Over half the MAGA Murder Bill’s healthcare carnage will kick in Before the Midterms

Fellow Michiganer Charles Gaba has an excellent post on his site ACA Signups, “Head’s up: Over half the MAGA Murder Bill’s healthcare carnage will kick in BEFORE the midterms.” Brief introduction:

Good place to go to for Tr__p’s Beautiful Bill Act information impact on healthcare. There is a large degree of developing uncertainty coming out of this administration much of which has not kicked in as of yet. It is coming though. The impact of the cuts in staffing at the Federal Government level have not taken place yet. We are only hearing of delays and shortage of staffing. Six months into his term in office and we are still hearing of an impact. As Charles Gaba write, the bills passed by Congress and signed off by this president are scheduled to take place after midterms. Charles . . .

Ever since the MAGA Murder Bill (officially H.R. 1, the so-called “One Big Beautiful Bill Act”) was passed by Republicans in the U.S. Senate & House and signed into law by Donald Trump a few days ago, I’ve seen a growing conventional wisdom taking hold on social media: People keep claiming that either all, “nearly all” or at least “most of” the budget cuts & other gutting of various programs and departments won’t actually kick in until after the November 2026 midterms.

Now, don’t get me wrong–most of those making these claims are well-intentioned; they’re saying this cynically, to underscore how disingenuous Congressional Republicans are by back-loading the pain until the midterms are safely in their rearview mirrors. And, to be fair, much of the damage won’t be until well after next November.

Over at The New Republic, Greg Sargent has taken this thinking one step further, noting that by delaying so much of the ugliness of the new law until 2027 or beyond . . .

“Republicans know how unpopular all this will be. So they’ve structured the bill so the tax cuts land immediately, while many of the Medicaid cuts get going in 2027 and 2028. That’s meant to spare them in the midterms.

But there’s a wrinkle here worth appreciating. Those policies will start hitting right when JD Vance’s bid to succeed Trump is getting underway. For Vance (perhaps the most prominent evangelist for Trumpism’s supposed promise for the working class) to have to defend all of that carnage while running for president could yet prove a form of poetic justice.“

Again, this is a fair statement, as far as it goes.

However, while I’m not an expert on any of the non-healthcare provisions, when it comes to the sections related to healthcare policy, a whole lot of the ugly will actually hit well before the midterms.

KFF has an excellent breakout of all of the various healthcare policy changes in both the House and Senate versions of the bill as they relate to Medicaid, Medicare, the ACA and even a few connected to Health Savings Accounts.

Overall, they break it out into 26 about Medicaid, 19 about ACA, 9 about Medicare and 11 about HSAs. However, 2 of the Medicare/Medicaid sections are identical since they impact both programs, and the Senate version (the one actually signed into law) didn’t include a lot of the House-passed provisions, so the grand total is actually:

• Medicaid: 19 total, 2 of which overlap w/Medicare
• Medicare: 5, 2 of which overlap w/Medicaid
• HSAs: 3
• ACA: 5

In addition, however, there’s also half-dozen other significant changes to the ACA via CMS’s recently-finalized “Integrity Rule”, as well as the expiration of the improved ACA subsidies provided under the American Rescue Plan Act & Inlfation Reduction Act. Oh, and there’s also the automatic Medicare cuts triggered by PAYGO legislation.

All told, that’s around 40 different major policy changes impacting the U.S. healthcare industry . . . over half of which will either be fully or at least partially implemented before November 3rd, 2026.

Charles has an excellent breakout for each of the four categories listed in red (above). I am not going to put that breakout up on Angry Bear as it is just too long. See ACA Signups for July 7th. Link is provided.