The One Big Beautiful Bill Act, signed by President Donald Trump, is expected to cut roughly $1 trillion from Medicaid over the next decade, making it the largest rollback of federal healthcare in American history. The Congressional Budget Office estimates that the bill will raise the number of uninsured people by 10 million by 2025, including 7.5 million on Medicaid or the Children’s Health Insurance Program, known as CHIP, up to 17 million who will lose health coverage when the Affordable Care Act marketplace subsidies expire. Medicaid is a vital program for mothers and the people who depend on them, covering 40% of all births in Illinois in 2023. Despite exemptions for pregnant women, changes to Medicaid financing are expected to increase the numbers of uninsured individuals, increase administrative burdens for states, providers, and families, and reduce access to care. The changes will vary across states and compound long-standing challenges in perinatal health, including persistent racial and geographic inequities, widespread closure of obstetric units, and lagging maternal and infant outcomes. Polls indicate that public opposition to the cuts are across party lines.