Cuts to Healthcare and Clean Air Programs Are Coming: How to Prepare

On July 4, 2025, a bill that the American Lung Association strongly opposed was signed into law (officially named the “One Big Beautiful Bill Act.”) Provisions of this law will begin to take effect at various points over the coming weeks, months and years, gutting funds which were allocated for healthcare and clean air programs for Americans. In short, it is very bad for lung health.

Below we explain some key changes to expect and what you can do to protect your access to healthcare and clean air.

What Will Change?

This law will make deep cuts to healthcare programs, causing millions of people to lose coverage and increasing healthcare costs for everyone. It cuts Medicaid funding for states and creates barriers to access for individuals with Medicaid by:

• Forcing certain people with Medicaid coverage to report work information or lose coverage. This work reporting requirement policy has already failed in the two states that tested it, but the law will now require it nationwide by 2027. We know 92% of adults under 65 with Medicaid already work, are caregivers, students or are unable to work due to illness or disability. Simple paperwork errors will result in some people who qualify losing coverage.
• Requiring some people to reapply for Medicaid every six months instead of annually, creating additional opportunities for paperwork errors.
• Imposing copayments for certain healthcare services. Many people with Medicaid coverage have low incomes, so higher copayments can mean delaying or going without lifesaving care.
• Changing how states can finance their Medicaid programs, leading states to lose funding and make additional cuts.

Those with healthcare plans from the Affordable Care Act Marketplace (healthcare.gov) may lose coverage too. The new law fails to protect enhanced healthcare tax credits that many people rely on to help them pay for their Marketplace plan. Now, the tax credits are set to expire at the end of December 2025. This law also makes it harder to enroll in Marketplace plans by:

• Ending automatic reenrollment in plans.
• Adding additional verification and paperwork requirements to sign up for coverage.
• Changing eligibility rules, meaning some lawfully present immigrants will no longer qualify for tax credits for Marketplace coverage.

Air quality also takes a hit. This law:

• Delays rules that would decrease oil and gas industry pollution by a decade.
• Slashes state and local funding to address climate change and reduce vehicle pollution across the U.S.
• Cuts funding used to decrease air pollution in schools.
• Ends tax credits that help families pay for cleaner energy home improvement projects and electric vehicles.
• Removes critical support for sustainable, renewable energy in the U.S.
• Helps fossil fuel industries increase and hide pollution and opens more public lands to build new polluting projects.

How Can I Prepare?

HEALTHY AIR

• Take advantage of tax credits to help purchase an electric vehicle by September 30, 2025.
• Take advantage of tax credits for clean energy home improvement projects (like solar panels, solar water heaters or geothermal heat pumps) by December 31, 2025.
• Take advantage of tax credits to build energy efficient home improvement projects (like heat pumps, water heaters and new insulation/doors/windows) by December 31, 2025.
• Check with your state governments or utility companies for any state or local level tax credits that continue to be offered.

HEALTHCARE

This year, open enrollment for Healthcare.gov will have the same dates (November 1 – January 15 in most states), and you can visit Lung.org/open-enrollment for updates and information on how to enroll. Since many of these changes will take place in the months or years ahead, for both Marketplace and Medicaid plans, it is important to keep your contact information up to date so that plans can communicate with you when changes are made and if they need any additional information from you.

What Happens Next?

Most of these changes will not take effect immediately. The American Lung Association will continue to support access to care, healthy air and lung health on a national and state level as these changes roll out.

Congress and the administration will turn its focus to other opportunities that can improve healthcare access and clean air – or make it worse. The American Lung Association will urge decisionmakers to protect lung health, and your help will be vital. Join the Lung Action Network to voice your support for healthy air, access to care and lung health.

Today, you can take action by asking your lawmakers to extend healthcare tax credits before they expire.