On July 4, 2025, $1 trillion was cut from Medicaid. Here’s exactly what to do about it.

The One Big Beautiful Bill Act (H.R. 1) cut $1 trillion from Medicaid over the next decade. Combined with the expiration of enhanced ACA subsidies, it’s the largest rollback of healthcare coverage in modern American history.

Up to 11.8 million Americans are projected to lose Medicaid coverage by 2034. Roughly 20 million Marketplace enrollees are seeing premiums double in 2026. Work requirements start January 2027. Eligibility gets re-checked every six months.

This is not a political book. It’s a survival manual.

Whether you’re on Medicaid, buying through the ACA Marketplace, covered by an employer, or uninsured — this affects you. Medical costs rise. ERs get more crowded. Rural hospitals close. And millions of people end up one health event away from financial ruin.

But there are real, concrete steps you can take right now. This guide walks you through every one of them.

27 pages. 10 chapters. Every chapter ends with a clear Action Step you can take today.