A little understood aspect of the big, ugly bill could cause devastating problems for seniors and others.
Norman J. Ornstein
July 16, 2025
PAYGO is not a term that crosses many lips in daily discourse. But it may soon be used more widely, as its impact resonates in the aftermath of the passage of the so-called One Big Beautiful Act. While the enormous and damaging cuts in Medicaid have dominated discussion since the bill was enacted—cuts that will take millions of Americans off of health insurance, force the closure of many rural hospitals and nursing homes, and likely put enormous increased pressure on emergency rooms across the country—another shoe is soon to drop. And that is major cuts in its sister program, Medicare.
I'm glad my grandmother passed away before all of this shit happened.