Opinion: Why the ‘Beautiful Bill’ fails Tennessee families in health care coverage
Main Street Nashville Opinion

On July 4, President Donald Trump signed into law what he called the “One Big Beautiful Bill Act.” While the title may be meant to inspire pride, the contents tell a different story — one that includes the largest health care cuts in U.S. history, with over $1 trillion slashed from Medicaid over the next decade.

For Tennessee and much of the country, the real-world consequences of this law are already unfolding. And they’re anything but beautiful.

According to the Congressional Budget Office, the ripple effect of this bill will leave at least 17 million Americans without health insurance in the next ten years. Nearly 11.8 million Americans are projected to lose coverage immediately, and on top of that, over 4 million could become uninsured as pandemic-era Affordable Care Act (ACA) credits expire.

And who carries the heaviest burden? States like ours.

The Washington Post reports that the bulk of the cuts will come from Medicaid, which is jointly funded by states and the federal government. In Tennessee, we call it TennCare. When federal support is withdrawn, services shrink, hospitals lose funding, and patients — often our most vulnerable neighbors — are the ones left behind.

If this is what “making America great again” looks like, who exactly is it great for?

When people lose coverage, they don’t stop needing care. They just lose access to it. That means hospital emergency rooms become the last line of defense. They fill up. They go unpaid. And in rural counties, they start to close.

Dr. Gerald Christian, a faculty member at Middle Tennessee State University, relies on Medicaid every day. Paralyzed from the armpits down since age 16, he told reporters that without Medicaid, paying for medical necessities like his $6,000 wheelchair, a $100,000 accessible van, and $50,000 in yearly home health care would be impossible. These aren’t luxuries — they’re the foundation of his independence and productivity. And as he states, “There’s no way you can take away billions without just impacting more than the scammers.”

And Christian is just one example. Across Tennessee, hospital systems like HCA and non-profit providers employ thousands. Shrinking Medicaid reimbursements put jobs, essential services and lives at risk.

The State Health and Value Strategies program at Princeton University estimates that hospitals could see an 18% loss in Medicaid funding — nearly $665 billion nationally over the next 10 years. Add to that the CBO’s finding that the law adds $3 trillion to the national debt while doing little to stimulate economic growth, and it becomes clear: this bill is neither financially sound nor ethically defensible.

Here’s what’s most frustrating — it didn’t have to be this way.

There are more responsible paths to saving money in the health care system. We could rein in the excess profits of private insurers, negotiate pharmaceutical prices at the federal level, or invest in preventive care that reduces long-term costs. Instead, this bill pulls away support from those who need it most and places a heavier burden on already overextended state and local governments.

This isn’t about partisan posturing; it’s about protecting the dignity and well-being of our constituents. It’s about recognizing that the health of our people is not a political game, but a moral responsibility.

This bill doesn’t reflect Tennessee values. It doesn’t value life, access, or fairness. And it will cause lasting damage if we don’t speak up.

To my fellow leaders in Tennessee and beyond: We can — and must — do better. Because what’s happening now isn’t just fiscally irresponsible — it’s morally indefensible.

State Rep. Bob Freeman, D-Nashville, represents House District 56 in the Tennessee General Assembly. Freeman is also the President of Freeman Webb Company in Nashville, a full-service real estate investment and management firm that specializes in the acquisition, management and rehabilitation of multi-family residential and commercial properties. 

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