On July 4, 2025, President Donald Trump signed the One, Big, Beautiful Bill Act into law during an Independence Day military family picnic on the South Lawn of the White House in Washington, D.C., according to the Capital Gazette. The bill, which has been touted by supporters as a sweeping reform, is set to reshape America's social safety net, tax code, and rural economy for years to come. But as its provisions begin to roll out, communities across the country are already feeling the ground shift beneath their feet.
The impact of the One, Big, Beautiful Bill Act (OBBBA) is staggered, meaning the full scope of its effects won't be clear for several years. Yet, in states like Nebraska and Montana, the consequences are already making headlines—and sparking fierce debate over what kind of future the legislation will bring.
In Nebraska, the OBBBA has sent shockwaves through the state’s health care system. Dr. Nikki Romanik, a distinguished senior fellow in global health security at Brown University School of Public Health, wrote in News from the States on August 15, 2025, that the bill would slash about $6.5 billion in federal Medicaid funding to Nebraska over the next decade. The result? More than 78,000 Nebraskans—including thousands of children—are expected to lose their health coverage. "These harmful cuts aren’t happening in a vacuum. They’re part of a trade-off, in which health care for vulnerable Nebraskans is sacrificed to fund tax breaks for the rich," Romanik argued.
The numbers are sobering. The bill also cuts $322 million from food assistance programs (SNAP), putting 155,000 Nebraskans—including 64,000 kids—at greater risk of hunger. More than 70 percent of Nebraska’s counties will struggle with food access, and the hardest hit will be rural communities. In fact, just hours after the bill passed, Curtis Medical Center announced it would shut down because of these funding cuts. Two more hospitals, Avera Creighton Hospital and Ogallala Community Hospital, are now at high risk of closing, with three more not far behind. In the past two years alone, one in five Nebraska hospitals has already eliminated key services such as labor and delivery units, nursing homes, behavioral health, home health, hospice, and EMS services.
The OBBBA does establish a new rural health fund, but critics say it’s simply not enough to offset the damage. "A short-term grant doesn’t replace the steady, reliable funding that keeps small hospitals afloat," Romanik wrote.
For Nebraskans, the stakes are incredibly high. Nearly seven in ten hospitals in the state are rural, and 14 counties lack even a single primary care physician. Nearly one in six mothers has to drive at least half an hour to find maternity care—double the national average. When hospitals close, it’s not just about longer drives; it means longer ambulance wait times, more crowded emergency rooms, and real danger during emergencies. As Romanik put it, "Imagine calling 911 because you’re having a stroke and being told the nearest ambulance is 45 minutes away." For many Nebraskans, that hypothetical could soon become a reality.
The economic effects are also far-reaching. The OBBBA’s Medicaid cuts are projected to cause about 5,000 job losses and slash $28 million annually in state tax revenue, shrinking Nebraska’s economy. And while the rural health fund offers a glimmer of hope, many worry it’s a band-aid on a much larger wound.
Meanwhile, in Montana, the OBBBA is making waves for a very different reason. As reported by News from the States on August 15, 2025, the bill introduces a senior deduction that exempts Social Security income from federal taxes for approximately 200,000 Montana retirees. The deduction, which provides $6,000 for individuals and $12,000 for married couples on top of existing age-based and standard deductions, is expected to help 88% of seniors nationwide pay no tax on their Social Security income—up from 64% previously. For the 2026 tax year, a single senior could deduct up to $23,750 in income, while married couples could deduct up to $46,700.
Montana, with one of the oldest populations per capita in the country, stands to benefit significantly. Out of just over 1 million residents, about 230,000 are aged 65 and older, and nearly all are expected to benefit from the new tax exemption. The White House has called it "the largest tax break in history for America's seniors," emphasizing the goal of letting retirees "save more of their money" after decades of paying into the system.
The bill also promises wage gains for Montana workers, with real wages projected to rise between $3,400 and $6,100, and take-home pay increasing by $7,000 to $9,900. Additionally, Montana is set to gain 500 new housing units via Opportunity Zone incentives—federally supported development in economically distressed areas. While these homes aren’t specifically for seniors, they could expand housing options in places where retirees are increasingly priced out.
However, the benefits aren’t universal. The deduction is not refundable, so seniors who already pay no federal tax—those relying solely on Social Security or small pensions—won’t see additional savings. Similarly, high-income seniors will be phased out, with the deduction beginning to reduce at $75,000 for individuals and $150,000 for couples, and eliminated entirely at $175,000 and $250,000, respectively. Thus, middle-income retired homeowners—especially those still paying income taxes while facing rising costs—are most likely to benefit.
There’s another catch: the senior deduction is only authorized through the 2028 tax year. Without further legislative action, it will sunset, potentially leaving seniors scrambling to adjust once again.
Back in Minot, North Dakota, the OBBBA’s impact on food assistance programs has become a local election issue. On August 5, 2025, Mark Jantzer reacted to unofficial results as the next mayor of Minot, according to local news reports. The bill’s cuts to SNAP benefits have become a flashpoint, with many families worried about how they’ll put food on the table.
All told, the One, Big, Beautiful Bill Act is a study in contrasts—offering what some see as much-needed tax relief for seniors and wage earners, while others warn of deep and lasting harm to America’s most vulnerable. "This bill threatens the foundation of Nebraska’s health care, not just facilities, but the people and values that keep our communities strong," Romanik wrote. As the nation watches the bill’s effects ripple outward, the big question remains: Will the gains in one state be worth the pain in another?
For now, communities across the heartland are bracing for more change—and hoping that, in the end, the promise of a "big, beautiful" future won’t come at too steep a cost.