On July 4, 2025, Congress enacted the One Big Beautiful Bill Act—formally known as Public Law 119‑21—marking one of the most sweeping health and entitlement reforms in recent U.S. history. Passed by narrow margins in both chambers, the legislation reshapes Medicaid and Medicare financing, imposes new eligibility requirements, and shifts financial responsibility to states and providers.
The law’s scope extends far beyond healthcare, but for hospitals and health systems, the implications are immediate and far-reaching: reduced reimbursement, rising uncompensated care, and new administrative burdens. In this landscape, AI is no longer a test case—it is a strategic imperative.
The Healthcare Impact: A Snapshot of the Big Beautiful Bill
Medicaid Reforms
- $1 trillion in cuts over 10 years
- Work/training/volunteer requirement: 80 hours/month for adults under sixty-five
- Eligibility reviews every 6 months
- Higher Copayments up to $35 for some services
- Tighter restrictions on provider taxes and supplemental payments
Medicare Changes
- Elimination of a rule supporting low-income seniors with premiums and out-of-pocket costs
- Some legal immigrants lose eligibility
- $500 billion in automatic deficit-triggered cuts
- Rural Hospital Pressures
- Increased closures expected due to Medicaid changes and uncompensated care
- A $50 billion Rural Health Transformation Fund was added by the Senate, but is widely viewed as insufficient
Coverage Losses
- 11.8 million projected to lose coverage by 2034, with disproportionate impacts on seniors, children, and people with disabilities
Sources: GovFacts.org, HooperLundy.com, USA Today, ACOI.org
A Pattern We’ve Seen Before
Disruption often drives digital transformation in U.S. healthcare:
- 2009: HITECH Act ($30B) spurred EHR adoption
- 2010: ACA introduced insurance exchanges and Medicaid expansion
- 2015: A record 112 hospital mergers fueled system-wide digitization
- 2020: COVID-19 normalized telehealth and catalyzed digital innovation
The Big Beautiful Bill may prove even more catalytic—because this time, the urgency isn’t optional.
What Health System Leaders Are Saying
According to a July 2025 KLAS report:
- Policy shifts are driving operational reconfiguration, not just cost-cutting
- Budgets are being restructured, not frozen
- Health systems are rethinking revenue strategies, especially around Medicare Advantage
- 40% of health systems are investing heavily in AI and automation to handle workforce and reimbursement strain
AI: From Pilot to Platform
At Get-to-Market Health, we believe the time for “AI pilots” is over. The Big Beautiful Bill is the forcing function health systems did not ask for—but must now respond to. Those who act decisively will find operational advantage.
Key Areas Where AI Will Lead:
- Agentic AI – Reducing friction for patients and staff with automated intake, FAQs, and scheduling
- AI enhancements driving diagnostic improvements across imaging modalities
- AI for Rural Health – Supporting thinly staffed hospitals and remote coverage
- Ambient AI – Automating clinical documentation and freeing up clinician time
- Care Transition AI – Enabling smooth coordination between acute & post-acute settings
- IoT + AI in Facilities – Lowering energy costs and improving operational efficiency
- Payer-savvy AI – Matching payer-side automation to ensure timely and full reimbursement
- Revenue Cycle Automation – Optimizing billing, coding, and denial resolution
- Virtual Nursing – Addressing labor shortages and improving care consistency
Final Thoughts
Healthcare leaders are facing a moment of profound disruption. Financial pressure is mounting. Staffing remains volatile. Policy has turned sharply. And yet, there is a way forward.
The solution isn’t just AI—it’s AI that is integrated, intentional, and outcome-driven.
Health systems that act now won’t just survive the Big Beautiful Bill—they’ll come out ahead of it.
