One Big Beautiful Bill Act and Travel Nursing

One Big Beautiful Bill Act and Travel Nursing

Introduced in July 2025, the One Big Beautiful Bill Act (OBBBA) brings significant adjustments to the healthcare system. Changes to an already struggling industry are a potential drawback, especially given the ongoing effects of the COVID-19 pandemic and burnout among nurses and other healthcare workers. However, there may be positive opportunities for travel nurses to grow their experience. This guide outlines the OBBBA's potential effect on travel nursing and possible changes to the industry moving forward.

What Is the OBBBA?

Also known as H.R. 1, the Bill restructures federal healthcare spending. A reduction in spending for Medicaid and the Children’s Health Insurance Program (CHIP) will be $1 trillion over the next decade. Eligibility criteria also change—by 2034, an estimated 7.5 million people will no longer receive Medicaid coverage.

The potential consequences of OBBBA on nursing are serious. Hospitals can expect rising costs from unpaid care bills alongside tighter Medicaid reimbursement. The industry is likely to face additional staffing challenges in an industry already struggling to retain healthcare professionals.

How Does the OBBBA Relate to Travel Nursing?

The OBBBA may impact facility budgets for hiring permanent staff and offer growth opportunities for specific travel nursing roles. The Bill shows particular areas where there will be a demand for travel nurses:

Rural Healthcare

Despite the reduction in Medicaid funding, spending on rural healthcare infrastructure will increase. Rural hospitals and facilities may have expansion opportunities, whereas those in more urban areas may face tighter budget constraints.

Patient Volumes

Due to the Medicaid changes, patient volumes may become unpredictable. Facilities may experience a surge of patients that they cannot handle on their own. Outsourced staffing will become a likely reality, potentially increasing opportunities for travel nurses.

Home and Community-Based Services

The Bill focuses on improving access to home and community-based services (HCBS). Better home care and community service delivery would create more opportunities for travel nurses, and a more diverse range of assignments may result.

Medicaid Eligibility and Payment Policy Changes

Various changes to Medicaid result from the OBBBA legislation, impacting clinical environments and building a potential need for more travel nurses. However, eligibility and funding challenges also apply. Below is a breakdown of what to expect:

• Eligibility adjustments:

  As of January 2027, individuals must provide evidence of 80 hours of work per month to receive Medicaid. The requirements cover employment, job training, higher education or community service. Eligibility for expansion adults—people aged between 19 and 64 in the 40 expansion states without dependent children or disabilities—will change every six months.

• Shrinking financing flexibility:

  States will experience restrictions in the funding they provide to Medicaid recipients. The safe harbor limit of 6% will reduce to 3.5% by 2032. The decrease will begin in 2028, with a 0.5% annual reduction. Tax rates for intermediate care and nursing home facilities are exempt from these changes.

• Uninsured emergency care increase:

  With Medicaid coverage declining, individuals are likely to leave conditions untreated until medical treatment becomes absolutely necessary. Emergency department visits will rise, and

  hospitals must treat all patients

  regardless of whether the patient has insurance.

• Strain on ED boarding:

  Due to the potential increase in hospital admissions,

  ED boarding stays will increase

  , causing additional strain on medical staff. A rise in patient numbers adds more pressure on staff to cover shifts and provide appropriate care.

• Uncompensated care and margin pressures:

  The financial constraints associated with treating patients without insurance may increase. Hospitals and other facilities will also likely face shortages in staff funding as they attempt to cover shortfalls from uninsured patients.

Why Medicaid Changes Matter for Travel Nurses

The demand for travel nurses will likely increase based on the following factors:

• Rising patient numbers:

  As patients surge, facilities can rely on travel nurses to fill the demand of short-term jobs.

• Better revenue outcomes:

  Due to the financial constraints of treating uninsured patients, travel nursing assignments allow for patient coverage without incurring the financial obligations associated with permanent staff.

• High demand in low-income areas:

  The H.R. 1 legislation is likely to put significant pressure on safety-net hospitals in poorer communities.

  Thin margins are already an issue

  in these facilities. Further constraints may result in the need for travel nurses and supplemental staff.

Multiyear Funding for Rural Hospitals and Providers

A substantial strategy to mitigate some of these issues is the introduction of the Rural Health Transformation (RHT) program. The RHT initiative will provide $50 billion to rural healthcare facilities from 2026 to 2030, equaling $10 billion every year. Funding will contribute to the implementation of new technology and the revamping of healthcare delivery.

Rural facilities have been facing nursing shortages due to various factors, including lower salaries in comparison with nurses working in urban areas and fewer development opportunities. On average, 40% of children in rural areas and 20% adults who are not elderly have Medicaid coverage.

Why Rural Health Matters for Travel Nurses

Changes from the OBBBA for rural health facilities may be beneficial for travel nurses:

• Employment opportunities:

  Travel nursing roles become available as rural facilities secure the funding to fill positions. The difficulty with employing permanent staff still exists, but the

  opportunity for travel nursing

  means potential for competitive assignments.

• Attractive compensation:

  Contract additions may include bonuses for joining and completing assignments set for a specific time frame.

• Hybrid working:

  Funding also supports the need for telehealth infrastructure. Travel nurses can work on-site at facilities delivering patient care, as well as offer virtual care assistance through technology funding via the RHT program.

Expanding Home and Community-Based Services

The legislation offers substantial motivations for travel nurses to deliver HCBS. An extension of the Money Follows the Person (MFP) program is in place, which prioritizes HCBS over institutional care. Much like rural healthcare, telehealth is a significant factor under this legislation. By introducing technology updates, patients can receive care in their own homes, tailored to their specific circumstances.

Why HCBS Matters for Travel Nurses

The expansion of HCBS offers new opportunities beyond clinic-based jobs:

• Diverse experiences:

  Travel nurses have the opportunity to care for patients with a wide range of conditions and expand their clinical expertise.

  Travel nurses have the flexibility

  to visit patients in their homes, educate them on care practices and offer medication and wound care.

• Transitional care opportunities:

  With home care as a key area of focus, travel nurses can bridge the gap between preventing readmissions and providing home care immediately after hospital discharge.

• Rising demand:

  States are working with the Centers for Medicare & Medicaid Services (CMS) toward

  quality improvements of Medicaid care

  in home environments. An increasing demand for travel nurses to fill occupancy spaces is likely.

• Chronic disease management programs:

  Patients with health concerns such as diabetes and heart failure require assistance from chronic disease management programs. Travel nurses have the opportunity to deliver personalized care plans for these patients, sometimes on a hybrid or fully remote basis.

One Big Beautiful Bill Act and Nursing FAQs

Explore the following FAQs to help you navigate the H.R. 1 impact on travel nursing:

Which Areas Should Travel Nurses Prioritize Based on OBBBA and Healthcare Staffing?

Based on funding for rural facilities between 2026 and 2030, prioritizing rural facilities and the surrounding communities will likely offer the best range of job opportunities.

What Does H.R. 1 and Nursing Education Mean for Job Growth?

Reallocating funds will also work for training programs, particularly with the introduction of new technology for virtual care services. Adopting these technologies helps toward the goal of HCBS and opens doors for new job opportunities.

Will the Overall H.R. 1 Impact on Healthcare Staffing Be Positive?

For travel nursing, there will likely be further job opportunities and experiences that help bridge care gaps in specific communities. However, changing eligibility requirements and potential strain on facilities caring for uninsured patients will cause strain on healthcare staff.

Build Your Travel Nursing Career Today

With the expected changes from the OBBBA, the demand for travel nurses is on the rise. Our team is experienced in finding high-paying nursing jobs for dedicated and passionate professionals. A recruiter connects with you one-on-one to explore your goals and match you with the best opportunities. Start your travel nursing career and apply to join Trustaff today.