The One Big Beautiful Bill Act's impact on physician practices

Physicians Practice: Just give us a quick and dirty explainer on, you know, what is the One Big Beautiful Bill Act?

Anders Gilberg: Okay, well, that's actually the name of the act now. So it's not just, we're using shorthand, so it's an interesting name for a bill. I think beauty is in the eye of the beholder. There's just so much in that bill that I'll probably be just talking about the healthcare provisions that MGMA is focused on.

P2: It's probably better not to get in the weeds on everything else.

AG: I think so too.

The One Big Beautiful Bill, the key issues for medical groups that we are monitoring closely will be, it's really kind of future, really, at this point would be implementation of the Medicaid cuts that the Congressional Budget Office predicts that potentially around 10 million people will lose coverage as a result of the Medicaid cuts. And a lot of the cuts are related to administrative issues within Medicaid, like work requirements and things that sound really easy, but the fact is in some of the states that have tested out some of the work requirement reporting, it's just shown that while someone might be actually doing the work, it's really about, did they report at the right frequency, and if they didn't, then they lose their coverage.

So that's kind of what CBO is looking at in the future. The one thing from, like an executive standpoint or a physician standpoint, that, just to remind everybody, is that the Medicaid cuts just really won't take place, or these administrative issues will not like be implemented. It's really 2027 and 2028. So, for all of the consternation about the Medicaid cuts, they still might not be even implemented in the same form as the One Big Beautiful Bill did it.

And why is that? I mean, just stepping back, a lot of Republicans who are in the majority kind of had to hold their nose on that provision with the bill, because they were concerned about their constituents, and they may still revisit it. There's an election next year prior to implementation of the Medicaid cuts, and so we could see changes to what they're doing. What's scheduled to happen in 2027 before it even is implemented. So stay tuned.

I will say, Keith, one of the things that worried me a little bit is I talked to some members, and they were talking about some of the medical groups in their community taking action and closing locations, and actually making business decisions based on this, I would just say, 'Wait, stay tuned. See what happens.'

There's also a big state component too. So it depends largely with Medicaid where you are practicing in your state. So the Medicaid issue is huge. We're monitoring it. We obviously express extreme concern over the Medicaid provisions in the bill. It was a positive piece in the bill that will increase physician reimbursement in Medicare next year 2.5%. So that was a small success in an otherwise huge bill, I will say is that we expressed a great deal of dismay that Congress did not fix the 2025 problem, though, so medical groups and physicians received a 2.83% cut in 2025 and that was not addressed. So even with the 2.5% increase next year, we still aren't where we were last year.

So that's a disappointment, and it really speaks to the fact that we need a permanent solution, and that's what we're continuing to work on, is like, find a permanent solution to all these Medicare cuts to physicians,