www.prh.org [www.prh.org]

Dear John,

“The One Big Beautiful Bill Act” (or OBBA as we will refer to it) is the antithesis of its name: while presented as an opportunity for financial savings in the average household, the bill eliminates federal funding for programs designed to keep our communities fed, housed, healthy, and safe.

This sweeping legislation is a direct attack on the people we advocate for and the values we fight for. Here’s a breakdown of what it would do in 5 critical areas:

1. Attack and close Planned Parenthood clinics
2. Defund health care with the largest cut to Medicaid in history
3. Gut SNAP benefits , putting families at greater risk of hunger
4. Target immigrant communities with a dramatic, supercharged funding for immigration enforcement
5. Continue unprecedented tax cuts to the wealthy while marginalized communities are left footing the bill

⬇️ Below, we’ve outlined the key facts you need to know about each of these devastating actions.

At PRH, we’re continuing to sound the alarm and fight back. With your support, our physician advocates are working to document how these harmful policies impact patients and communities — and to bring those stories directly to Congress, state officials, and the media.

You make this work possible in an increasingly hostile environment. And in this moment, your support is more vital than ever. [[link removed]]

Thank you for partnering with us in resistance. Even in the face of perceived defeat, we will not give up hope.

In solidarity,

Lisa Sangoi, she/her
Public Policy Director

***

Explained: One Big Beautiful Big Act

1. Unprecedented attack on Planned Parenthood

* The OBBA attacks Planned Parenthood by prohibiting clinics and providers that offer abortions from accepting Medicaid for the other family planning and reproductive health care services they provide. While PP is not explicitly mentioned in the bill, it only applies to PP and independent clinics that are a part of Maine Family Planning.

* On 7/7/25, a federal district court judge prevented the ban from going into effect against Planned Parenthood for 14 days and will consider a longer pause on 7/21.

* If this provision were to go into effect:

* Planned Parenthood estimates up to 200 of its health centers will close (or 1 in 3 Planned Parenthood centers, or 1 in 4 abortion providers nationally), depriving our communities of vital sexual and reproductive healthcare, like cancer screening, STI testing and treatment, and birth control.

* This is not what the American people elected our officials to do. A new Kaiser Family Foundation poll revealed that 75% of Americans, including a majority of Republicans, support federal Medicaid reimbursements for Planned Parenthood.

* The people who will be most hurt by this are those who already face hurdles to getting the care they need: Black and Latino communities, LGBTQ+ people, people who live in rural or medically underserved areas, and people who have low incomes.

* Let’s call “defunding” Planned Parenthood what it is: a backdoor abortion ban.

2. Unprecedented defunding of health care

* The nonpartisan Congressional Budget Office (CBO) estimated that the OBBA will cut federal spending on Medicaid and Children’s Health Insurance Program (CHIP) benefits by $1.02 trillion [[link removed]] —the largest ever cut in history. As a result of the BBB, 17 million people [[link removed]] will lose health insurance, through cuts to CHIP, Medicaid, and the Affordable Care Act.

* The OBBA eliminates Medicaid access to some categories of lawfully present immigrants who prior had access to Medicaid (such as people with Temporary Protected Status and valid visa holders).

* The OBBA will impose unnecessary work requirements with burdensome accompanying paperwork requirements in an effort to kick millions of people off Medicaid rolls.

* States will be restricted in their ability to impose health care “provider taxes” that help them fund a portion of their Medicaid programs especially in rural areas.

* The OBBA will increase Medicaid out of pocket costs by forcing states to charge up to $35 per health care service.

* The OBBA will cause hospital closures in rural areas, layoffs of the health care workforce, and affect our most vulnerable communities the most.

* The National Partnership for Women & Families has released a new analysis [[link removed]] showing how devastating Medicaid cuts would be for maternal health care in rural areas, with more than 140 labor and delivery units in rural areas are at risk of closure or severe service cutbacks.

3. Unprecedented defunding of the Supplemental Nutritional Assistance Program (SNAP)

* The bill will require the biggest cut to SNAP since the food stamp program began in 1939, during the Great Depression.

* These cuts will cause 22.3 million families [[link removed]] [[link removed]] to lose some or all SNAP benefits.

* The legislation will make it more difficult for people to qualify for benefits and reduce those benefits for those who are eligible. It freezes future increases to benefits so that they don’t keep pace with inflation and rising food costs.

* The OBBA eliminates SNAP access to some categories of lawfully present immigrants who prior had access to SNAP (such as people with Temporary Protected Status and valid visa holders).

4. Unprecedented attack on immigrant communities

* The OBBA funds a dramatic expansion of immigration detention, including family detention, quadrupling Immigration and Customs Enforcement (ICE)’s annual detention budget. The law explicitly approves the use of these funds for family detention, a practice medical and mental health experts call out as causing psychological trauma and long-term mental health risks to children, even when used for short periods.

* The OBBA provides supercharged funding for immigration enforcement (additional $32 billion) and supercharged funding for border enforcement and militarization (additional $75 billion) with few guardrails in place for how that money can be used.

* The OBBA eliminates SNAP and Medicaid access to some categories of lawfully present immigrants who prior had access to SNAP (such as people with Temporary Protected Status and valid visa holders).

5. Unprecedented tax cuts to the most wealthy

* This bill overwhelmingly benefits the wealthiest individuals and big corporations by extending to them big tax cuts, while at the same time cutting tax credits to an estimated 2.6 million U.S. citizen children [[link removed]] who would otherwise qualify but don’t have parents with social security numbers. These tax cuts will cost trillions of dollars and are being paid for by our most marginalized communities.

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Physicians for Reproductive Health
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