Arthritis Foundation: “One Big Beautiful Bill” Threatens Arthritis Care

ATLANTA (July 9, 2025) – The Arthritis Foundation exists to support and speak up for the 60 million people diagnosed with arthritis in the United States. We are here to ensure that our constituents have access to the care and treatments they need to manage their disease and improve their quality of life, regardless of where they live or their income. 

With the final passage of H.R. 1, also known as the “One Big Beautiful Bill Act,” signed into law on July 4, 2025, the Arthritis Foundation is deeply concerned about the troubling implications it will have for health care in the United States. This new law makes major and harmful changes to how people get the care they need, putting millions at risk of losing access to essential health services. That is why the Foundation stands alongside many other health care organizations in strongly opposing provisions in this bill that have direct and devastating consequences for the communities we serve.   

While the legislation represents sweeping health care policy changes that will likely destabilize insurance markets and undermine coverage, the Arthritis Foundation finds several mandates and finalized rules of particular concern, including:

• “Community Engagement” requirements compelling adults insured through the Affordable Care Act’s Medicaid expansion to complete 80 hours of work or community service every month to keep their health care coverage. Many people living with chronic conditions, including arthritis and other disabling diseases, may be physically unable to meet these rigid requirements. This provision will lead to more people losing coverage — not because they don't qualify, but because they can’t keep up with the administrative burden, including filing paperwork regularly to show that they are working, in school, volunteering or that they qualify for an exemption to receive Medicaid.
• Shortening the open enrollment period for the Health Insurance Marketplace by one month. 
• Ending automatic renewal for Marketplace enrollees unless they take proactive steps to confirm their eligibility.

These changes will create new barriers to staying covered, especially for those managing chronic conditions, for caregivers and for those with complex health needs.   

One provision in the Act that would be a step in the right direction is the expansion of Health Savings Accounts to cover more telehealth services. These services will become even more invaluable in rural areas, where care is not easily accessible — and where reductions in Medicaid funding will further undercut rural hospitals and other health care facilities. Such limited improvements do not come close to offsetting the damage caused by deep cuts to Medicaid, stricter Medicaid eligibility requirements, and the rollback of protections that millions rely on to access care.

“Our work to ensure affordable, high-quality care for all people with arthritis, who rely on regular access to care continues,” says Steven Taylor, President & CEO of the Arthritis Foundation. “We call on states, Congress and the Administration to prioritize key reforms that were left out of the legislation, despite strong bipartisan support, such as extending the enhanced Advanced Premium Tax Credits to stabilize health care markets and passing Pharmacy Benefit Manager reform.”

The Arthritis Foundation will continue to engage with lawmakers and administrative agencies to provide patient perspectives now that the rulemaking process has begun.