector for the 2026-27 fiscal year. According to Prothom Alo, the budget slashes $793 billion from Medicaid and the Supplemental Nutrition Assistance Program (SNAP), $300 billion from the Affordable Care Act, and $50 billion from Medicare. The impact? More than 2 million low-income Americans and immigrants may lose access to healthcare, with an estimated 200,000 Bangladeshi immigrants—many living in states like New York, New Jersey, California, Florida, Texas, and Michigan—directly or indirectly at risk.
“The majority of us are engaged in middle and low-income jobs and depend on government assistance for healthcare,” said Sunny Khan, a Bangladeshi immigrant. Workers in home care, ride-sharing, restaurants, delivery services, and taxi driving would be affected in myriad ways. The bill’s 1,116 pages devote just 48 to healthcare and pharmaceuticals, leaving many communities uncertain about the full scope and consequences of these reforms.
Dilip Nath, district leader of Assembly District 25, emphasized the breadth of the proposed cuts, warning that the healthcare of some 23 million Americans and between 200,000 and 250,000 Bangladeshi immigrants hangs in the balance. “Many home care agencies, day-care centers, and even hospitals could shut down,” Nath told Prothom Alo. In the United States, medication cannot be purchased without a doctor’s prescription, and the new budget offers no guidance for people struggling with partial mental illness. Job losses in the healthcare sector loom large.
Healthcare for seniors, however, is set to remain unchanged—for now. Gias Ahmed, head of Immigrant Elder Home Care, noted, “People aged 19 to 64 who have the means but do not work at least 20 hours a week would lose access to Medicaid. For senior citizens aged over 65, there would be no change of services.” Ahmed added, “I believe that those who work for cash and do not pay taxes regularly, or those who live entirely on government assistance without working, should not have the right to receive government healthcare.”
But the reach of these federal changes extends far beyond immigrant communities. In Oregon, a pioneering $64 million Medicaid expansion designed to provide targeted health services to people about to be released from jail or prison has been put on indefinite hold. According to InvestigateWest, the program was set to launch in late 2025 for juveniles and early 2026 for adults, offering critical care—such as drug prescriptions, behavioral health and addiction counseling, and doctor’s visits—three months before release. The goal was to smooth the difficult transition from incarceration to society, reducing the risk of overdose, psychosis, or recidivism.
Yet this summer, the Oregon Health Authority quietly delayed the program, citing anticipated changes to Medicaid funding under President Trump’s tax and spending cuts package, the “Big Beautiful Bill.” Kristen Lambert, a spokesperson for the agency, explained that the pause was necessary to ensure that “entities tasked with implementing it would be properly resourced and supported.” But with no new launch date in sight and the federal authorization for the program set to expire in 2027, the program’s fate now rests with the Trump administration—and its willingness to reauthorize it.
Angela Kim, a former critical care nurse who spent nearly two decades incarcerated at Coffee Creek Correctional Facility, described the setback as devastating: “This is not about luxury health care. … This is about making sure people who are leaving prison don’t overdose or end up in a psychosis or even go back to prison.” Research by Oregon Health and Science University, Oregon State University, and the Department of Corrections found that formerly incarcerated Oregonians are ten times more likely to experience an opioid overdose in their first two weeks post-release compared to the general public.
The program was originally authorized under a Section 1115 demonstration waiver by the Centers for Medicare and Medicaid Services (CMS) during the Biden administration, part of a broader push to expand Medicaid’s reach. But as Amaya Diana of the Kaiser Family Foundation noted, presidential administrations hold significant sway over these waivers, which must be renewed every few years. Recent moves by CMS—including rescinding frameworks that allowed Medicaid waivers to cover “health-related social needs” and phasing out mechanisms for innovative state health programs—signal a sharp policy reversal. Oregon’s reentry program, and similar efforts in states like California, Utah, Kentucky, and Washington, now face an uncertain future.
“All of the vital needs that people have in their lives are in chaos after they’re released from custody,” said Wanda Bertram of the Prison Policy Initiative. Without a stable bridge to healthcare, many may fall through the cracks. Oregon’s plan would have allowed eligible individuals to consult with providers 90 days before release, access addiction counseling, and secure a short-term supply of prescription medications—potentially a lifeline for those at risk of relapse or medical crisis.
Meanwhile, the Trump administration’s approach to healthcare regulation is also under scrutiny in Washington, D.C. On the same day as the budget announcement, CMS proposed expanding its Competitive Bidding Program to include urological, ostomy, and tracheostomy supplies—products essential for millions of seniors, veterans, and people with disabilities. According to a policy analysis, this move could limit patient choice, forcing individuals to use generic products that may not fit their needs and risking infections, ER visits, or even hospitalizations.
“Catheters, ostomy bags, and trach tubes help people safely go to the bathroom, breathe, and live with independence and dignity,” the analysis stated. “These highly individualized products must be fitted carefully to each person’s body and are not easily interchangeable.” Critics argue that the proposed rule is at odds with President Trump’s previous policies, which emphasized patient choice and deregulation. Small, community-based medical suppliers—many serving their regions for decades—could be driven out of business, replaced by large national chains able to win federal contracts with the lowest bids.
The rule also reverses a bipartisan decision made in 2003, when Congress excluded these supplies from competitive bidding under the Medicare Modernization Act. If enacted, critics warn, it could be a "death sentence" for small suppliers and a blow to patient independence—particularly for vulnerable populations already facing challenges under the proposed budget cuts.
As the Trump administration’s healthcare agenda unfolds, millions of Americans are left wondering what the future holds. From immigrant families and incarcerated individuals to seniors and people with disabilities, the stakes couldn’t be higher—or the questions more urgent. The coming months will reveal whether these sweeping changes will deliver the promised efficiencies or deepen the cracks in America’s already strained healthcare system.
