Today, AMSA sent the following letter to U.S. Senate leaders expressing deep concerns and firm opposition to H.R. 1, the “One Big Beautiful Bill Act”.
We invite you to read on, share this letter with classmates and colleagues, and TAKE ACTION to protect health care.
June 26, 2025
The Honorable John Thune
Majority Leader
U.S. Senate
Washington D.C. 20510
The Honorable Chuck Schumer
Minority Leader
U.S. Senate
Washington D.C. 20510
Dear Majority Leader Thune and Leader Schumer:
On behalf of over 30,000 medical students, pre-medical students, advocates and alumni physicians at the American Medical Student Association (AMSA), we would like to convey our firm opposition towards the reconciliation package recently passed by the U.S. House of Representatives. Established in 1950, AMSA is the oldest and largest independent association of physicians-in-training in the United States. The members of our organization are deeply concerned about H.R. 1, the “One Big Beautiful Bill Act” and the immense harm it spells for the health and welfare of the nation and our healthcare infrastructure at large.
H.R. 1 will make the largest cuts to health care in United States history, slashing funding for federal health care programs, like Medicaid and the Affordable Care Act (ACA), by over $1 trillion. If this legislation passes, these cuts, alongside the elimination of tax credits for ACA coverage will cause 16 million people across the U.S. to lose health insurance coverage and access to basic health care.
An $863 billion cut to Medicaid will devastate people who rely on this service for basic coverage and services like substance use treatment, behavioral health, home-based long-term care and nursing home services. The bill’s critical failure to renew tax credits for people who purchase Affordable Care Act coverage will strip coverage from 4.2 million people. Tens of thousands who gained coverage under the Medicaid expansion will also lose coverage because of increased red tape and bureaucracy under new “work requirement” rules. States that have implemented similar policies in the past show no increases in employment and many eligible people losing coverage. This policy will also increase administrative burden on healthcare providers, forcing future physicians to spend less time on highly skilled patient-centered care and more time on needless documentation and paperwork.
The impact of this bill will reach far beyond those who lose health insurance as a direct result of this legislation, ultimately devastating the very backbone of the American health care system at large. Due to cuts, private insurance holders’ premium costs, copays, and costs at the pharmacy counter are projected to skyrocket. Older adults will be hit especially hard, with some being expected to pay at least $10,000 more in additional premium costs for ACA marketplace coverage. Higher costs and lower reimbursement will mean that hospitals will be forced to lay off clinical staff, even as we find ourselves amid a physician shortage crisis. Healthcare facilities will be forced to shutter their doors entirely, due to an estimated $31 billion dollar increase in uncompensated care. Families across America, regardless of whether they are currently on Medicaid, will find themselves entirely unable to take care of themselves and their families.
The stakes are particularly heightened for those in rural communities. A recent report by the American Hospital Association projects that 1.8 million individuals in rural communities will lose their Medicaid coverage. Beyond insurance coverage, rural hospitals themselves will undergo significant financial strain, to the extent that many would be forced to reduce services, cut clinical staff, and close their doors. Indeed, at least 380 rural hospitals nationwide are at risk of closure. As Texan neurologist Dr. Audrey Nath puts it,
“These cuts will cause rural hospitals… to close entirely… I am terrified that the closest hospital for many rural folks may then be hours away.
During an ischemic stroke, there is only 3 hours of precious time…
the increased travel time may cause unnecessary cases of paralysis and death.”
Under H.R. 1, record numbers of people will lose the health care that they depend on to take care of themselves and their families, shift massive burdens to the state budget, and put the nation’s economic future at risk by adding trillions to the deficit. The American people will suffer profoundly – all in order to fund tax breaks for the wealthiest of our nation, including more than 800,000 millionaire households. Ultimately, this legislation will render health care inaccessible to low-income people, offset by tax cuts that will make the top 10% of American households even richer. Trillions will still be added to our national deficit.
We urge you and your Senate colleagues to reject the House-passed reconciliation package and instead put forward legislation that puts working families, state budgets, and an economy that works for everyone ahead of tax benefits for the wealthy and corporations.
On behalf of the AMSA Board of Trustees and membership,
Nikitha Balaji, National President, American Medical Student Association
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About the American Medical Student Association: AMSA is the oldest and largest independent association of physicians-in-training in the United States.
Founded in 1950, AMSA is a student-governed, non-profit organization committed to representing physicians-in-training, advocating for quality and affordable health care for all,
and building the next generation of physician leaders. To join our community, visit AMSA.org.
