Medicaid and Marketplaces Changing Landscape for Bleeding Disorders Community with Johanna Gray

Today on Beyond the Bleeds, John and I delve into the “One Big Beautiful Bill,” a landmark legislation signed into law on July 4, 2025, and its far-reaching impact on individuals and families living with bleeding disorders. We break down what this trillion-dollar healthcare bill really means—from increased costs and new eligibility rules to the practical next steps for protecting our access to care. An extraordinary advocate and expert joins us to help navigate the changes ahead.

 Johanna Gray is a Principal at Artemis Policy Group, a health policy and association management firm in Washington, DC. She works with clients, including patient advocacy groups and associations of specialized treatment centers, to develop and implement successful advocacy strategies involving Congress and federal public health agencies. She has served as a federal policy advisor to the National Bleeding Disorders Foundation since 2007 and the Hemophilia Alliance since 2011. Johanna began her career as an intern for then-Senator Barack Obama and has held several positions in policy analysis and government affairs before founding Artemis with her partners, Ellen Riker and Elizabeth Karan, in 2020. She received an MPA from the Maxwell School at Syracuse University and a B.A. in Public Policy Studies with honors from the University of Chicago. Outside of work, she reads extensively to stay current with two book clubs and enjoys traveling, trying new restaurants, and exploring DC with her husband, Dave, and rescue pup, Frank.

“I also think our advocacy with partners made H R1 less bad than it could have been…we have moved mountains before, and we will have to again.” ~Joanna Gray

Today on Beyond the Bleeds:

• The “One Big Beautiful Bill” (HR1) implements approximately $1 trillion in healthcare spending cuts, primarily affecting Medicaid and Marketplace (Obamacare) insurance, which will impact approximately 100 million Americans.
• An estimated 12 million people could lose coverage due to the combined effects of HR1 and new federal rules, making advocacy and vigilance crucial.
• Medicaid changes will raise barriers through more frequent eligibility checks, new paperwork requirements, higher out-of-pocket costs, and, in some cases, work requirements.
• Marketplace (Obamacare) insurance buyers will see higher premiums, more verification hoops, and reduced access to subsidies as ACA tax credits are set to expire in 2025 unless Congress acts.
• Every state may implement changes differently—if you’re in a Medicaid expansion state, or even if not, always check for updated policies, as many states may adopt cuts voluntarily.
• Don’t rely on internet searches for insurance—use healthcare.gov for the federal or state-based marketplace and consult HTC social workers for guidance.
• It’s critical to keep your contact information current and respond quickly to any notices about your coverage to avoid loss due to simple errors or missed deadlines.
• Grassroots advocacy—sharing personal stories and contacting lawmakers—remains the most powerful tool to protect coverage, as legislators closely tally constituent outreach.

Guest Contact Information:

Joanna GrayArtemis Policy GroupResources Mentioned:bleeding.quorum.us

Wisconsin Department of Health Services – Badger Care Plus

National Bleeding Disorders Foundation Action Alerts

Healthcare.gov for Marketplace insurance enrollment

Hemophilia Alliance-advocacy and resources

Community Counts (CDC Data Surveillance)

To stay informed and make your voice heard, visit the resources above, connect with your HTC, and remember that every story and every email to Congress truly matters.

Looking for practical tips, expert advice, and a sense of community while living with or supporting someone with a bleeding disorder?

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