How H.R. 1 Reshapes Healthcare for Older Adults

H.R. 1, or the One Big Beautiful Bill Act (OBBBA) was signed into law on July 4, 2025. The legislation introduced wide-ranging reforms across Medicaid and Medicare, with significant implications for how states finance and deliver care to older adults. In addition, OBBBA includes changes to social services, such as the Supplemental Nutrition Assistance Program (SNAP), and provides funding for transforming rural healthcare systems.

This issue brief highlights OBBBA’s key Medicaid and Medicare provisions, and other significant changes to the continuum of services for older adults that affect healthcare access and affordability for older adults. While OBBBA’s changes will present challenges to states, understanding these provisions can help policymakers and stakeholders find innovative opportunities and solutions to mitigate potential risks for older adults.