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Signed into law in July 2025, the "Big Beautiful Bill"—officially the One Big Beautiful Bill Act—represents one of the most comprehensive legislative packages in recent memory. While much of the public attention has focused on its tax and social spending provisions, the bill also brings significant changes to the U.S. insurance landscape, particularly in the areas of health insurance and property and casualty (P&C) insurance.

Health Insurance: Major Shifts and Challenges

The bill enacts sweeping changes to Medicaid and the Affordable Care Act (ACA) marketplaces. Over the next decade, Medicaid will see nearly $1 trillion in funding cuts. These reductions are expected to force states to scale back coverage, increasing the financial burden on vulnerable populations and likely resulting in higher uncompensated care costs for hospitals. New work and reporting requirements for Medicaid enrollees will make it more difficult for low-income individuals to keep their coverage, with estimates suggesting millions could lose access to health insurance.

For those relying on the ACA marketplace, the bill introduces stricter eligibility verification for subsidies and shortens the annual open enrollment period. Policyholders must now update their information annually, and delays in subsidy approvals during special enrollment periods may leave individuals temporarily uninsured. Compounding these challenges, the bill allows enhanced premium subsidies—introduced during the pandemic—to expire. As a result, many ACA enrollees could see their premiums rise by as much as 75% next year.

These combined changes are projected to increase the uninsured population by approximately 16 million by 2034, reversing a decade-long trend of declining uninsured rates. Hospitals and healthcare providers, particularly in rural areas, will face higher uncompensated care costs and may be forced to cut services, reduce staff, or even close facilities. While the bill does include a $50 billion fund to assist rural hospitals, many industry groups argue this amount is insufficient to offset the broader impact.

Change	Estimated Uninsured Increase by 2034
Medicaid cuts	7.8 million
ACA marketplace restrictions	3.1 million
Codification of program integrity rule	0.9 million
Expiration of enhanced tax credits	4.2 million
Total	~16 million

For consumers, the implications are stark. Millions, especially those in low-income and rural communities, are at risk of losing coverage or facing significantly higher costs for health insurance.

Property and Casualty Insurance: Tax and Investment Incentives

The property and casualty insurance sector will also feel the effects of the "Big Beautiful Bill," primarily through changes in tax policy and investment incentives. The bill restores 100% bonus depreciation for qualifying property placed in service after January 19, 2025, and before January 1, 2030. This provision allows businesses, including property owners and real estate investors, to fully deduct the cost of eligible property in the year it is placed in service, improving cash flow and encouraging reinvestment in new assets.

Additionally, the cap for Section 179 expensing is increased to $2.5 million, with phase-outs beginning at $4 million. This change benefits small and mid-sized businesses by enabling more immediate write-offs for equipment and property purchases. While certain incentives for energy-efficient construction, such as Section 179D and 45L credits, are extended through 2026, they will phase out thereafter. This affects long-term planning for property developers and insurers interested in risk mitigation through resilient construction.

The bill also modifies the rules around casualty loss deductions, which could impact how insurers and policyholders handle claims for property damage and disaster-related losses. These changes may alter the financial calculus for both insurers and insureds in the aftermath of disasters, potentially affecting claims frequency and severity.

The restored and enhanced depreciation and expensing provisions are expected to spur investment in property, renovations, and equipment, leading to increased demand for property and casualty insurance products as more assets are acquired and improved. The temporary nature of energy efficiency incentives may lead to a surge of projects before the credits expire, followed by a slowdown, which could affect the flow of new or upgraded properties entering the market.

The "Big Beautiful Bill" marks a fundamental reshaping of the U.S. insurance landscape. The health insurance sector faces a rollback of coverage expansions, with millions projected to become uninsured, higher costs for those who remain insured, and increased pressure on healthcare providers. Meanwhile, the property and casualty insurance sector will benefit from a more favorable tax environment for property investment and upgrades, though it must also navigate uncertainty from the phase-out of certain incentives and changes to casualty loss rules. Both sectors will need to adapt to a more complex and dynamic policy environment, with significant consequences for consumers, providers, and insurers alike.