President Trump signed into law the "One Big Beautiful Bill Act", which includes significant changes to the health care system.[1] Establishes for Medicaid work requirements, biennial eligibility reviews for adults above 100% of the federal poverty level beginning December 31, 2026, and mandatory copayments up to $35 per medical service beginning October 1, 2028, with exceptions for primary care, mental health, and addiction treatment.[1] The law limits access to Medicaid and the ACA's premium tax credits to citizens and qualified residents, imposes five-year waiting periods for legal immigrants, including refugees, beginning October 1, 2027, and limits Medicare Part A to citizens or legal residents.[1] Cut about $1 trillion from Medicaid and SNAP over the next decade, which could result in 8 to 12 million people losing insurance.[1] Establishes a rural health care fund, delays the implementation of low-income savings programs in Medicare until October 1, 2034, and provides a 2.5 percent increase in physician pay in 2026.[1] It also regulates negotiations on drug prices, including the exclusion of periods for orphan drugs.[1]