This week at Unbreaking, July 10
The Trump megabill has passed, and the top line outcome of the bill is grim: it’s expected to push 17 million people out of healthcare coverage.
As always, we’re keeping an eye out for how communities and institutions respond to the bill, as well as the ways it will impact all healthcare in the United States. You can find more on this below, and on our Medicaid page.
We also have updates this week on Republicans’ failed attempts to restrict gender affirming care, and a new Supreme Court ruling that clears a path for even more layoffs within the federal workforce.
Medicaid
As we expected, the reconciliation bill signed into law last week cut a trillion dollars from Medicaid, the program that provides free or low-cost healthcare coverage and long-term-care coverage for 1 in 5 people in the US. With other Trump administration policy changes, the bill is expected to push about 17 million people out of healthcare coverage.
The largest Medicaid cut in the bill works by requiring millions of people who became eligible for Medicaid through the Affordable Care Act expansion to regularly submit paperwork proving their eligibility. Requirements like these have failed to increase employment while unfairly excluding eligible people from Medicaid in several states, but are expected to roll out across the US by the end of 2026. The billions of dollars in non-work-reporting cuts are expected to sharply reduce funding to hospitals and force states to cut funding for in-home care for elderly and disabled people.
Transgender Healthcare
After weeks of back and forth, concerted campaigns (led largely by trans folks) to pressure representatives, updates from the Parliamentarian, and holding our breath to see what the Senate Republicans might do, both provisions that would slash funding and access to gender affirming care were removed from the bill without forcing the issue to go to debate. These provisions would have made it harder and more expensive for trans folks across the country to access life saving care. This is a win, and worth celebrating!
There are, of course, still plenty of attacks to healthcare access for trans people — including a change to the Affordable Care Act that will prohibit states from mandating that insurance covers gender-affirming care. That change goes into effect in a couple of weeks, and we’ll be watching how it impacts folks around the country.
Equality at Work
The federal government has long stood both as a model for equal employment practices and as one of the most accessible workplaces for people traditionally excluded from private sector work — especially Black workers and veterans. So the Trump administration’s ongoing efforts to hollow out the federal workforce are hitting Black workers, and Black women, especially hard: In April, 106,000 Black women lost their jobs, the largest job loss of any demographic that month; in the June jobs report released just last week, the unemployment rate for Black women rose to nearly 6% — twice the rate of white workers.
Meanwhile, on July 8, the Supreme Court issued a stay of a lower court ruling that had halted many of the federal workforce reductions, clearing the way for large-scale layoffs to continue.
Up next
Over the next few weeks, you can expect new pages on data security, plus a deep dive into immigration issues including the very critical right to due process.
We’ll continue to update you here, as well as on Bluesky.
Until then, we invite everyone to use and adapt our content for sharing with your readers and communities: everything on our site is available under a CC BY 4.0 license. We welcome translations, adaptations to other formats, and especially encourage organizers and journalists to make use of what we’ve developed. And if you make something with our content, please let us know — we’d love to hear from you.