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President Donald Trump’s “big beautiful bill” would make sweeping changes to U.S. health care, leaving millions without health insurance and threatening hospitals. 
The Senate passed the spending measure after a marathon voting session on amendments, but the bill faces another major test in the House.
Recent changes to the bill would cut roughly $1.1 trillion in health-care spending and result in 11.8 million people losing health insurance over the next decade, according to estimates from the nonpartisan Congressional Budget Office.

An aerial view of Valley Health Hampshire Memorial Hospital on June 17, 2025 in Romney, W.V.
Ricky Carioti | The Washington Post | Getty Images

President Donald Trump’s “big beautiful bill” would make sweeping changes to U.S. health care, leaving millions of vulnerable Americans without health insurance and threatening the hospitals and centers that provide care to them. 
The Senate on Tuesday voted 51-50 to pass the spending measure after a marathon overnight voting session on amendments. But the bill will face another major test in the House, where Republicans have a razor-thin majority and some members have already raised objections to the legislation. 

Recent changes to the bill would cut roughly $1.1 trillion in health-care spending over the next decade, according to new estimates from the nonpartisan Congressional Budget Office.
More than $1 trillion of those cuts would come from Medicaid, a joint federal and state health insurance program for disabled and low-income Americans, according to the CBO. The funding cuts go beyond insurance coverage: The loss of that funding could gut many rural hospitals that disproportionately rely on federal spending.
The CBO estimates that the current version of the bill would result in 11.8 million people losing health insurance by 2034, with the majority of those people losing Medicaid coverage.
But the implications could be even bigger. Trump’s bill combined with separate policy changes could result in an estimated 17 million people losing health insurance, said Robin Rudowitz, director of the program on Medicaid and the uninsured at health policy research organization KFF.
She said those other changes include new regulations that would dramatically limit access to Affordable Care Act Marketplace coverage and expiring enhanced ACA tax credits.

“If all of this comes to pass, it would represent the biggest roll back of health insurance coverage ever due to federal policy changes,” Cynthia Cox, KFF’s director of the program on the ACA, said in an analysis published Tuesday. 
Approximately 72 million Americans are currently enrolled in Medicaid, about one-fifth of the total U.S. population, according to government data. Medicaid is the primary payer for the majority of nursing home residents, and pays for around 40% of all births. 
The Trump administration and its allies insist the cuts in the bill aim to eliminate waste, fraud and abuse. Democrats have said they break the president’s repeated promises not to touch the Medicaid program. Medicaid has been one of the most divisive issues throughout negotiations in both chambers, and some House Republicans have expressed reservations about how deep the cuts are. 
“I get that they want to cut fraud, but taking a swipe across the top is not going to solve the issue,” said Jennifer Mensik Kennedy, president of the American Nurses Association. 
She said the cuts could shutter hospitals and health centers in rural areas and lead to job losses for health-care staff such as nurses. 

Millions of Americans will lose coverage

The cuts in the bill come from several different provisions, but the lion’s share of Medicaid savings will come from two changes. 
One would establish a new, strict national work requirement for certain Medicaid beneficiaries ages 19 to 64. It would require childless adults without disabilities and parents of children older than 14 to work, volunteer or attend school for at least 80 hours a month to keep their insurance coverage, unless they qualify for an exception. 
Current law prohibits basing Medicaid eligibility on work requirements or work reporting rules, according to KFF. 
The new work requirement in the bill won’t kick in until 2026. It is projected to save about $325 billion over a decade, the CBO said. 
An analysis published June 23 by the UC Berkeley Labor Center said that the work requirement would cause the most people to lose insurance and “poses an especially draconian barrier to older adults.” The center said there is a steady drop-off in employment after age 50 due to factors “outside [people’s] control,” including deteriorating health, age discrimination and increasing responsibility to provide care for aging family members. 
“These same factors make older adults particularly vulnerable to coverage loss under Medicaid work requirements,” the analysis said.
People living in rural communities, such as seasonal farmers, may also struggle to find employment for parts of the year, Mensik Kennedy said.
AARP, an advocacy group focusing on issues affecting those 50 and older in the U.S., sent a letter over the weekend to Senate Majority Leader John Thune, R-S.D., and Senate Minority Leader Chuck Schumer, D-N.Y., opposing another provision that would disqualify people who fail to meet Medicaid work requirements from receiving premium tax credits to purchase coverage through the ACA Marketplaces.
“This creates a steep coverage cliff for those in their 50s and early 60s — particularly for those nearing retirement or working part-time — who may be left with no affordable coverage option at all,” the group said. 

Hospitals, health centers, patients in rural areas at risk 

A surgeon walks past in the surgical unit at Valley Health Hampshire Memorial Hospital on June 17, 2025 in Romney, W.V.
Ricky Carioti | The Washington Post | Getty Images

Another driving source of Medicaid savings will come from a provision that will cap and gradually reduce the tax that states can impose on hospitals, health plans and other medical providers. Those provider taxes are designed to help fund state Medicaid programs, with the federal government matching a portion of the state’s spending. 
Some members of the Trump administration and conservative lawmakers argue that it is a loophole for states to receive disproportionately more federal funds than they contribute. 
The bill’s restrictions on provider taxes and another strategy called state-directed payments would cut spending by a combined $375 billion, according to the CBO report.
But some GOP senators and experts raised concerns that capping provider taxes would threaten a critical funding stream for rural hospitals, which could force them and other health centers to close. Mensik Kennedy said health-care providers in rural areas, particularly critical access hospitals, rely more on Medicaid funding to support them compared with those in urban areas. 
“You’re going to see closures of rural hospitals that are the backbone of their community and were already struggling financially. You’re going to see half a million job losses,” Mensik Kennedy said. 
She said pregnant women in rural areas could be forced to drive 30, 40 or more miles to deliver a baby, while emergency medical services could have to drive an hour to reach a patient having a heart attack. 
Patients in rural communities already have higher rates of chronic illnesses and mortality because they have limited access to care, according to the Centers for Disease Control and Prevention. 
Senate Republicans have added a $25 billion fund to the bill to help rural hospitals stay open in the face of Medicaid cuts. 
But Mensik Kennedy said that fund is “putting a bucket of water on the house fire,” adding that it is not enough to offset the cuts from the cap on provider taxes and other provisions. 
Cuts in overall Medicaid funding for rural hospitals would exceed 20% in more than half of states, according to a report from the National Rural Health Association.

A win for pharma 

Senate Republicans handed a win to drugmakers after they added back a provision into the bill that would exempt more medicines from the Inflation Reduction Act’s Medicare drug price negotiations. 
Under the bill, medicines used to treat multiple rare diseases will be exempt from those price talks between Medicare and manufacturers. The Senate initially left out that provision, called the ORPHAN Cures Act, in its first draft of the bill last month. 
The pharmaceutical industry argues that excluding those drugs from the negotiations will encourage more investments in treatments for rare conditions. Currently, only drugs that treat a single rare disease or condition can be exempted from price talks.
“The ORPHAN Cures Act will enable more options for Americans living with rare disease,” the trade group Biotechnology Innovation Organization wrote Wednesday in a post on X. The group also said only 5% of rare diseases have an approved treatment, while the economic toll of rare conditions in the U.S. surpassed $997 billion in 2019. 
But on Tuesday, drug pricing group Patients For Affordable Drugs Now called on the House to remove the ORPHAN Cures Act from the bill and allow Medicare drug price negotiations to deliver more savings to patients. 
The decision to include it in the legislation “moves us in the wrong direction, undermining hard-fought progress to lower drug prices,” Merith Basey, executive director of the group, said in a statement. 
“Pharma lobbyists will stop at nothing to maintain industry profits, and when a majority of the Senate caves to their interests, it’s a reminder to Americans why they’re paying the highest drug prices in the world. Simply put: it’s because Congress allows it,” Basey said.
She called it a “completely unnecessary $5 billion giveaway” to the pharmaceutical industry, referring to CBO estimates for how much the ORPHAN Cures Act would cost taxpayers over the next decade.  More

Constellation Brands missed Wall Street’s estimates for its quarterly earnings and revenue, as it saw lower demand and paid more in aluminum tariffs.
The brewer reiterated its outlook for fiscal 2026.
The company’s stock has shed more than 20% of its value this year, fueled by concerns about how tariffs would affect demand for its beer.

Case of Modelo, a beer imported from Mexico, are seen for sale at a grocery store in Arlington, Virginia, February 3, 2025, following the announcement of tariffs by US President Donald Trump on important goods from Canada and Mexico.
Saul Loeb | Afp | Getty Images

Constellation Brands on Tuesday reported quarterly earnings and revenue that missed analysts’ estimates as tariffs on aluminum weighed on its profitability.
Still, the brewer reiterated its forecast for fiscal 2026, showing confidence that it can hit its financial targets despite the weaker-than-expected quarterly performance and higher tariffs.

Shares of the company fell less than 1% in extended trading. The stock has shed more than 20% of its value this year, fueled by concerns about how the higher duties imposed by President Donald Trump would affect demand for its beer.
Here’s what the company reported compared with what Wall Street was expecting, based on a survey of analysts by LSEG:

Earnings per share: $3.22 adjusted vs. $3.31 expected
Revenue: $2.52 billion vs. $2.55 billion expected

The report, which covers the three months ended May 31, includes the start of Trump’s tariffs on canned beer imports in early April. He also hiked trade duties on aluminum to 25% in mid-March and to 50% in early June.
Both imported beer and aluminum are crucial to Constellation’s beer business, which accounts for roughly 80% of the company’s overall revenue. Constellation’s beer portfolio only includes Mexican imports, like Corona, Pacifico and Modelo Especial, which overtook Bud Light as the top-selling beer brand in the U.S. two years ago.
Constellation reported fiscal first-quarter net income of $516.1 million, or $2.90 per share, down from $877 million, or $4.78 per share, a year earlier. Constellation’s operating margin fell 150 basis points, or 1.5%, in the quarter, in part driven by higher aluminum costs.

Excluding items, the brewer earned $3.22 per share.
Net sales dropped 5.8% to $2.52 billion, fueled by weaker demand for its beer and the company’s divestiture of Svedka vodka.
Constellation is still facing softer consumer demand, CEO Bill Newlands said in a statement. He attributed the weaker sales to “non-structural socioeconomic factors.” Constellation’s beer business saw shipment volumes fall 3.3%, caused by weaker consumer demand.
Last quarter, Newlands said Hispanic consumers were buying less of the company’s beer because of fears over Trump’s immigration policy. Roughly half of Constellation’s beer sales come from Hispanic consumers, according to the company.
Constellation executives are expected to provide more commentary on the quarter during the company’s conference call on Wednesday at 10:30 a.m. ET
For fiscal 2026, Constellation continues to expect comparable earnings per share of $12.60 to $12.90. The company is projecting that organic net sales will range from declining 2% to rising 1%. More

Most U.S. infrastructure was built decades ago and therefore designed for a climate that no longer exists.
Sectors with the worst grades from the American Society of Civil Engineers include airports, power and telecommunications infrastructure.
There is a $3.7 trillion spending gap over the next 10 years to get U.S. infrastructure to a state of good condition, according to the ASCE.

U.S. infrastructure is barely getting a passing grade, and one of the fastest growing problems is climate change. Airports are flooding, bridges are melting from extreme heat, and telecommunications are getting slammed by increasingly extreme weather.
In 2023, at Fort Lauderdale/Hollywood International Airport, historic rainfall turned runways into rivers, shutting down operations and stranding passengers. In New York City last summer, extreme heat caused metal on a bridge over the Harlem River to expand so much that the bridge got stuck open.

Every single category of U.S. infrastructure is at growing risk from climate change — a finding by the American Society of Civil Engineers, which trains engineers and informs federal, state and local building codes.
ASCE’s latest infrastructure report card gave the nation overall a “C” grade, saying climate-related challenges are widespread, affecting even regions previously resistant to these events.
“We continue to see more extreme weather events, so our infrastructure, many times, was not designed for these types of activities,” said Tom Smith, ASCE’s executive director, adding that it will only get worse.
“Whether it’s ice, snow, drought, heat, obviously, hurricanes, tornadoes, we have to design for all of that, and we have to anticipate not just where the puck is now, but where we think it’s going,” Smith said.
Sectors with the worst grades include airports, power and telecommunications infrastructure. CNBC asked First Street, a climate risk analytics firm, to overlay its risk modeling on these specific locations nationally. It found that 19% of all power infrastructure, 17% of telecommunications infrastructure and 12% of airports have a major risk from flood, wind or wildfire.

Most U.S. infrastructure was built decades ago, and therefore designed for a climate that no longer exists. This has a direct impact on investors in the infrastructure space.
Sarah Kapnick, formerly chief scientist at the National Oceanic and Atmospheric Administration and now global head of climate advisory at JPMorgan Chase, said her clients are asking more and more about the climate impact to their investments.
“How should I change and invest in my infrastructure? How should I think about differences in my infrastructure, my infrastructure construction? Should I be thinking about insurance, different types of insurance? How should I be accessing the capital markets to do this type of work?” Kapnick said.
Both Kapnick and Smith said making infrastructure climate-resilient comes back to the science.
“Climate and science is something that we take very, very seriously, working with the science, connecting it with the engineering to protect the public health, safety and welfare,” said Smith.
But that science is under attack, seeing deep cuts from the Trump administration, which fired hundreds of employees at NOAA, FEMA and the National Institute of Standards and Technology — key government agencies that advance climate science.
“There’s going to be this adjustment period as people figure out where they’re going to get the information that they need, because many market decisions or financial decisions are based on certain data sets that people thought would always be there,” Kapnick said.
The nation’s infrastructure also needs funding. ASCE estimates there is a $3.7 trillion spending gap over the next 10 years to get U.S. infrastructure to a state of good condition.
The Trump administration cuts to spending so far include ordering FEMA to cancel the nearly $1 billion Building Resilient Infrastructure and Communities program, which was specifically aimed at reducing damage from future natural disasters. More

Ford sales rose 14.2% during the second quarter over the year-earlier period.
Rival automaker GM reported a 7.3% sales increase for the second quarter.
South Korean automakers Kia and Hyundai both reported their best-ever first-half sales results on Tuesday, up 8% and 10% from a year ago, respectively.

Ford sales rose 14.2% during the second quarter over the year-earlier period, about 10 times the estimated 1.4% industry increase, the automaker said Tuesday.
New vehicle sales for the second quarter totaled 612,095, led in part by gains in its F-Series trucks and “electrified” vehicles, which includes hybrids and EVs.

F-Series trucks saw their best second quarter since 2019, climbing 11.5% to 222,459. New pickup sales overall totaled 288,564 for the quarter, Ford said.
Sales of Ford electrified vehicles totaled 82,886 during the second quarter, up 6.6% from 2024. But of those “electrified” vehicles, pure EVs saw a 31.4% drop, while hybrids were up 23.5%.
For the first half of the year, Ford sold a record 156,509 EVs and hybrids, up 14.7% from the same time last year.
Auto industry forecasters Cox Automotive and Edmunds forecasted new vehicle sales would increase 1.7% and 2%, respectively, for the second quarter from the year-earlier period. They cited a strong market in April and early May as driving the increases, while June sales were expected to be softer.
Earlier this year, President Donald Trump implemented 25% tariffs on imported vehicles and many auto parts imported into the U.S. The levies initially pulled forward demand from price-conscious buyers, but analysts expect that increase in demand to fade if higher prices take hold. 

Rival General Motors reported a 7.3% sales increase for the second quarter and a nearly 12% increase for the first half of 2025. The automaker credited its growth to sales within its trucks, crossovers, EVs and gains in the luxury market led by Cadillac.
South Korean automakers Kia and Hyundai both reported their best-ever first-half sales results on Tuesday, up 8% and 10% from a year ago, respectively. More

Lucas Beyer is not a celebrity. But in Silicon Valley’s rarefied world of machine-learning talent, he is seen as one. A former researcher at OpenAI, Mr Beyer announced last month that he was leaving the artificial-intelligence (AI) lab behind ChatGPT to join Meta, a social-media giant with big AI ambitions of its own. With rumours swirling that Mark Zuckerberg, Meta’s boss, was offering packages worth $100m to poach AI whizzes, Mr Beyer clarified that he had not secured a nine-figure deal. That he needed to say so at all reflects the extent of the frenzy. More

The English Premier League and Microsoft announced a new partnership that infuses AI into the league’s app, website and fantasy sports platform.
With Microsoft AI, fans will be able to access videos, articles and stats dating back to the league’s founding in 1992.
Under the partnership, Microsoft is also becoming the league’s cloud computing partner.

Kobbie Mainoo of Manchester United during the Premier League match between Manchester United FC and Aston Villa FC at Old Trafford on May 25, 2025 in Manchester, England.
Alex Livesey | Getty Images

The English Premier League is bringing artificial intelligence to the soccer pitch through a new partnership with Microsoft.
The five-year agreement will integrate Microsoft’s Copilot AI into the English Premier League app, offering fans access to more than 300,000 articles, 9,000 videos and statistics from the league dating back to its founding in 1992.

Future iterations of the technology will translate text and audio into a user’s native language and will enhance the digital Fantasy Premier League offerings.
Terms of the agreement were not disclosed.
“This partnership will help us engage with fans in new ways — from personalized content to real-time match insights,” Richard Masters, English Premier League CEO, said in a news release.
The English Premier League is widely seen as the most prestigious soccer organization in the world and is the most-watched, airing matches in 189 countries and reaching 900 million homes globally, according to the league.
“By leveraging our secure cloud and AI technologies — including Azure AI Foundry Services with Azure OpenAI, Microsoft 365 Copilot, and Dynamics 365 — we will transform how football is experienced, delivered, and managed on and off the field,” Judson Althoff, executive vice president and chief commercial officer at Microsoft, said in a statement.

Under the partnership, Microsoft is also becoming the league’s cloud computing partner after a previous contract with Oracle ended.
The English Premier League season begins Aug. 15. Before that, fans can watch the Premier League Summer Series, a tournament of “friendly,” or exhibition, matches, from July 26 to Aug. 3 in the U.S. The first matches will be held at MetLife Stadium near New York City with Everton facing AFC Bournemouth and Manchester United facing West Ham United. More

U.S. consumers are spending more on luxury jewelry while pulling away from handbags and clothes, according to a Citigroup analysis of credit card data.
The run-up in gold prices is just one factor in play, according to Citi analyst Thomas Chauvet.
Luxury spending decreased less than feared in May, but it’s too early to say that upper-income consumers have reached a turning point, he said.

Domenica Graci, the CEO and Founder of travel agency One Luxury, is seen wearing a golden Vintage Alhambra bracelet from Van Cleef & Arpels, a golden Love bracelet from Cartier, a golden Juste un Clou nail bracelet from Cartier and an Essential Lines bracelet from Cartier.
Moritz Scholz | Getty Images Entertainment | Getty Images

Luxury retail was expected to stage a turnaround in 2025 after a promising fourth quarter marked by holiday shopping and post-election euphoria. Instead, U.S. credit card spending on luxury goods fell during the first five months of the year compared with the same period in 2024, according to data from Citigroup.
For the month of May, luxury spending held up better than expected, dipping 1.7% year over year, compared with a 6.8% decline in April and 8.5% in March. Combined spend for the top luxury brands, such as Hermès, even eked out a 0.2% uptick on an annual basis, according to Citi’s analysis of a subset of transactions by the bank’s 10 million-plus U.S. cardholders.

However, these gains aren’t equally distributed. Jewelry has proven to be a bright spot, consistently outperforming other categories like leather goods and ready-to-wear.
Monthly spend on luxury jewelry has increased on an annual basis each month since September, according to Citi. In May, total luxury jewelry spend surged 10.1% year over year.
What’s more, while other categories were buoyed by increases in average spend by customer, jewelry was the only product type to also see an increase in individual customers. Within the jewelry category, however, a cohort of high-end brands lost 2.7% of customers, but those who remained spent 11.7% more on average.
Citi analyst Thomas Chauvet told CNBC that sales have likely been buoyed by the perception of jewelry as investment pieces. Jewelry can also carry more sentimental value, he said, as a gift or to commemorate a life milestone.
“When you have $3,000 to spend on luxury, you know, are you going to buy a piece of jewelry or a handbag for the same price?” he said. “Perhaps the piece of jewelry gives you superior intrinsic value given the precious metals content and superior emotional value and meaning.”

Chauvet added that the recent run-up in gold prices provides further justification.
“It is probably sensible to buy a Cartier bracelet now, given they have increased prices by less than 5% since the beginning of 2025, when gold prices have appreciated by over 25%,” he said.

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Handbag brands, on the other hand, have steadily increased prices as much as 30% to 40% since the pandemic without the consumer getting more bang for their buck, he said.
“Handbags have offered limited newness,” Chauvet said, with the caveat that a few fall and winter 2025 collections showed some promise. “In the last five years, from brand A to brand B, most bags shapes and styles are very difficult to differentiate from one another.”
Luxury watch spending has seen some gains this year, but less consistently than that of jewelry. Across all luxury watch brands, spending increased 14.7% compared with May 2024. However, results for the top watch brands fell 10% in May on an annual basis.
While surges in Swiss watch exports have made headlines, Chauvet said it was largely driven by retailers stocking up and watch manufacturers rushing product to U.S. subsidiaries in reaction to President Donald Trump’s threatened 31% tariff on Swiss goods.
The spending uptick in May may reflect an uplift in consumer sentiment but not necessarily a turning point for high-end shoppers, according to Chauvet. While equity markets have rebounded, the U.S. dollar is down about 10% year to date.
“We know the U.S. consumer feels better about life when the dollar is strong,” he said. “One example of that in luxury is your ability to travel and to spend abroad on luxury is augmented by a strong dollar.”
Other potential threats to consumer spending loom large. The 90-day pause in Trump’s so-called reciprocal tariffs is less than two weeks from expiring, and the Iran-Israel conflict has roiled oil prices, Chauvet noted. More

Home Depot’s SRS Distribution unit is buying GMS, a building-products distributor, for about $4.3 billion.
Home Depot is trying to attract more sales from contractors and other home professionals.
The deal is expected to close in early 2026.

A Home Depot store in San Carlos, California, US, on Monday, Nov. 11, 2024.
David Paul Morris | Bloomberg | Getty Images

Home Depot said Monday that it is buying GMS, a building products distributor, for about $4.3 billion as the retailer moves to draw more sales from contractors and other home professionals.
Shares of Home Depot fell nearly 1% on Monday. GMS shares rose about 12% and touched a 52-week high.

As part of the deal, the Home Depot-owned subsidiary SRS Distribution will purchase all outstanding shares of GMS for $110 per share, which adds up to about $4.3 billion and amounts to total enterprise value including net debt of about $5.5 billion, the company said.
Home Depot said it expects the acquisition to be completed by early 2026.
Home Depot’s announcement also concludes a potential bidding war between the big-box retailer and billionaire Brad Jacobs. Jacobs’ building-products distributor QXO had offered about $5 billion in cash to acquire GMS and said it would press forward with a hostile takeover if the company’s management rejected the proposal.
As Home Depot chases growth, it’s gone after a steadier and more lucrative piece of the home improvement business: electricians, roofers, home renovators and other professionals who tackle large projects year-round and need a lot of supplies. Home Depot said it’s speeding along that strategy with the GMS deal.
Home Depot bought SRS Distribution — the subsidiary that’s acquiring GMS — last year for $18.25 billion, in the largest acquisition in its history. Texas-based SRS sells supplies to professionals in the landscaping, roofing and pool businesses and it has bought up many other smaller suppliers as it’s grown.

Home Depot’s focus on selling to professionals is well timed. Sales from do-it-yourself customers have slowed as higher mortgage rates have decreased housing turnover and dampened homeowners’ demand for larger projects because of higher borrowing costs.
The company said it expects total sales to grow by 2.8% for the full fiscal year and comparable sales, which take out the impact of one-time factors like store openings and calendar differences, to rise about 1%.

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