U.S. House of Representatives Speaker Mike Johnson looks at U.S. President Donald Trump signing the sweeping spending and tax legislation, known as the "One Big Beautiful Bill Act," to mark Independence Day, at the White House in Washington, D.C., U.S., July 4, 2025.

The reduction in patients who qualify for Medicaid will mean free clinics must fundraise or find other funds to cover costs for care. In addition, some people would lose ACA coverage, causing more people to seek care at free clinics that are already stretched thin.

Federal cuts to Medicaid passed under President Donald Trump’s signature legislation — dubbed as the “big, beautiful bill” — are raising concerns among Maryland health advocates and policymakers who warn the changes could affect not only low-income residents but also those with private insurance.