This spring has marked a turning point in Washington, D.C. as Congress focuses its attention on a sweeping reconciliation bill known as the “One Big Beautiful Bill Act.” The bill has delayed progress on the Fiscal Year 2026 appropriations process and is now one step closer to reaching President Trump’s desk after clearing multiple rounds in both chambers.

Throughout this time, GO2 for Lung Cancer has remained actively engaged, working to protect access to care and preserve critical funding for lung cancer research. We are deeply concerned about several healthcare provisions in the bill, which—if enacted—would roll back coverage and reduce support for patients and providers across the country.

Medicaid cuts and consequences for lung cancer care

The legislation extends tax cuts and increases funding for defense and border security, but it offsets those costs by cutting deeply into healthcare. Over the next decade, it is projected to reduce federal healthcare spending by $800 billion, primarily through the largest Medicaid cuts in U.S. history, and cause more than 11 million Americans to lose health coverage.

One of the changes is a new cap on what states can pay hospitals and nursing homes that care for Medicaid patients, limiting payments to Medicare levels. This could result in significant funding losses—especially for rural and safety-net providers—and threaten the availability of care in underserved communities. Medicaid is vital for cancer screening, diagnosis, treatment, and survivorship. Federal funding caps could lead to delayed diagnoses, missed treatment opportunities, diminished quality of life, and lower survival rates. These restrictions could also drive up overall healthcare costs due to an increase in late-stage cancers that could otherwise have been prevented.

Barriers for patients and families

The bill also makes several changes to Medicaid and Medicare. It imposes work requirements not only for childless adults but also, under the Senate version, for parents of children over age 13. GO2 is particularly concerned about the impact on cancer patients, many of whom are unable to work due to the toll of the disease and the side effects of treatment. Individuals diagnosed with lung cancer who rely on Medicaid should not have to bear the added burden of proving work eligibility while fighting a life-threatening illness. These provisions pose long-term, harmful consequences for patients nationwide.

The bill also requires states to verify eligibility for Medicaid expansion enrollees every six months beginning in 2026, adds restrictions on provider taxes, and limits federal matching funds through tighter definitions. Although the proposal to reduce the federal match for expansion states was dropped, the bill prevents any new states from receiving the enhanced 90% match after January 1, 2026, preventing further Medicaid expansion. This is a major step backward at a time when research continues to show the life-saving impact of Medicaid expansion.

The evidence is clear: Medicaid expansion saves lives 

A new study found that states that expanded Medicaid under the Affordable Care Act enabled more individuals with early-stage non-small cell lung cancer (NSCLC) to access critical care. Additionally, a January 11, 2024, JAMA article linked Medicaid expansion to significant reductions in both 30-day and 90-day postoperative mortality rates among lung cancer patients. Medicaid expansion has also been linked to significant reductions in both 30-day and 90-day postoperative mortality rates among lung cancer patients.

A threat to rural hospitals and the ACA

Furthermore, the bill creates a $50 billion rural hospital stabilization fund. Still, that amount falls far short of the estimated $155 billion in Medicaid funding losses to rural communities over the next 10 years. The Congressional Budget Office estimates that nearly 12 million people will lose coverage, including 1.8 million in rural areas, where hospital closures and service reductions are already a pressing concern.

The bill weakens the Affordable Care Act by shortening the annual open enrollment period by one month, introducing new verification requirements that add paperwork and red tape, eliminating automatic reenrollment, and narrowing access to special enrollment periods. These changes would make it harder for individuals and families, especially those with lower incomes or life-changing circumstances, to sign up for or maintain health insurance.

GO2 will continue to fight for lung cancer patients 

As the bill advances, GO2 for Lung Cancer remains committed to standing with the healthcare community in its advocacy for patients and providers. We will continue to push for policies that preserve healthcare coverage, safeguard access to care, support medical innovation, and ensure that those impacted by lung cancer are not left behind.