The Impact of the “One Big Beautiful Bill Act” on Nurses

Medicaid Cuts and Reimbursement Reductions

The One Big Beautiful Bill Act (OBBBA), passed by Congress in July 2025, makes major changes to the healthcare system. Among these, the bill includes over $1 trillion in cuts to Medicaid funding over the next decade. This amount is the largest reduction in the program’s history and has immediate effects for nurses working in long-term care, skilled nursing facilities, and rural clinics. These workers now face fewer resources, tighter staffing, and increased pressures in their daily jobs.

Hospital and Facility Closures

Changes to provider tax rules and Medicaid reimbursements pose a serious risk of closure for hundreds of rural hospitals and clinics. As a result, care options become increasingly limited in underserved areas, and job availability for nurses is reduced.

Ripple Effects on Nursing Jobs

These systemic changes might result in fewer nursing jobs in certain areas, potentially leading to decreased employment opportunities for nurses in those regions. Additionally, these changes could slow down the pace of wage increases, making it more challenging for nurses to see significant financial growth in their careers. Moreover, the increased workload and staffing challenges may contribute to heightened stress levels among nursing staff, which, coupled with existing pressures, is likely to cause burnout to worsen even further as healthcare facilities try to stretch their teams more thinly than before, often requiring nurses to work longer hours or take on more responsibilities.

Shifts in Nursing Employment Models

The rapidly changing healthcare landscape is likely to accelerate the transition toward more flexible staffing arrangements and the use of independent contractors. An increasing number of healthcare facilities may begin to rely on nurse contractors rather than traditional, long-term employees. This shift can open up a variety of new opportunities for nurses, including the possibility of starting their businesses, working as independent contractors, and contracting directly with care providers. Such developments could significantly alter the employment dynamics within the healthcare industry, empowering nurses to take more control over their careers and work arrangements.

Stay tuned as we continue to break down these policy changes and help you navigate them with power, purpose, and independence.

– The Nurse Mosaic Team –

Learn More From These Sources:
– https://www.businesswire.com/news/home/20241204377563/en 
– https://www.shiftmed.com/insights/knowledge-center/the-state-of-gig-work-in-2023 
– https://www.kff.org/medicare/issue-brief/what-could-the-health-related-provisions-in-the-reconciliation-bill-mean-for-older-adults 
– https://nashp.org/what-health-care-provisions-of-the-one-big-beautiful-bill-act-mean-for-states 
– https://www.hklaw.com/en/insights/publications/2025/07/considering-the-one-big-beautiful-bill-acts-impact-on-skilled-nursing  
– https://www.nationalnursesunited.org/press/nations-largest-nurses-union-condemns-republican-budget-bill