LISA DESJARDINS: The Trump administration# is planning sweeping cuts to health care## funding across the country.

Some# of those federal funding cuts have## already taken effect.

Others will be# rolling out in the next few years as## President Trump's so called One Big# Beautiful Bill Act is implemented.

That law will reduce what the# federal government expects to## spend on Medicaid by more than# $900 billion over a decade.

KFF Health News looked at# what that means for states,## which will have to shoulder more# of the costs of health programs,## and they found they're being forced to make# tough choices about what they can afford.

Stephanie Armour is the senior health# policy correspondent at KFF News and## joins me now.

Stephanie, first of all,# help our viewers understand which of## these health cuts have already happened# and which ones are coming down the road?

STEPHANIE ARMOUR, KFF Health News: That's# actually a really important question because## states are grappling with what's already# happened.

They've already seen tens of## millions of dollars cut.

For example, the# Trump administration is clawing back about## $11 billion just in funding that was given to# states to help them cope with the pandemic.

And a number of states had earmarked# those funds for public health programs,## and now they're having to cut that.

Also what's looming is even more troubling for# states because it's about almost a trillion## dollars in reduced Medicaid spending is# coming in the next year or two.

So right## now you're seeing states grappling not only# with the cuts that are happening right now,## but what are they going to down the line.

LISA DESJARDINS: Your work has really looked# at the ups and downs across the country and## it varies by quite a lot.

By your analysis, for# example, Texas expects to lose some $40 billion## in Medicaid funding.

Delaware's already seen# almost 40 million in public health funds cuts.

What do you see as the most painful# decisions going on out there right now?

STEPHANIE ARMOUR: Yeah, I think what's really# hard for states right now is they were kind of## going through a good time financial,# and they gave a lot of tax breaks to## residents in their state.

That's# been something that's been going on## across the country.

So that's really# eaten into states revenue already.

So on top of the fact that revenues are kind of# down because of that, they're seeing the cuts## that have already happened, plus the cuts that are# coming.

And for some states, there's not much they## can do.

They don't have a lot of other resources,# so they're going to have to cut programs.

Other states are trying to do what they can to# kind of bulk up what still exists.

For example,## New Mexico, creating a trust fund to try to keep# Medicaid going like so it will be there for the## years to come.

But by and large, for states,# this is a really tough time.

And they're just## now kind of getting the sense of the scope# of how big these cuts are really going to be.

LISA DESJARDINS: You know, Republicans, when# they passed the Big Beautiful Bill Act into law,## they insisted that this was about trying# to stabilize the Medicaid system overall## and that it would not hurt the vulnerable.# We've done a lot of work on that on the show,## and that's a debate remains# to be seen what happens.

But how do states view that problem# potentially?

Are states worried about## more uninsured on their rolls, or do they# think this could make the system more stable?

STEPHANIE ARMOUR: Well, I think it's both.

I think# a number of states sort of welcome some of the## oversight in terms of, you know, cracking down# on fraud and abuse, that's certainly an issue.## But I think states right now they're having to# put into place a lot of bureaucracy for this.

Like, one of the things that's going to be# required under the Big Beautiful Bill Act## is a work requirement.

And for enrollees, this is# going to be a lot more bureaucracy and paperwork.## And there's a lot of concern that's what's# going to cause people to drop off the roles,## that they're just not going to be# able to contend with the paperwork,## which we saw earlier with some states# when they imposed work requirements.

So I think states are kind of## both ways.

In some ways they kind# of welcome the additional oversight,## but it's also going to be a big financial# conundrum for them right now just setting it up.

LISA DESJARDINS: This area of American# health care is really among the most## complex problems this country has, and# it's confusing to many people.

But can## you help people understand if you're not on# Medicaid, maybe if you don't have a direct## connection to these health programs.

Could# this still affect you, all of these cuts?

STEPHANIE ARMOUR: Absolutely.

The Congressional# Budget Office estimates we'll see more than 7## million people uninsured compared to what we# have now.

And that's a significant number.## And what happens when that occurs# is hospitals, for example, they're## still required under federal law to treat# anyone who comes in their emergency room,## but you're going to have more people# who don't have insurance coming in.

So what that's going to do is add to what they# call uncompensated care.

The hospitals are going## to have to cover this one way or another.# So what you'll see is premiums potentially## rising for everybody who has private insurance# or employer insurance to help make up that gap.

So it definitely is going to affect everyone,# regardless of whether they're on Medicaid or## another federal program.

This is something that's# across the board.

Everyone's going to feel this.

LISA DESJARDINS: Such important and# smart reporting.

Stephanie Armour,## thank you so much for joining us.

STEPHANIE ARMOUR: Oh, thank you.