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Medicaid cuts still in ‘big beautiful’ bill after parliamentarian ruling

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An inflated pig with the message “Medicaid Is Not A Piggy Bank For Billionaires” is stationed at a rally opposing House Republicans Tax Proposal prior to the final House Vote on Capitol Hill on May 21, 2025 in Washington, D.C.

Jemal Countess | Getty Images Entertainment | Getty Images

While some Medicaid cuts proposed in Republicans’ One Big Beautiful Bill Act were rejected by the Senate parliamentarian on Thursday, other reforms to the program that could affect individuals’ access to coverage were left untouched.

The Senate parliamentarian rejected proposed changes aimed at capping states’ provider taxes, which are used to help fund states’ Medicaid expenditures. The Senate provision reduces the safe harbor limit in expansion states and puts a moratorium on any new provider taxes in all states.

Yet other parts of the proposed Medicaid cuts — including new work requirements of 80 hours per month and more frequent redetermination evaluations every six months — made it past the Senate referee.

“The Senate bill, like the House bill, includes deep cuts to Medicaid and other health programs, and is deeply harmful, whether or not these provisions stay in or out,” said Allison Orris, senior fellow and director of Medicaid policy at the Center on Budget and Policy Priorities.

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The House version of the One Big Beautiful Bill Act would reduce federal Medicaid spending by almost $800 billion, according to estimates from the Congressional Budget Office.

Republican lawmakers are pushing to pass the bill through budget reconciliation, an expedited legislative process that requires a simple majority vote. This week, the Senate parliamentarian evaluated whether the proposal complies with the Byrd rule, which prohibits the inclusion of changes that are extraneous to the budget.

While the Senate parliamentarian’s decisions mean certain provisions cannot stay in as written, that leaves room for lawmakers to change the language of the proposal or make other adjustments.

How Medicaid provider taxes may affect coverage

Medicaid provider taxes offer a way for states to raise money for the non-federal share of funding toward the program, Orris said. If states are limited on how they can do that, the federal government will spend less on Medicaid, she said.

The CBO scores a reduction in provider taxes as a Medicaid cut, Orris said, because it is assumed states will not be able to replace that revenue.

CMS Administrator Dr. Oz: Major goal in Medicaid is to align the federal government with the states

In response to restrictions on provider taxes, states could make decisions that would result in people losing Medicaid coverage, Orris said. Based on the House version of the bill, the CBO has estimated around 400,000 people could lose Medicaid coverage based on the proposed changes to provider taxes, she said.

Some Republican lawmakers have expressed concerns that the changes to the provider taxes would hurt rural hospitals financially and prompt them to reduce services or close.

In addition to Medicaid provider taxes, the Senate parliamentarian also rejected proposals to make certain immigrants who are not citizens ineligible for Medicaid coverage.

About 7.8 million people may lose Medicaid coverage based on both the House version of the “big beautiful” bill and Affordable Care Act changes including expiring subsidies and rule changes proposed by the Trump administration, according to Washington, D.C.-based think tank Third Way.

In a recent report, Third Way found the budget bill may increase medical debt by $50 billion — a 15% rise over today’s $340 billion in unpaid debts.

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Personal Finance

Maximizing Returns in High Rate Climate and market uncertainty

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Maximizing Returns in High-Rate Climate

In the macroeconomic environment of late July 2026, personal cash management requires an active, structured approach to wealth preservation. With central bank benchmark rates remaining elevated to ensure long-term disinflation, conservative yield-bearing vehicles—such as short-term U.S. Treasury bills, money market funds, and high-yield savings accounts (HYSAs)—continue to offer reliable nominal returns between 4% and 5%. For individual investors, maximizing net returns requires moving beyond passive checking accounts and executing a disciplined cash laddering strategy.

Leaving substantial liquid capital in traditional bank deposits creates an invisible drag on personal net worth due to ongoing inflation. By implementing a tiered liquidity framework, individuals can split emergency cash reserves and short-term capital allocations across rolling maturities. Allocating cash into 4-week, 8-week, and 13-week Treasury bills creates a continuous cycle of maturing liquidity, allowing investors to continuously reinvest capital at prevailing market yields while maintaining immediate access to emergency funds.

Tax efficiency represents a critical dimension of high-yield cash optimization. For high-earning individuals residing in states with substantial local income taxes, direct holdings in short-term U.S. Treasury instruments often deliver superior net post-tax yields compared to standard commercial bank HYSAs. Because interest earned on federal Treasury bills is strictly exempt from state and local taxation, investors can retain a larger portion of their compounding interest gains without taking on additional credit or market risk.

Ultimately, personal wealth accumulation in mid-2026 relies on intentional capital deployment. Cash should be managed as a productive asset class that generates consistent, risk-free returns. Regularly auditing account yield terms, automating recurring transfers, and leveraging tax-advantaged fixed-income instruments ensures that personal liquidity remains fully optimized against macroeconomic fluctuations.

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Algorithmic Wealth Management: Balancing Automated Financial Planning with Human Oversight

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Balancing Automated Financial Planning with Human Oversight

The personal finance industry in July 2026 is experiencing a technological evolution, driven by the wide deployment of next-generation algorithmic wealth management tools. Modern digital financial platforms have expanded far beyond basic automated index investing; today’s robo-advisors utilize real-time tax-loss harvesting, dynamic portfolio rebalancing, and hyper-personalized spending analysis to optimize retail investor outcomes. However, as these digital solutions become ubiquitous, investors face the crucial challenge of balancing automated execution with human strategic judgment.

The core advantage of automated financial planning platforms lies in their ability to remove emotional bias from investment execution. During periods of market volatility or localized sector realignments, automated algorithms systematically rebalance portfolios back to target asset allocations without falling victim to panic selling or speculative enthusiasm. Furthermore, integrated cash-flow monitoring algorithms analyze individual spending patterns in real time, automatically sweeping surplus income into designated retirement or debt-liquidation accounts to accelerate net worth accumulation.

Despite these operational advantages, algorithmic tools have inherent structural limitations when addressing complex, highly personalized financial life events. Decisions involving multi-generational estate planning, highly complex tax strategies, small business exits, or nuanced real estate transactions require contextual human judgment that software models cannot replicate. Relying solely on automated models without periodic human professional review can result in misaligned risk profiles or overlooked tax liabilities during major life transitions.

The optimal approach for personal financial planning in late 2026 is a hybrid advisory model. Individuals should utilize automated platforms for routine asset allocation, continuous tax optimization, and low-cost passive index tracking, while engaging qualified human financial advisors for periodic strategic planning, estate structuring, and qualitative risk evaluations. This dual approach ensures maximum cost efficiency and disciplined execution while retaining essential strategic guidance.

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High-Yield Optimization: Structuring Personal Cash Reserves in a Sustained Rate Environment

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Structuring Personal Cash Reserves in a Sustained Rate Environment

In the financial environment of mid-2026, personal cash management has re-emerged as a vital component of holistic wealth building. With central bank policy rates holding firm to maintain long-term price stability, yield-bearing instruments such as money market funds, high-yield savings accounts (HYSAs), and short-term Treasury bills continue to offer compounding returns around 4% to 5%. For individual investors, effectively structuring cash reserves requires shifting away from passive bank deposits toward active yield optimization.

A frequent pitfall in personal asset management is leaving substantial liquid capital in traditional checking or low-yield savings accounts, where real returns are continuously eroded by baseline inflation. By implementing a disciplined ‘cash ladder’ strategy—allocating liquid funds across tiered maturities using ultra-short Treasury instruments and FDIC-insured high-yield accounts—individuals can secure maximal yields while retaining immediate liquidity for emergency expenses or tactical investment opportunities.

Simultaneously, investors must evaluate the tax efficiency of their cash holdings based on their tax bracket and geographic location. For high earners situated in states with high local income taxes, direct holdings in short-term U.S. Treasury bills often yield a higher net post-tax return than standard high-yield savings accounts, as Treasury interest is strictly exempt from state and local taxation. Understanding these nuanced tax distinctions allows individuals to capture significant incremental gains without taking on additional market risk.

Ultimately, personal financial health in late 2026 hinges on intentional liquidity management. Cash reserves should not be viewed merely as static emergency funds, but as a dynamic asset class that contributes positively to net worth growth. Regularly auditing yield terms, automating cash transfers, and optimizing for post-tax efficiency ensures that personal capital remains fully productive across all economic conditions.

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