Passed on July 4, 2025, H.R. 1—frequently referred to by President Donald Trump as the "One Big Beautiful Bill"—implemented substantial changes to federal budget reconciliation and Medicaid funding. One year after its enactment, data from the CDC and public health organizations indicate that the U.S. maternal mortality rate stands at 17.9 deaths per 100,000 live births. Health advocates note that this rate remains higher than those of other high-income nations, with the CDC estimating that approximately 80% of these deaths are preventable.
The legislation included provisions that blocked Medicaid reimbursements for Planned Parenthood health centers for one year and introduced significant cuts to the broader Medicaid program. According to a report from Planned Parenthood Action Fund, these changes led to the closure of nearly 30 health centers, primarily in rural or underserved areas. The report also cited a 26% decline in patient visits for long-acting contraception and a 20% drop in breast exams at these facilities. In response to the federal funding shifts, 15 states reportedly allocated an estimated $400 million in emergency funds to maintain services for displaced patients.
The Trump administration has defended its healthcare approach, launching initiatives such as Moms.gov and the Rural Health Transformation grant program. While the administration describes these as targeted efforts to support families and rural infrastructure, critics and healthcare providers argue that the programs do not address systemic issues. Advocates for reform are calling for a policy framework focused on expanding obstetric care in "maternity care deserts" and addressing the racial equity gap, noting that Black women remain three times more likely to die from pregnancy-related causes than white women.