How OBBBA Changes Medicaid, Planned Parenthood, Health Subsidies and Access for Immigrants

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In this episode of The Sunlight Tax Podcast, I’m unpacking the One Big Beautiful Bill Act (OBBBA)  and what its sweeping health care changes mean for real people and families. We’ll dig into how this new legislation affects Medicaid coverage, Planned Parenthood funding, and low-income immigrants, plus what’s changing for marketplace insurance subsidies and health savings accounts (HSAs).

I’ll also share key insights from an excellent healthinsurance.org article by Louise Norris, titled “One Big Beautiful Bill Act Brings Sweeping Changes to Health Coverage.” With her permission, I’ll be reading excerpts from that piece and you can find the full article linked in the show notes. It’s a must-read if you want a deeper understanding of how the One Big Beautiful Bill Act (OBBBA) could reshape American health care and insurance coverage in the years ahead.

Also mentioned in this episode:

03:29  Health Care Provisions Overview

07:02  Medicaid Changes and Impacts

09:17  Planned Parenthood Funding

11:37  Subsidy Eligibility for Low-Income Immigrants

12:32  Impact of Subsidy Changes on Self-Employed

17:09  Health Savings Accounts and Marketplace Plans

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Credit:

Key insights in this episode come from an excellent article by Louise Norris for healthinsurance.org, titled “One Big Beautiful Bill Act Brings Sweeping Changes to Health Coverage.” Shared with permission. 

Links:

Article by Louise Norris published in healthinsurance.org: One Big Beautiful Bill Act brings sweeping changes to health coverage by Louise Norris 

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Save Money at Year-End: Healthcare

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Today, I’m chatting about healthcare related year-end tax planning strategies that you can use to save money if you are self-employed. I’m diving into the differences between Flexible Spending Accounts and Health Savings Accounts including the benefits and how you can maximize your contributions.

Join me in this episode to learn how you can make sure you’re making the most of your healthcare savings as the end of the year approaches.  

Also mentioned in today’s episode: 

• Flexible Spending Accounts 5:50

• Health Savings Accounts 9:10 

• Maximizing your HSA benefits 16:05

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Some Real Numbers for Artists on the ACA Repeal

When I went back to school for accounting, I never thought I’d get an education in healthcare. But the Affordable Care Act (ACA, aka Obamacare) forced tax preparers like me into learning about our healthcare system, because most of the credits and penalties are reconciled on the tax return. As an accountant for artists, I see the direct benefits of the ACA on my clients. I am required, per the ACA, to find out if my clients were covered by health insurance all year, and if not, I calculate the penalty for each month they weren’t. I record the premiums my clients pay, which can be a big deduction for a freelance arts worker. And I see the monthly subsidies that they get, because I reconcile them on the annual tax return (the “Premium Tax Credit”). I also calculate the 3.8% Net Investment Income Tax and the additional .9% Medicare tax for my very highest-income clients – these are the additional taxes on the top income earners that effectively pay for the subsidies provided by the ACA. This amount is only calculated on the very top dollars of their income and it hits a proportionately tiny slice of my clients.

Given this background, I have some insights on what the new Republican proposal, the “American Health Care Act” (ACHA, aka Trumpcare) would do to you, me, and our federal budget. It’s not good.  Read more...