A provision tucked inside President Trump’s so-called “big, beautiful bill” will make it harder for thousands of aspiring doctors to finance their education as the country faces a growing shortage in that profession.

As the burden for Medicaid changes shift to the states, the states will have to make very difficult decisions.

Some of the bill’s changes go into effect later this year, while others won’t start until after the midterms in 2026.

A small provision added to President Donald Trump’s “One Big Beautiful Bill Act” — that came to light days before the president signed the bill into law July 4 — could have a major impact on sports betting.

During his campaign, Trump promised to eliminate federal taxes on Social Security benefits. While that measure was cut from the final bill, the majority of seniors are still set to receive a tax break.

“Medicaid really is a foundational pillar of hospital financing in the U.S., particularly for those hospitals that serve low-income, elderly or disabled populations across the country,” said Alan Condon, the editor-in-chief of Becker’s Healthcare, a health care business news publication.