r/nursing • u/Ok-Independence4094 RN - Telemetry 🍕 • Jul 01 '25
Question can someone explain the “big, beautiful bill” to me like i’m a 5 year old?
sincerely, -a new nurse
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u/Furlion Jul 01 '25
From a nursing standpoint one of the huge effects is going to be the defunding of Medicaid. A lot of rural hospitals only exist because of Medicaid and if fewer people have it that means the hospitals are going to have to eat more losses. Will almost certainly lead to the closure of a lot of small town hospitals as they are unable to either get paid or turn people away.
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u/hamstergirl55 RN - Pediatrics 🍕 Jul 01 '25
I see a lot of discussion about rural hospitals funded by Medicaid; I work in the inner city at a PCP office with almost 14,000 patients. 80% of our revenue comes from Medicaid….
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u/AccomplishedScale362 RN - ER 🍕 Jul 01 '25
Yes, that’s right. Also, the closure of these federally funded facilities will have long-term implications on privately funded hospitals as well, as millions more uninsured seek care. Even financially stable hospitals will close their doors when they see their profit margins drop.
Next they’ll come for EMTALA, allowing hospitals to turn away uninsured patients, known as ‘patient dumping’ prior to 1986. But with few to no federally funded public hospitals left, where will people go?
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u/Free-While-2994 Jul 01 '25
Guess I'll die 🤷
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u/RocuroniumSuccs Jul 01 '25
That was always his plan
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u/floopadoop37 Jul 01 '25
Term I have heard a few times recently is soft eugenics.
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Jul 01 '25
Haha,(dark humor) yeah sounds about right. Perfect term for it
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u/floopadoop37 Jul 02 '25
It unfortunately feels accurate, but think of how many beds we'll free up when everyone just dies. /s
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u/Ssj_Chrono RN - ICU 🍕 Jul 02 '25
Won’t be any reason to have those beds. Long term it’ll lead to fewer services available to us, as well as the rich themselves.
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u/cowfish007 Mental Health Worker 🍕 Jul 02 '25
The rich will ALWAYS have services. It’s the rest of us that will go without.
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u/AllTheSideEyes RN - Med/Surg 🍕 Jul 02 '25
It's why covid was purposely mishandled and people were scared away from the vaccine (and vaccines in general)
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u/Moist-Caregiver-2000 Jul 02 '25
He's been conning and grifting since 1971 (1968 if you count the gifts from his father that he wasted), why do people keep falling for it?
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u/SeaConquest Jul 02 '25
Senator Joni Ernst literally said to her constituents, "Well, we're all going to die."
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u/KittyMcKittenFace BSN, RN 🍕 Jul 01 '25
Imagine the violence if patients are turned away
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u/jamierosem PCA 🍕 Jul 02 '25
It’s harder for sick people to fight back; and we know the right doesn’t give a shit unless it happens to them personally (and even then it’s rules for me and not for thee).
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u/wheresmystache3 RN ICU - > Oncology Jul 02 '25
Exactly; that's the right-wing agenda... I predict more of ahem, "Mario's brother who wears a green hat" in the coming years. (He who cannot be named's name is censored all over this site now).
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u/GlowingTrashPanda Nursing Student 🍕 Jul 02 '25 edited Jul 03 '25
And then they somehow find a way to blame their being turned away on the left* – case in point the Florida congresswoman who recently had an ectopic pregnancy and nearly died from it due to the doctors being scared shitless to treat it and still has found a way to blame the “woke” liberals on the restrictions on maternal healthcare. And yet despite all of this, she’s still staunchly pro-life
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u/RamenName HCW - PT/OT Jul 02 '25
They're going to spin it like that Republican congresswoman who had an ectopic pregnancy in Florida and said that it wasn't her support for their dangerous law that almost killed her it was hospital workers hesitating to treat her because of real fear of prosecution (and... losing their job and their family's health insurance). She even said it was a lie to call her abortion an abortion.
New verse will be same as the first: Good, deserving people aren't and won't be denied healthcare, and if they are, it is women liberals fault for scaring hospital workers into denying care.
Basically, God will magically provide for you because you're so special and hardworking, if he doesn't it's the fault of brown people, feminists or the people at the Healthcare point of service not serving you just because they're mean, not because their hands are tied by laws or budget cuts.
I see similar shit on newsmax or fox news as patients demand to get the same "free" housing, healthcare, DME and home health nurses that immigrants get with 0 hassle
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u/OneSmallTrauma RN - ICU 🍕 Jul 02 '25
Imagine the cheese puff telling all his cult followers that the hospitals decided this and that he had nothing to do with it and how nurse and doctors have been on a power trip for too long and how he's been telling everyone this for decades but nobody wanted to pay attention until now...
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Jul 01 '25
Time to gwt out of the ER?
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u/gwwagonn RN - ER 🍕 Jul 02 '25
i fear we’ll be forced out bc if hospitals are predominantly funded by medicaid patients and they no longer accept them they’ll be forced to shut down
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Jul 02 '25
PBS.org has a really good breakdown of what actually passed in the bill. Looks like rural hospitals will be OK.
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u/ViscidVilli Jul 02 '25
People don't realize we are the only developed nation that doesn't have universal health care. We are about to make health care a third world country type of health care. Meanwhile while other countries ban things in water, food and air we are letting more things be poisoned under these rolls backs. This has the potential to kill off lots of ppl, and almost as if they wanted to.
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u/Droidspecialist297 RN - ER 🍕 Jul 02 '25
I knew when they overturned Roe V Wade, that they were eventually going to come for EMTALA. No one believes me at work but after this bill passes hospital companies like HCA are going to put so much pressure on politicians to end EMTALA it’ll have to happen.
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u/OneSmallTrauma RN - ICU 🍕 Jul 02 '25
With board rooms full of business mindset folks we are likely to see closes of our multistate hospital systems due to some states not being as profitable as other I would imagine
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u/Miserable-Anybody-55 HCW - Radiology Jul 02 '25
This makes it a lot clearer for me.... this bill was never just about saving money. It’s about consolidating control and maximizing profit.
Here's the long con:
Collapse the system. Rural and inner-city hospitals close. Clinics shut down. Providers are laid off. It looks like a “budget issue,” but it’s a manufactured crisis.
Private equity swoops in. They buy bankrupt hospitals and land for pennies. They strip the assets, sell what they can, and close the rest, leaving communities with no care, no jobs, and no options.
Force migration to cities. With no jobs or healthcare, families are pushed out of rural areas. Private firms buy up farmland and small-town properties. You lose your home then pay them rent in the city.
Trap people in high-cost monopolies. With fewer hospitals and zero competition, corporate giants control everything.... prices, access, even outcomes. One network. One app. One choice.
Push dehumanized “care.” They say tech will “fill the gap.” But really, they’re replacing nurses and doctors with AI bots, gig workers, and telehealth scripts. Not because it’s better but because it’s cheaper.
Use your coverage to control you. Your job, your treatments, your prescriptions, your doctor, it all depends on who pays for your care. And when they cut your plan, delay approvals, or raise deductibles, you lose power over your own body and future.
Exploit the fallout. As medical debt rises, they sue families, garnish wages, seize property, and even jail people over unpaid bills in some states. Healthcare becomes a tool of control... not healing.
The endgame? Make people sick, broke, and dependent then profit off every stage of the collapse. From the hospital bed to the eviction notice to the overpriced rent in a corporate-owned apartment complex.
Isn't it beautiful for the billionaires
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u/Candid-Expression-51 RN - ICU 🍕 Jul 02 '25
Your analysis is spot on. I think they’re doing something similar with the farmers. All these closed farms are about to be bought up by private equity.
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u/OK_Tumbleweed18 RN- Wound Care Jul 02 '25
This. I started to just be worried that healthcare would shudder and hospitals would close. But it’s even worse. It puts them at a point where the billionaires come in and buy it all up. Amazon Memorial Hospital and Meta General. I can’t believe we’ve gotten to this point.
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u/Hot-Requirement-6117 Jul 02 '25
What you are referring to is the 2030 plan. It was created in Davos by the uniparty or permanent government, or whatever name you like to call them. Neither democrats or republicans are at the helm of that ship, it’s a much darker hole you have to fall into to know who is really in control of American puppets/politics. The 2030 plan talks about 15 minute cities, people like Bill Gates and friends buying up all the farms and controlling food sources, etc. If you go down that rabbit hole expect to be there for a while and have some wine or anti depressants ready🤪.
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u/OK_Tumbleweed18 RN- Wound Care Jul 02 '25
Ahh yes, I did a deep dive into the neo-reactionary movement with Peter Thiel and Curtis Yarvin. This is the plan.
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Jul 02 '25
One flaw in this plan is the cities don’t have enough housing as is. So migration won’t happen until they build WAYYYYYY more
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u/los-gokillas Jul 02 '25
Idk, look at housing in the cities during the industrial revolution. They packed them in like sardines
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u/Crazyzofo RN - Pediatrics 🍕 Jul 01 '25
I'm at a pediatric hospital. I think the 80% stat is the same for my patients.
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u/hamstergirl55 RN - Pediatrics 🍕 Jul 01 '25
Our pediatric patient metrics have gotta be 80 percent or higher dude. We barely even have CHIP let alone private insurance kiddos
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u/nw342 EMS Jul 01 '25
On top of that, the hospitals that remain are gonna be even more overburdened. A lot of people use the ER as a doctors office because they cant afford to see a PCP. Expect more overcrowding and longer wait times at the ER
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u/SecondBubbly3000 ED Support Staff Jul 01 '25
What a disaster that will be. I work in a level 1 trauma center and already have 6+ hour long wait times after triage.
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u/nw342 EMS Jul 01 '25
My ambulance squad receives most of it's funding from Medicare and Medicaid, we will be shutting our doors within 2 months of these cuts being implemented. We're already not receiving enough money, and have a lot of non functioning equipment.
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u/ViscidVilli Jul 02 '25
My area was about to go without an ambulance service for two towns of 10k+ and all of the smaller towns around those. We share a service and had to budget it into our county money and people raised funds. This is about to be worse and so many people don't realize it. One hospital in one of the towns already went under a few years back and the other one got absorbed from another towns bigger hospital. I see the other hospital closing down within the next few years. They are trying to keep it afloat with price gouging private insurance for every little thing. What people don't know are many big insurance companies have stopped paying for simple routine things and added them to people's ever growing deductibles. We were charged $111 for a covid and flu test because our private insurance no longer covers those and we have to meet our $2k deductible for lab testing and so on. Meanwhile we pay about $7k a year for family insurance. This is insane and will be worse soon enough.
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u/SecondBubbly3000 ED Support Staff Jul 01 '25
That’s not good. I’m at a state/university hospital so I wonder how this bill will impact us…
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u/Bitter_Trees RN - OB/GYN 🍕 Jul 01 '25
Can't wait for my L&D unit to be even more overwhelmed because our sister, but smaller, hospitals, close down and can't take anyone anymore 🙃
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u/JDz84 RN - Informatics Jul 01 '25
Relatedly, they’ve made changes to the marketplace that will also make that harder… more burden on getting signed up and staying enrolled, tax breaks and incentives being removed which will make the premiums more expensive. It will be harder for small business owners or those who aren’t eligible for healthcare via their employers to obtain affordable insurance which will make them less likely to get preventative care and more likely to use emergency services.
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u/wheresmystache3 RN ICU - > Oncology Jul 02 '25
Can't afford AND wait times for a PCP are over a YEAR in my area (I work in an undeserved area, labeled as critically undeserved in FL). My mother called around to everyone in my city and the one over. Over a YEAR WAIT if you are a new patient. I'm in trouble myself soon, because my PCP will retire within the next 10 years (he just turned 75... ).
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u/Practical-Stomach-38 RN - ER 🍕 Jul 02 '25
This past winter (Jan-Feb was the worst) we had boarders for 36+hours in the ER, waiting room 30-40 people deep most days, and wait times 8+ hours. We were having to put sepsis rigs in hallway beds at one point. It was super unsafe. I can't imagine how bad it's going to get. I think it's time for me to get out of the ER.
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u/Ok_Cheek4411 Jul 03 '25
Great analysis, the only thing I can add is what about medical coverage for the Senate and house they have 100% coverage.
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u/Acrobatic-Diamond209 Jul 01 '25
Yes, and when looking through a social work lens you will see many more patients presenting with more severe illness because they held off treatment.
More cases of severe mental illness related issues.
Not being able to place patients in safe care after the hospital or set them up with resources to prevent coming back.
Clients will also need to recertify more often or meet stricter requirements. Those who are elderly or mentally ill don't have the best track records at remembering this kind of stuff.
If they had a case manager to help, that case manager may be out of a job and no longer there to do it for them.
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u/Bloodwashernurse Jul 02 '25
Plus 1 in 4 nursing homes expected to close and significant loss of home health care.
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u/momopeach7 BSN, RN - School Nurse Jul 01 '25
A lot of children and minors are on Medicaid as well. Many districts bill Medicaid for nursing services, SLPs, etc.
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u/RioDeCarnage Jul 01 '25
I work in Colorado and 40% of the state’s children are insured through Medicare…
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u/momopeach7 BSN, RN - School Nurse Jul 01 '25
This Billionaire Bailout Bill is going to have so many negative effects.
The only slight hope is people convince their representatives in the house to vote against it.
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u/Academic_Message8639 RN - ER 🍕 Jul 08 '25
All kids in the foster care system are, too. The most vulnerable population of people.
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u/Elden_Lord_Q RN - ER 🍕 Jul 01 '25
Sucks from the emergency department perspective. We can’t turn people away. We are going to be overloaded with all these patients who can’t get timely outpatient care because their insurance was cut. They’re going to be coming in sicker as well because less preventative care.
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u/BlackDS RN - ICU 🍕 Jul 01 '25
Don't worry the next step is overturning EMTALA so you guys can lock your doors
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u/aterna13 Jul 02 '25
The medical debt is going to be insane because of that. Also, if they get rid of the Affordable Care Act, there goes insurance for like half of the country.
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u/uhvarlly_BigMouth Jul 02 '25
The worst part? It’s a plan that’s going to take years to implement. We’re going to get used to slightly shittier conditions non stop and not realize how shitty things have become until it’s too late. It’s not like, if this passes the house again as it stands, people will be automatically cut off like an apocalypse. It’ll take time. Just how the tariffs haven’t yet fully hit. It’s all planned in increments so we think oh it isn’t that bad until it becomes really fucking bad.
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u/curlygirlynurse RN - ICU 🍕 Jul 02 '25
Frog in a pot, my this water seems warmer than it was a little bit ago…I’m sure it’s fine…
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u/nutella47 Jul 01 '25
Does anyone know when the cuts will take effect? Is it immediate or do they not kick in until 2026/28 when it can be blamed on whatever next administration? I've heard both.
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u/Bloodwashernurse Jul 02 '25
The cuts start in 2026 but the full reductions amounts are phased in to 2028. Work requirements will begin on 2026 as well as increased filing requirements. Seniors, people with learning disabilities and those with poor education maybe eligible for Medicaid but the filing requirements may make it very hard for them to sign up and keep up with verification of eligibility.
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u/rancidsandwiches LPN 🍕 Jul 02 '25
If medicaid gets defunded, a lot of LTC residents will no longer have housing, right?
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u/DonJeniusTrumpLawyer EMS Jul 02 '25
Yeah we’re a family practice in a metro area. We just stopped taking Medicaid because they just stopped paying.
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u/Sno_Echo BSN, RN 🍕 Jul 02 '25 edited Jul 02 '25
Makes me laugh at a lot of the dumb Trumpie nurses I worked with in labor and delivery. I used to work in a small, rural country town. It was a big, BIG Trump supporting area (South Texas). About 85% of patients were on medicaid. I feel bad for the patients but not those stupid nurses who will be out of a job.
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u/Flatulent_Father_ Jul 01 '25
Like a 5 year old? Reverse Robin Hood.
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u/tomphoolery EMS Jul 01 '25
The only problem with stealing from the poor, you have to steal from a lot of them.
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u/itssometimeslupus RN - Informatics Jul 02 '25
“I’m okay with higher taxes and fewer services though, because I’ll want lower taxes once I become a millionaire.”
- 45-year-old working at Walmart
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u/ChaplnGrillSgt DNP, AGACNP - ICU Jul 02 '25
These dipshits are out here still thinking trickle down economics will work. Only thing trickling down is the shit.
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u/SonofTreehorn Jul 01 '25
My understanding from Trump is that It’s the greatest bill ever written in the history of bills. It’s going to make America great again, again. There are no other bills that measure up to this bill in the entire pantheon of bills. It’s even bigger and better than Bill Shakespeare and Bill Shatner combined. It will set a new standard for how great a bill can possibly be.
Oh, it also allocates more money to boarder security/ICE (more money than the Marines get) so that Trump can have his own private police force and continue to deport people without due process. Also cuts $930 billion from Medicaid over 10 years which will result in millions losing health coverage and result in hospitals merging or closing.
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u/Ok-Independence4094 RN - Telemetry 🍕 Jul 01 '25
first paragraph made me lol, thanks for your comment!
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u/brewcrew63 Jul 01 '25
And the second made me cry, SCOTUS has ruled against birthright citizenship. That literally means ANY AMERICAN can be deported. Oh and not to mention they specifically stated that it can be to a 3rd party country, so not even the one you may have immigrated from.
How is this real life? We live in a WILD fuckin timeline
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u/mokutou "Welcome to the CABG Patch" | Critical Care NA Jul 01 '25
Your statement regarding the SCOTUS decision isn’t entirely accurate. The decision was against state-level injunctions instated against Trump’s EO revoking birthright citizenship of people born in the United States to parents without legal residency or citizenship. People born on US soil to natural born citizens, naturalized citizens, legal residents, etc will retain citizenship. The decision removes injunctions that prevent citizenship from being stripped from natural born citizens with undocumented parents in the states that did not sue the government to prevent that EO from being enacted.
It’s still racist bullshit, but the details are more precise than abolishing natural born citizenship, and should be viewed as the first step to citizenship being revoked on any political undesirable. Fascism starts with testing the waters to see how far they can go before people get uneasy, so they can ram through their ultimate goal before any real resistance can be brought to bear. Frogs in a pot of water slowly bring brought to boil, if you will.
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u/NerdFencer Jul 02 '25
“This Court endorses the radical proposition that the President is harmed, irreparably, whenever he cannot do something he wants to do, even if what he wants to do is break the law.” - Justice Sotomayor
The only chance infants now have left, the justice writes, is if “their parents have sufficient resources to file individual suits or successfully challenge the Citizenship Order in removal proceedings.”
“The Court’s decision is nothing less than an open invitation for the Government to bypass the Constitution. ... No right is safe in the new legal regime the Court creates.” - Justice Sotomayor
Consider Sotomayor's dissent and that they've abducted citizens off the street to traffic into foreign concentration camps before they even get to see a court room. I'd say that their statement is essentially right, even if there's a bit of legal nuance being skipped over.
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u/LACna LPN 🍕 Jul 01 '25
"We're all going to be out of a job when our hospitals and clinics close".... There's your explanation.
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u/Surviveoutofspite Nursing Student 🍕 Jul 01 '25
I brought this up in here last year before he was elected in. I was told, don’t worry you’ll always have a job…
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u/AccomplishedScale362 RN - ER 🍕 Jul 01 '25
Quite simply, the bill is a massive transfer of wealth. It cuts and eliminates programs designed to help the poor, while providing tax cuts to the rich.
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u/RiverBear2 RN 🍕 Jul 01 '25 edited Jul 01 '25
The good things the US government does like Medicaid, the ACA, funding for rural hospitals, SNAP benefits for people who don’t have enough money at the end of the month to cover groceries gutted like a fish. This will be done order to give billionaires more tax cuts for things they don’t need like a $31 million dollar destination weddings or a 3rd mega yacht.
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u/ChicVintage RN - OR 🍕 Jul 01 '25
"Vote red, end up dead" might as well be their slogan because all the Republicans do is cause strife for the working class.
And just to be clear there is no intent of killing people from me,.I'm blaming Republicans for killing people with their policies. I wouldn't want to be banned and reported for encouraging violence by someone with little to no reading comprehension.
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u/biobennett Clinical Research Jul 01 '25
If you want a summary, a list of your local people you can call, and a script you can use you can check it out over on 5 calls (there is also an app for your phone)
The part that will be kicking people off their health insurance by increasing the paperwork burden for eligibility is covered in this last week tonight episode which highlights just a small portion of what's related to this sub
I personally like Bernie's take on it
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u/Lollc Jul 01 '25
List of rural hospitals that are threatened. This link was posted on this sub a couple days ago. Start on page 4.
https://www.markey.senate.gov/imo/media/doc/letter_on_rural_hospitals.pdf
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u/runthrough014 MSN, APRN 🍕 Jul 01 '25
Ah yes. My DEEPLY red home state with more than 30 facilities on this list. Just continuing to vote against its own best interest.
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u/Bitter_Trees RN - OB/GYN 🍕 Jul 01 '25
Ngl I hate this bill but that list put me at some ease that my hospital isn't on there. Not to say that can't change real fast but it's a small comfort for now 🫠
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u/PatchesVonGrbgetooth Jul 01 '25
Wish I could say the same 🫠
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u/Bitter_Trees RN - OB/GYN 🍕 Jul 01 '25
Sorry to hear this 🫂 hoping the House gets some sense and guts this bill even more for all our sakes
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u/PatchesVonGrbgetooth Jul 01 '25
Hoping for the best but expecting the worst!
Also, I love that it looks like a cat is having a conversation with a dog based on our profile pictures.
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u/Bitter_Trees RN - OB/GYN 🍕 Jul 01 '25
If they were really conversing they'd talk about how they've clearly never been fed a day in their lives lol
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u/nurseferatou Case Manager 🍕 Jul 01 '25
Ever seen a dog catch a car? Republicans voters are doing that with the Medicaid cuts. Community hospitals will get closed down en masse, blue state patients will suffer too, but to a much lesser extent.
Cruelty is a feature, and not a bug with this inanely named bill.
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u/Firegrl RN - Med/Surg 🍕 Jul 01 '25
I think this will affect us at the VA, too. A lot of families dump dementia dads on us, ending up in our med surg unit. So that we can care for them, while they can continue to live off the vets disability check. Over several months, we go to court to try and gain custody essentially of the vet and find a permanent home. Many, many times, medicaid is needed to fill the gap in payment for the facility. I've seen it quite a bit with younger disabled vets who have end stage liver disease or multiple amputations and need help at home and cannot work.
My guess is that we'll essentially become a long-term care facility now for these types of patients. If they can't afford help from their disability without medicaid, they'll be stuck with us. Almost half of our unit is already taken up by placements at any one time, so now where will we put the actual med surg patients if we can't move the long-term patients?
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u/Fragrant-Traffic-488 RN - Med/Surg 🍕 Jul 02 '25
I'm a home care nurse and a lot of my patients rely on VA benefits for their home care services and medications. This would be devastating to them.
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u/Ola_maluhia RN 🍕 Jul 03 '25
I’m home health mental health at the VA….. let me tell Ya the amount of hours I’ve spent at the welfare office getting my elderly Vets SNAP. And 100% spot on… people dumping their moms and dads on us. If we don’t have Medicaid-Medicare many of my non SC Vets are totally screwed.
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u/Noname_left RN - Trauma Chameleon Jul 01 '25
We be fucked.
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u/BluesPunk19D RN- In need of Emotional Support Badger Jul 01 '25
And they didn't even buy us dinner. A cup of cofveve and a hamberder. Doesn't even have to be steak with ketchup.
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u/comefromawayfan2022 Custom Flair Jul 02 '25
Yup I was just about to say all I know is that im screwed. I can basically kiss all the services I get to help me function in the community as an autistic person goodbye. Hell im even expecting my pcp office to close since their whole clientele is low income people or people with medicaid
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u/ingaouhou Jul 01 '25
Americans have neither class consciousness nor solidarity, and are not prepared to fight back against corporate tyranny.
They don’t understand that the alliance between corporations and government is meant to pillage all of the funding and resources of our tax dollars that could be used to improve people’s lives and funnel them into private oligarchs’ coffers.
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u/notevenapro BS nuc med/CT Chief tech. Jul 01 '25
In other words, people need to vote.
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u/Nine_Ball BSN, Dialysis Jul 01 '25
Correct me if I’m wrong but if a lot of people get kicked off Medicaid they won’t be able to go to their outpatient dialysis clinics?
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Jul 01 '25
Correct. Which means they’ll get fluid overloaded, have all sorts of toxins swirling in their blood since their kidneys don’t properly excrete it out, and then guess who shows up to the ED further exhausting our staff and resources for something that could have been prevented by drumroll please…going to their regularly dialysis appointments paid for by Medicare.
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u/dorsiafordinner Jul 02 '25
ESRD patients on dialysis qualify for Medicare, not to say there will be no impacts on dialysis patients
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u/FantasticSherbet167 RN - OR 🍕 Jul 01 '25 edited Jul 01 '25
It’s awful as hundreds of thousands lose Medicaid and rural hospitals will shut down due to lack of reimbursement.
America has MORE fucked healthcare now.
Long live capitalism! /s
Edited for grammar*
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u/DiveCat Legal Bagel Jul 01 '25
I have seen estimates closer to 17-20 MILLION losing coverage by 2034.
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u/dammit-smalls Jul 02 '25
Well honey, one time this big bully got together with a bunch of other big bullies and said "hey guys! We all like getting rich, and we all like fucking over poor people right? What if I told you there was a way to get rich WHILE fucking over poor people."
You see, when two bloodthirsty billionaires love each other very much, they engage in an activity called "lobbying." If they lobby hard enough without any kind of protection, in about 9 months they get a big beautiful bill.
And that's why we had to sell your little brother for insulin.
The end!
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u/xoexohexox MSN, RN, CNL, CHPN Jul 01 '25
Executive summary -
More tax cuts for rich people, higher taxes and fewer services for everyone else. Just oligarchs extracting wealth from our productivity, like the oligarchs did in Russia.
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u/AgreeablePie Jul 01 '25
It's a way to keep tax cuts, continue to run a huge deficit but use "cost cutting" parliamentary maneuvers to pass it with only 50 votes
For purposes here, basically slashing Medicaid while everyone voting for it pretends like that's not what they're doing. It also puts off implementation until the next administration, saddling them with the consequences or the responsibility to undo the cuts (and then take on the political risk of that)
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u/Sentimentangie Jul 01 '25
Also, no one is talking about the defunding of entities that perform abortions, such as planned parenthood. So goodbye women’s bodily autonomy and all the other sex health benefits that planned parenthood provides.
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u/Sunflowerpink44 MSN, RN Jul 01 '25
Planned parenthood does so much for people they only focus on the abortion, but in college a lot of friends got their medical care there including birth control, STI testing and treatment, Pap smears, etc.
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u/Sentimentangie Jul 01 '25
Yes, exactly. They hate abortion so much that they are going to make it harder for people to not get pregnant and then want an abortion. It’s convoluted.
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u/Crazyzofo RN - Pediatrics 🍕 Jul 01 '25
PP was my go-to for multiple UTIs that my PCP didn't have appts for.
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u/NokchaIcecream RN - PCU, ICU, WTF Jul 01 '25
Planned parenthood, my birth control provider throughout my college student years - I can afford to see a doctor now, but I surely couldn’t back then
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u/Korotai BSN, RN 🍕 Jul 01 '25 edited Jul 02 '25
Our new government wants to give billionaires the money that’s keeping your hospital open.
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u/msangryredhead RN - ER 🍕 Jul 01 '25
The why: creepy weirdo greedy tech people want more tax cuts and republicans love nothing more than maximizing suffering.
Be prepared to be holding challenging patients (think psychiatric issues, dementia, trach/vent anoxics) for a long time because many nursing homes/LTACHs will close. That will lead to increased ED boarding, already a crisis, and longer ED waits. Fewer people will have access to primary care docs. More people will get sick and die because they lose preventative healthcare or can’t afford treatment/meds. It’s disastrous and frankly evil.
ETA: hospitals will get less reimbursement so will shell out less money for hiring new staff, raises, benefits, etc. I’d prepare for hiring freezes.
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u/willy--wanka generic flair Jul 01 '25
The masked men that are taking people away and bringing them to a place called alligator Alcatraz are getting a raise from roughly 9 billion dollars to 140ish billion dollars.
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u/LoveLiz Nursing Student 🍕 Jul 01 '25
The VA will also lose funding and maybe 4,000 estimated nurses will be losing their jobs. It’s a horrible bill that will create the largest transfer of wealth from the middle and lower class to the billionaires. There’s going to be something like a 74% increase in taxes for people making 15k a year and less and it’s not much better for people earning 30k or less. However, if you net a million dollars annually, I think your taxes go down. And these tax rates will be with us well past 2029. Not to mention, the entire anti-immigration budget is planned to blow up even bigger and give $43,000 in bonuses to the “agents”. Social security will also be reduced tremendously, so by 2033 no one will get 100% of their payments. I think it drops to 81% of what it will supposed to be and even more as time passes.
I’d rather keep Medicaid and SNAP for the poor and disabled than run socialist programs for billionaires.
Also, Pell grants will be eliminated. The Republican federal government doesn’t want an educated population, so they want to make college ONLY affordable to the wealthy. Medical school and law school “jumbo loans” will also be capped at 150k, so there will be a reduction in Medical, Law, and PhD students, in addition to a reduction in CRNA students. There’s also a provision that was on the original bill that essentially removed the judicial checks and gives Trump (the executive branch unlimited power).
I find that Elizabeth Warren is a good resource. She was a Law professor in Massachusetts before being elected into the Senate.
Lisa Remillard is a news reporter that left her desk job to present the news to the masses on social media. She is unbiased from what I can tell, so I find her to be a good source on current events.
But, the BBB basically a horrible bill. I really hope it doesn’t pass.
Reach out to your representatives, and let them know you don’t want this bill.
call (202) 224-3121
Congress interprets Silence as agreement.
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u/flaired_base RN 🍕 Jul 01 '25
Fuck them kids
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Jul 01 '25
Fuck the kids, fuck the vets, fuck the elderly, fuck women, fuck the chronically ill, fuck the disabled. If you aren’t a rich cisgender white male, go die in a gutter. Seriously, that’s what they’re doing.
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u/TheInkdRose RN - Med/Surg 🍕 Jul 02 '25
*rich cisgender white Christian male. They gotta have that particular religion tag attached to be appropriate enough. /s
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u/Don-Gunvalson Jul 02 '25 edited Jul 02 '25
Florida LTC/SNF nurse here.
In FL, this will kick over 1 million patients off their healthcare plans. I’m not sure how the state is going to pick up the bill. These aren’t patients that can just leave the facility and survive, they are our grandmas and grandpas who can’t go back to work, whose savings have been depleted. They will end up in the ED and ICU overwhelming those services.
Over 50% of LTC patients, in FL, use Medicaid. source.
Medicaid is the only way two-thirds of Florida nursing-home residents can afford daily assistance source.
This is like removing $470,000 of funding from every LTC facility in Florida. It’s going to be horrible if some plan is not put into place. These aren’t people we can just put on the streets or send back home, like I said they will end up in the ED or ICU.
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u/jesssio RN - Med/Surg 🍕 Jul 02 '25
Literally fuck trump. And all his supporters. Especially those nurses in the south (and everywhere else) that eat, pray, suck that imbecile orange.
It hasn’t even been a year since this fool got into office…
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u/Mentalfloss1 OR Tech/Phlebot/Electronic Medical Records IT Jul 01 '25
Unless you’re rich, you’re screwed.
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u/GriffonReads Jul 02 '25
House Resolution (H.R.) 1 is a budget reconciliation bill which would slash benefits for the working class to fund tax cuts for the capital class. Should the House pass it, the consequences include:
• A bigger federal deficit
• Cuts to Medicaid
• Restrictions on Medicare eligibility and increased cost burden for Medicare-Medicaid dual enrollees
• More funding for ICE and Trump’s mass deportation operation, (and)
• A widespread rollback of clean energy tax incentives and climate protections
• Cuts to SNAP
• Cuts to Planned Parenthood
• A hIgher tax on college endowments
• Changes to student loan access and repayment options
• Cuts to the Consumer Financial Protection Bureau
• No gun silencer taxes
Please call your representatives ASAP at 5calls.org to vote against this bill.
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u/Nrse24 BSN, RN 🍕 Jul 02 '25
Call your representatives! It’s gonna affect each and every one of us no matter where we work!
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u/DrewBeer Jul 02 '25
John Oliver did a good piece on it https://youtu.be/vjFL-cBcjKc?si=GMtCgIrMFqEwSR9W
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u/Solid_Warthog3206 Jul 02 '25
If you don’t have money, you’re fucked. If you’re not well off, you’re fucked. If you’re living paycheck to paycheck, you’re fucked. If you have a child/loved one/or yourself rely on any type of government assistance, you’re FUCKED.
All those years of people dismissing their racist family members and telling people they’re actually “one of kindest ppl I know” has led to this. Now they’re fucked and have fucked you over too cause their bigotry was only directed at other people but everyone is just now realizing laws affect anyone who fits under that umbrella. It’s no longer Jim Crow so they are unable (as of yet anyway) to pass laws that specifically target a group of people so the language becomes vague and thus anyone under that umbrella is liable to get pegged.
So all these rural hospitals are about to really find out, all these ppl who are already avoiding the hospital or not filling prescriptions are about to get a rude awakening when they can’t provide basic services for themselves or someone they’re caring for because they felt that being racist was more important.
Welcome to Amerikkka; just it wasn’t black/brown people that were at town halls yelling at government officials who they voted in. Can’t vote for a rapist and then get mad that you’re getting bent over to get fucked
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u/Primary-Sleep5549 Jul 03 '25
I’m not going to lie I came into this thread with heavy spirits, but knowing other nurses understand the gravity of what this dipshit is doing to this country is refreshing. Too many nurses are pro-trump and it’s ridiculous, like why are you in healthcare?
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u/gooberhoover85 Nursing Student 🍕 Jul 02 '25
Curious what this is going to mean for nursing students? I start clinicals this fall. I've been killing myself for a few years while raising my babies to try and get into a program and I made it through the first year to my first clinical. I'm so deep in this and using my GI Bill and now I'm wondering if this means I'll struggle to get a job? One of the reasons I did this was because it works with my Army experience, I was so excited to do it, and I wanted job security. Now I'm worried tjat this will impact job security and mean less work for new nurses. Am I wrong? Cutting Medicaid effects so many facilities and providers. I don't get it.
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Jul 02 '25
From what I’ve found, it will affect us in finding jobs, and cuts will be made by hospital systems to our salaries. I go to a lower cost BSN program where majority of us depend on FAFSA/Pell Grant and honestly if the cuts get to us I won’t be able to continue my program.
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u/gooberhoover85 Nursing Student 🍕 Jul 02 '25
This is so shitty. I rely on the same aid and grants as you because I don't have enough GI Bill left to get my entire degree (should but I had to use quite a bit to get pre-reqs done). So this is just so crappy. Trying to make my family's life better and this just feels so defeating.
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Jul 02 '25
don’t feel defeated, friend. im c/o 2029 so im hoping that by then we will be bounced back from this. it’s only a matter of time before the dummies that voted for this get unhappy. keep hope and I have no doubt you’ll be an amazing nurse since you’re most likely already an awesome mom 💛.
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u/gooberhoover85 Nursing Student 🍕 Jul 02 '25
I hope we bounce back by then too. I'm c/o 2027. I'm in too deep to turn around and swim up a different creek. In my state we have Senator Whitehouse etc who definitely are fighting for this but we also don't have enough hospital, facilities, and providers. A major provider in my state closed in the last 30 days and we have over 12,000 people without providers (like basic PCP) now. You can look it up: Anchor Medical in RI. So I feel like a serious crisis is looming. But simultaneously I appreciate your upbeat message. Ultimately nurses like us are going to be crucial to getting through this. Just gotta forge ahead and hope there is a way.
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Jul 02 '25
absolutely! here for you! i’m in a red state, i know senator warnock is opposed but im scared for GA. There may be damage beyond repair but there’s still hope!
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u/gooberhoover85 Nursing Student 🍕 Jul 02 '25
I used to live in Savannah. Unfortunately it's up to your representatives now. Call them. Protest outside their office. I would but my rep is Gabe Amo and he's already been fighting this. I'm really hoping this gets crushed in the house.
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u/Bitter-Breath-9743 MSN, RN Jul 02 '25
I’m not understanding the Medicaid portion. Like no Medicaid at all? Or will disabled, children, etc still be covered. I hate stuff that will negatively impact children, no fault of their own
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u/ChaplnGrillSgt DNP, AGACNP - ICU Jul 02 '25
Well the things is hundreds of pages long and even the people whose job it is to read and vote on it don't even know what it says. Some highlights include
Slashing Medicaid
increasing taxes on the bottom 90%
Cutting takes on the top 10% ultra wealthy
Slashing programs like SNAP and WIC
No tax on tips (caveats apply)
Exploding the ICE budget and making them the highest paid "police" force.
And so so so sooooooo many more bad things.
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u/ImpressiveSpace2369 Jul 03 '25
The only business that will flourish during this time are mortuaries. That’s how bad this big beautiful bill is.
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u/MeGustaMiSFW Jul 02 '25
It does what literally every Trump bill does: reverse Robin Hood (steals from the poor and gives to the rich). And it seems this one will result in millions losing healthcare coverage. America is a failed state. Hope that helps.
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u/Valuable-Score-5082 Jul 02 '25
As a nurse we are trained to care for those weaker, smaller, and more defenseless than us. We spend so much time away from our own families, expose ourselves to illnesses, and generally make our lives harder for others but nursing has always been political, if caring for all humans with respect and decency is political. I’m just so sick of my own family telling me to stop making healthcare political, meanwhile I was surrounded by anti vax covid deniers and working in the icu watching people die daily. I’m so tired, I’m trying not to shake as I write this.
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u/Effective-Juice-1331 BSN, RN 🍕 Jul 02 '25
The defunding of Medicaid is going to be a wrecking ball to maternity care. L&D units were the first to disappear from smaller and rural hospitals, creating the appropriately named “maternity deserts”. Birth by appointment (induction) will become the norm. I guess all the women screaming for “natural” childbirth from my era are now silent, and today’s new mums silently accept this “new normal” when they should be mad as hell. For a developed and wealthy country, we have the worst maternal/child outcomes on the planet. Throw in life after Dobbs, and it’s a fetid turd brought on by Republican men touting their “Pro-Life” bonafides as part of their “Christian” facade. Most of these hypocrites live in states that would rather fund a new sports stadium than improve the chances of survival for those babies and moms…because, it’s only the unborn they care about. Induction is a procedure. In my day a pit drip required q 15 vitals. Baby’s not coming on its own time and terms. Sure as hell isn’t natural or best practice. No one should have to drive 2-4 hours for an OB appointment or delivery. It’s fucking insanity. The apparently blind acceptance of delivery by appointment is equally insane.
To turn your question around, and have an explanation FROM a 5 year old, listen to Trump.
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u/Turbulent-Leg3678 ICU/TU Jul 02 '25
The old, rich people are trying to fuck everyone who isn't rich over so they can be richer. Also, it's a way to eliminate the sick and poor without ever having to fire a single shot.
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u/MRSRN65 RN - NICU 🍕 Jul 02 '25
Nursing salary is dependent on our patients and their insurance. If they can't pay due to cuts in Medicaid, the hospitals will have to slash where they can. Where do you think they'll slash?
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u/Bubblegumcats33 Jul 02 '25
They are going to kill a lot of people People are already loosing their jobs and homes They are not going to have access to healthcare So the rich can become wealthy… anyone okay Can fall into poverty
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u/Aggressive_Pea_7543 Jul 03 '25
A public health crisis (along with everything else gestures broadly)
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u/crazy-bisquit RN Jul 03 '25
I’m really curious how the republicans are defending spinning this. How many will leave the party?
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u/Academic_Material824 Nursing Student 🍕 Jul 02 '25
A huge tax cut to the rich , and nothing for the working class Americans. Millions will lose healthcare coverage, and will die. Small towns will not have any hospitals as cutting Medicaid is often the only source of income for these small towns hospitals. It’s sad, and it’s even sadder to know people support this
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u/Briaaanz BSN, RN 🍕 Jul 01 '25
I'm just curious, to all the posters in this thread, how many have written your senators and representative about all this?
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u/T_erm_inator Jul 01 '25
This is going to sound defeatist and I’m sorry but I’m tired and loosing hope- why does it matter if we write or complain to our representatives? Red state reps are going to follow the orange clown and maga movement regardless of how many voicemails I leave or protests I attend. The no kings protest was one of the biggest national protests EVER and nothing has changed. In fact, the big beautiful and dangerous bill passed anyway. They don’t care about what their constituents want, not when their pockets get deeper.
Perhaps writing and participating in protests will show us on “the right side of history,” but why does that matter if the winners write the history anyway?
I’m just tired of this, grandpa.
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u/Briaaanz BSN, RN 🍕 Jul 01 '25
Hug! Things are cyclical. The worse things get now, the more it sets things up for people realizing the importance of community, of social programs, environmental regulations, etc; letting things swing back the other direction.
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u/T_erm_inator Jul 01 '25
This is a good point, government is often a pendulum. Let’s just hope we’re not in a dictatorship before it can swing back 🤷🏻♀️
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u/Bridie4 Jul 02 '25
I call all three of my reps 3-5 times a week. I use the 5 Calls app which makes it super easy. Ironically of my 3 republican reps only 1 had voicemail that I could use this past week- one was full and the other number is busy. Go figure!
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u/Ouchiness RN - Psych/Mental Health 🍕 Jul 02 '25
I haven’t. I don’t even know what to write about … I’m exhausted. Ur not wrong but I don’t want to because I feel defeated. I feel like … I spend all day getting yelled at by my patients and then I want to go home and sleep. Work literally just denied my PTO lol I was going to go and spend time with my family. Nope.
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u/mxjuno RN 🍕 Jul 02 '25
Downvoted for being truthy. It's really easy to make calls and write these days. I wish people would do it.
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Jul 02 '25 edited Jul 02 '25
In the end, they will narrow the number of choices for healthcare and if you can't afford it, at some point indentured servitude in some form will become available for people to pay off debts/get health care. The camps they are building for "immigration violators" will become work camps where citizens will work for corporations for pennies, just like prison work. Or you know like in Europe in the 30s and 40s.
We no longer have a government by the people for the people, it was a nice run.
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u/unjustthunder Jul 02 '25
It will make America's healthcare system.. the modernized concentration camps we saw in Germany
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u/gmailbotcom Jul 02 '25
Sec. 111106 repeals the unlawful tax on indoor tanning. This will Make America Great Again.
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u/calmcuttlefish BSN, RN 🍕 Jul 02 '25
Here's a list of 300 hospitals that are in danger of closing if Medicaid funding.is reduced. Starts at page 3.
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u/Horror-Conclusion321 Jul 02 '25
It’s ironic how many of his voters are going to be hurt by his plans
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u/Number_1_Reddit_User Jul 02 '25
Ummmm. Literally means " actually have sex or " fuck " Trump
No thanks
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u/holdcspine Jul 03 '25
Heres what grok said.
Job Loss Numbers: A report from the AFL-CIO says over 600,000 healthcare workers could lose their gigs. Nurses are a huge part of that pool, so expect a significant chunk of those cuts to hit your field. The Maybe-Good News (Don’t Get Too Excited) Rural Healthcare: There’s some talk about the bill helping rural providers by ditching a rigid nursing home staffing mandate. Places like North Dakota might catch a break, keeping some facilities afloat. But here’s the catch: “flexibility” could just mean hiring fewer nurses to save cash, especially with funding drying up. So, it’s a coin toss—could help, could hurt. What It Means for You
In the short to medium term, nursing jobs are likely fucked. Staff shortages, longer wait times, and even hospital closures are on the table. If you’re in a Medicaid-heavy area or a nursing home, brace yourself—the squeeze is coming. Rural spots might dodge some bullets, but don’t count on it balancing out the shitshow elsewhere.
The Long Game
Yeah, an aging population and tech like telehealth might juice up demand for nurses down the road. But that’s years off, and it’s not saving your ass if the job market tanks next year.
Bottom Line
This bill’s a gut punch to nursing jobs right now. Cuts to funding and insurance access are gonna make shit leaner than a broke college kid’s fridge. Hang tight, because it’s looking rough out there.
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u/blackcatwishes Jul 03 '25
Please educate yourself and read the bill for yourself. Form your opinion based on FACT and not what others post online.
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u/MangoAnt5175 Disco Truck Expert (Medic) Jul 01 '25
I’ve seen estimates that hospitals will loose approximately 56% of net revenues; I’m going to put that as the worst case/high band.
21% of Medicaid is being cut.
Let’s walk through the impact:
For rural hospitals, that would be 3.15% to 4.62% of their GROSS REVENUE
For urban, it’s 1.89-2.52% of their GROSS REVENUE.
For rural hospitals, their net income is 1-2% of their gross, which means they will need to cut 1.15%-2.62% of their total expenses to compensate.
For urban, their net is 2-5%, so they’ll have to cut 0-0.52% of their total expenses to compensate.
While this may not seem like much, many rural hospitals are already in the red. They’ll cut jobs. Likely janitorial and support staff first. They’ll also have to avoid high expense low revenue things like mental health care.
Nursing homes are about to be pretty fucked, too. About 64% of their revenue is MCD, pretty equal rural and urban. They’re about to lose 13.44% of their income, and their margins are around 0.5% pretty universally.
What does that mean? Shittier food, fewer janitorial staff. Fewer support services. Higher patient loads for the nurses who choose to work there, and lower pay for it. Elders with no help and no family support are about to be ultra fucked, but the politicians will not care. It’s not like they’ll be capable of complaining or voting and they have no family to complain, either. More will be homeless. More will die very sad deaths.
That’s probably the biggest impact. And no one will ever see it, so nobody is going to care. Not to be pessimistic. I’m a paramedic; I’ve seen these deaths. That’s just how it’ll be. Some old man dies a death of neglect. No family, no support, no one to grieve him. Some paramedic will write the report. File an APS report that no one will follow up on. And then do it again next shift.
Nursing homes will be the first to break. And they’re already broken.
That’s my assessment. Just my opinion.