TUCSON — Major changes could be coming to Arizona’s health care funding after House Republicans approved President Donald Trump’s legislative package, officially titled the “One, Big, Beautiful Bill."
FROM SCRIPPS NEWS | Trump's 'Big, Beautiful Bill' approved by House after overnight session
In Arizona, approximately 2 million people rely on Medicaid, also known as Arizona Health Care Cost Containment System (AHCCCS), for health coverage.
One of those recipients is 23-year-old college student Garrett Newell.
"I fear that I'm going to be cut off from all these social services that have helped me throughout my life," said Newell, who has depended on Medicaid since childhood for doctor’s visits, medications, leg braces, physical therapy and surgeries to treat cerebral palsy.
"My right leg has certainly been affected in terms of like walking properly," he said, demonstrating how he walked with a limp before undergoing surgeries.
But, his medical journey isn’t over. He said he struggles both mentally and physically to consistently walk correctly. If his right leg muscles tighten up, he said he could experience a limp again and require another operation.
"That is a high possibility if I don't continue my stretches," he said — a possibility he fears could come without coverage.
Under the “One, Big, Beautiful Bill,” Medicaid would face nearly $700 billion in cuts over 10 years, according to the CBO. That could force costs to shift on to states, causing them to either raise taxes or reduce eligibility and benefits.
Newell worries that could mean losing coverage for medications, equipment, prescriptions or services like vision care. "Like, not being able to get new prescription glasses that are paid for by AHCCCS," he said.
The Center for American Progress, a public policy research and advocacy organization, estimates 4% of rural hospitals in Arizona are at the brink of closure.
"Seeing any type of additional funding cuts on the Medicaid front would certainly only exacerbate some of those concerns around rural hospital sustainability," said Natasha Murphy, the director of health policy at CAP.
The bill would also impose new work requirements on able-bodied adults without dependents, mandating 80 hours per month of work, education or volunteering starting Dec. 31, 2026.
U.S. Rep. Juan Ciscomani, R-Ariz., voted in favor of the bill.
"They're in working age. They don't have dependents, they don't have kids that depend on them. So that we can protect it for the single moms, those with disabilities or the people that are in poverty really going through some real struggles,” Ciscomani said. "Those are the people we want to protect the program for."
Ciscomani also backs the bill’s proposal to increase eligibility checks to twice a year — instead of once — saying it's part of preventing fraud and abuse.
"We need to make sure the people are eligible for the Medicaid benefits a couple of times a year, not just once. So, these are common sense reforms that we that we're tackling," Ciscomani said.
But, Murphy says this could negatively affect those who are eligible, citing those who might have trouble submitting paperwork or completing monthly reporting requirements.
"If you don't report them, you end up losing your coverage, so that's what helps to generate savings," she explained. "Those are two of the primary mechanisms that the bill generates savings, but it's really at the expense of individuals who oftentimes are still eligible for Medicaid coverage."
An analysis from KFF, a health policy research organization, reports roughly 320,000 Arizonans could lose their health insurance over the next decade.
Currently, the federal government helps fund Medicaid through a formula called FMAP. As of FY 2025, Arizona’s FMAP rate is 64.34%, meaning the federal government covers about 64 cents of every Medicaid dollar the state spends, with Arizona covering the rest.
Rep. Ciscomani says he fought to keep that system instead of switching to a “per capita cap,” which would limit federal funding to a set amount per enrollee.
He also says he helped prevent cuts to the state’s provider tax rate, which helps fund AHCCCS.
Still, Newell worries the proposed changes could hurt those who need help the most.
“Don't dismiss them, don't dismiss their stories. Don't dismiss their struggles,” he said.
Senate Republicans hope to vote on the bill by July 4 to avoid a possible U.S. debt default.
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Maria Staubs joined KGUN 9 as a multimedia journalist and producer in July of 2024. Her passion for writing and storytelling stems from anchoring her middle school’s news show and editing her high school’s yearbook. She holds a bachelor's degree in journalism and mass communication with a minor in film and media production, as well as a master's degree in mass communication. You can email Maria at maria.staubs@kgun9.com or reach out to her on X/Twitter or Instagram.
