Two weeks ago, I discussed how the One Big Beautiful Law’s (OBBL) Medicaid funding could bring more support to mother and child wellness care, particularly in combatting Alabama’s maternal mortality rates.
This week, let’s discuss how the OBBL affects Medicaid in general, along with the messaging from two U.S. representatives on the topic.
Thanks to U.S. Rep. Terri Sewell (D-Birmingham), who voted against the One Big Beautiful Bill (OBBB), vociferously opposing it during debate in the House of Representatives, we hear lots of Democrat Party talking points with few supporting facts. Sewell’s videos decrying the OBBB and the OBBL were all over X, making spurious claims of Alabamians losing their health coverage.
After President Trump signed the OBBL on July 4, Sewell posted this fact-free statement on social media:
While the rest of America was sleeping, House Republicans were busy doing the bidding of the billionaire class. Instead of keeping their promise to lower costs, Donald Trump and Congressional Republicans have perpetrated the greatest betrayal of working families in modern history and set us on a path to greater inequality, deeper poverty, and needless suffering, all to give another tax break to the wealthy. It is shameful.
My heart aches for the millions of Americans who will be hit hardest by this cruel and heartless bill: the single mom at risk of losing her child's Medicaid coverage, the grandmother who may no longer qualify for SNAP, the families in rural Alabama whose nearest hospital may soon be forced to shut its doors.
House Republicans may have sold them out, but the American people are paying attention, and they will not forget this betrayal.
At this point you would think Sewell would be helping her constituents with combatting these supposed losses, working to ensure her people can navigate the new law and find ways that the OBBL could assist them. Perhaps she is doing that; however, her recent social media activity only reflects TDS (Trump Derangement Syndrome) and Republican bashing, with little actionable information that her constituents could use.
U.S. Rep. Robert Aderholt (R-Haleyville) is seemingly taking the opposite tack. He championed and voted for the bill, and is now using his representative role to give information on how the OBBL will benefit Alabamians overall.
Aderholt graciously supplied some bullet points on how those Medicaid cuts Sewell says are a betrayal to the American people will actually make Medicaid better for those who truly need it, saying:
Medicaid was originally intended to protect the poor, children and pregnant women, and the elderly. If we keep expanding this and helping everyone else, the whole program will collapse.
Numbers from the Congressional Budget Office reflect that if the OBBL had not passed, Medicaid costs would balloon for every state, likely leading to its insolvency.
According to an explainer by Foley & Lardner LLP on their “Health Care Law Today” blog, some of the critical “cuts” made are how Medicaid and Medicaid Coverage Expansion under the Affordable Care Act would work:
These Medicaid eligibility and coverage changes fall within three main categories: (1) changes applicable to the adult, non-family populations enrolled under the Medicaid Coverage Expansion (MCE) under the Affordable Care Act, (2) changes applicable to all Medicaid populations, and (3) changes applicable to coverage for non-citizens.
Aderholt’s bullet list alludes to this, noting, “Reporting Requirements: requires Medicaid recipients to prove their eligibility twice a year, instead of annually.”
There is nothing wrong with more focused oversight. If one is required to be accountable, then they are less likely to take advantage of benefits they no longer need. If the benefits are needed, one has the opportunity demonstrate this. Aderholt’s bullet points further address the expanded work requirements included in the OBBL.
“Health Care Law Today” also expands on what this means:
Community Engagement / Work Requirements. The Act requires all states to impose new ‘community engagement’ requirements (generally, 80 hours of work, community service, or education per month) for the MCE population, effective January 1, 2027. MCE individuals who are not exempt and who are unable to demonstrate adequate community engagement will be notified that they will lose Medicaid coverage. Some individuals, including the ‘medically frail,’ are exempt. States may also choose to make exceptions for ‘short term hardship events’ (including a hospital admission during a month of demonstration). Review of the community engagement requirements must occur at least during every redetermination of eligibility.
Aderholt spoke to these exemptions, saying it “include[s] exemptions for caregivers for dependent children or for pregnant women, among others.” So, those who have exemptions in place will not be affected. This is the opposite of Sewell’s doom and gloom analysis that, “greater inequality, deeper poverty, and needless suffering” will result.
But the biggest bogeyman that Sewell and Democrats keep trotting out is that rural health care will be decimated. According to Aderholt, this is simply not the case as the OBBL:
Inserts a provision creating the ‘Rural Transformation Program’ to establish a $50 billion funding stream through CMS [the Centers for Medicare & Medicaid Services] for state investments in rural health and support for rural health providers. Funding for this program lasts for 5 years, starting in 2026.
This funding is distributed directly to the states to utilize as they choose. While Aderholt, Sewell, and other Alabama representatives could lean on state leaders to make sure the Certificate of Needs (CON) Board utilizes that money properly, for the most part, their role in the story has ended. Now, it’s our turn.
Only we can ensure our money goes to ensure the most vulnerable communities are assisted and rural health is expanded to all 67 Alabama counties. So find a way to get involved in how the CON Board plans to implement these funds, and demand accountability, oversight, and that services like mobile medicine and midwifery, which show evidence of changing rural health outcomes for the better, get all the money they need to succeed.
Jennifer Oliver O'Connell, As the Girl Turns, is an investigative journalist, author, opinion analyst, and contributor to 1819 News, Redstate, and other publications. Jennifer writes on Politics and Pop Culture, with occasional detours into Reinvention, Yoga, and Food. You can read more about Jennifer's world at her As the Girl Turns website. You can also follow her on Facebook, Twitter, and Telegram.
The views and opinions expressed here are those of the author and do not necessarily reflect the policy or position of 1819 News. To comment, please send an email with your name and contact information to [email protected].
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