How Trump’s “One Big Beautiful Bill” Could Affect You

After weeks of tense negotiations, Congress has passed, and President Trump has signed into law, H.R. 1—officially known as the “One Big Beautiful Bill” (OBBB).

The bill, which narrowly passed the House by a vote of 218–214, extends the tax cuts enacted in President Trump’s first term, cuts green energy incentives, and raises the debt ceiling by $5 trillion. The 870-page bill also makes sweeping changes to Medicaid, the Affordable Care Act (ACA) and Medicare.

At Nash Disability Law, our Chicago disability lawyers help people with health impairments apply for financial assistance through Social Security Disability. Here are what we see as some of the key provisions of the bill which may affect Americans with disabilities and low-income Americans:

• Medicaid Cuts and Work Requirements
  The law imposes new work requirements and frequent eligibility redeterminations for Medicaid recipients. The Congressional Budget Office estimates that 11.8 million Americans could lose Medicaid coverage over the next decade, including many who have disabilities or are in the process of applying for benefits.

• SNAP (Food Stamps) Restrictions
  SNAP recipients face expanded work requirements. A statement from Illinois Governor JB Pritzker’s office said that over 1.9 million Illinois residents use taxpayer-funded SNAP benefits and estimates 360,000 of them could be at risk because of the new eligibility requirements. The bill also restricts what expenses households can claim when calculating eligibility—such as internet service.

• Medicare
  The OBBB includes provisions that limit eligibility for some lawfully present immigrants who have previously qualified based on work history or residency. This includes refugees, people with asylum status, and others who have paid into the system, according to the Center for Medicare Advocacy.

  The bill may also increase health care costs for low-income enrollees. The bill blocks a regulation that would have streamlined enrollment in Medicare Savings Programs (MSPs), potentially leading to higher out-of-pocket costs for low-income Medicare beneficiaries. These programs help cover Medicare premiums and cost-sharing.

• Affordable Care Act
  Key changes impacting the ACA include ending automatic re-enrollment, shortening the open enrollment period, and requiring more stringent income verification. These changes are projected to reduce enrollment and increase out-of-pocket costs for many ACA enrollees.

  The OBBB does not extend the ACA’s premium tax credits, known as “enhanced subsidies,” passed via the American Rescue Plan of 2021. These were temporary provisions that make health insurance purchased through the ACA Marketplace more affordable. The enhanced subsidies will expire at the end of this year unless Congress extends them.

  The Kaiser Family Foundation reports that, “The expiration of the enhanced tax credits is expected to cause ACA enrollees’ out-of-pocket premium payments to increase by over 75% on average, with people in some states seeing their payments more than double on average. Lower-income and older enrollees, as well those who live in states that have not expanded Medicaid, are expected to see the most significant premium payment increases.”

• Child Tax Credit
  The child tax credit, originally set to drop back to $1,000 in 2026, will now permanently increase to $2,200, providing some relief to families with children. However, stricter Social Security number requirements may limit access for households lacking valid SSNs.

• Tipped and Overtime Worker Tax Relief
  Workers can deduct up to $25,000 of tips and overtime pay through 2028. After that, the provision sunsets. This deduction is phased out based on income.

New Senior Tax Deduction Tied to Social Security

Although the OBBB does not make structural changes to Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), it includes a new tax benefit that affects older Americans receiving Social Security:

• Temporary Senior Tax Deduction (2025–2028)
  H.R. 1 provides a $4,000 per-person deduction for taxpayers aged 65 or older, even if they itemize deductions. This additional deduction is designed to offer tax relief for seniors, particularly those with moderate to high incomes.

• Income-Based Phase-Out
  The deduction phases out at a rate of 4% for income above $75,000 (single filers) or $150,000 (joint filers). For example, a 65-year-old earning $85,000 would receive a $3,600 deduction.

• No Change to Taxation of Social Security Benefits—But Fewer Will Pay
  While the bill does not eliminate federal income taxation of Social Security benefits, it includes language intended to ensure that nearly 90% of beneficiaries will no longer owe federal taxes on their benefits. This represents a shift in tax burden away from lower-income and middle-income seniors.

While H.R. 1 does provide a temporary tax break for some seniors, some experts are concerned that the Social Security-related tax changes will negatively impact Social Security trust fund solvency, hastening the date when reserves are depleted.

Reducing taxes on Social Security benefits is expected to decrease the revenue into the Old Age and Survivor Insurance and Disability Insurance trust funds. The combined trust funds normally receive almost 4% of total income from taxation of Social Security benefits.