1. United States
2. Ariz.
3. Letter

Dear Congress: The One Big Beautiful Bill Act (OBBBA) severely compromises the nation’s fiscal stability and fundamentally dismantles the American healthcare safety net to finance tax windfalls for the wealthiest households. With the U.S. gross national debt officially crossing the catastrophic milestone of $40 trillion this week, Congress cannot ignore the mathematical reality. The Congressional Budget Office (CBO) estimates the OBBBA adds $3.4 trillion to the primary deficit ($4.1 trillion including debt interest through FY 2034), accelerating trust fund insolvency and driving federal interest costs to record highs. Furthermore, this multi-trillion-dollar deficit triggered automatic Statutory Pay-As-You-Go (S-PAYGO) sequestration, mandating $45 billion in Medicare cuts for FY 2026 and nearly $500 billion through 2034. Alongside $16 billion in hospital Disproportionate Share Hospital (DSH) reductions, these cuts directly jeopardize medical provider networks for over 65 million seniors and accelerate the Medicare Hospital Insurance Trust Fund's insolvency by a full year. Simultaneously, the law enacts a historic $911 billion to $990 billion gutting of federal Medicaid over ten years via strict work-reporting mandates ($317B–$336B), six-month redetermination hurdles, and provider tax bans ($191B–$217B). This is projected to cause 10 to 10.9 million Americans to lose health coverage, shifting a crushing $63+ billion surge in uncompensated care and $25 billion in annual revenue losses onto community and rural safety-net hospitals. These devastating healthcare reductions stand in stark contrast to the $1 trillion in net tax breaks delivered to the top 1% (averaging ~$69,000 annually per top earner). While the highest 10% of earners see resources rise by 2.7%, resources for the lowest 10% fall by 3.1%. Coupled with severe SNAP cuts, this economic contraction threatens over 1.22 million jobs nationwide, including nearly 500,000 healthcare positions. We DEMAND immediate, bipartisan legislative action to repeal these destructive provisions and restore fiscal and healthcare stability.