The One Big Beautiful Bill Act (OBBBA) proposes $1.3 trillion in cuts to federal healthcare programs, including $1 trillion from Medicaid and $300 billion from the Supplemental Nutrition Assistance Program (SNAP). This legislation requires a substantial response from the U.S. healthcare system. Key actions include updating strategic and capital planning, enhancing revenue cycle management, improving labor and supply chain operations, and creating new sources of nonoperating revenue to support organizational missions. The OBBBA signifies a shift toward a market-based healthcare system, where healthcare organizations must reduce reliance on third-party reimbursements and focus more on direct spending, nonoperating revenue, and market-driven demand.