How Trump’s “Big Beautiful Bill” Impacts Private Practice Owners

Donald Trump’s soon to be passed “Big Beautiful Bill” is being hailed by supporters as a transformative tax-and-spending package—but for private practice owners in fields like healthcare, law, and financial services, the implications are mixed.
Let’s unpack what this bill means for your practice, your bottom line, and the patients or clients you serve.

1. Taxes: A Double-Edged Sword

Good news first:

The bill increases the Qualified Business Income (QBI) deduction from 20% to 23%, offering pass-through entities—like S corps, partnerships, and sole proprietors—additional tax relief. This could result in thousands of dollars in savings for many small-to-mid-sized private practices.

The catch:

The bill eliminates the SALT workaround, which previously allowed partnerships and LLCs in high-tax states to deduct state income taxes at the entity level. Now, those taxes are subject to a hard cap - raising the effective tax burden for many professionals in states like California, New York, and New Jersey.

Takeaway:

Work with a tax advisor now to reevaluate your business structure—consider converting to a C-corp if it offers a better tax profile under the new rules.

2. Medicaid & Healthcare Changes

If your private practice serves Medicaid patients, or works adjacent to federally subsidized healthcare, you’ll want to pay close attention. The bill remains subject to change as it moves through the legislative process, but, in its current form, more than $600 billion could be cut from Medicaid. It would also impose work requirements for adults without dependents or disabilities up to the age of 64, require 80 hours of work a month, with documentation twice a month in most cases, and reduce funding for state Medicaid expansion. In summary:

The bill introduces strict Medicaid work requirements (80 hours/month).
Retroactive coverage is reduced, and eligibility verification is now more frequent.
The Congressional Budget Office (CBO) estimates that 7–11 million Americans may lose Medicaid or ACA coverage over the next decade.

For medical, mental health, and dental practices, this could mean:

Fewer insured patients
More unpaid bills
Increased administrative load to verify insurance or offer sliding-scale alternatives

Takeaway:

Private practices reliant on Medicaid should start building cash-pay models, telehealth options, or ancillary revenue streams to reduce exposure.

3. Business Deductions Reimagined

The bill reinstates 100% bonus depreciation through 2029. You can fully write off equipment, tech, or office improvements in the year they’re purchased.
Changes to interest deductibility offer more breathing room for financing growth or acquisition of assets.

This is a major incentive to invest in long-term growth, whether it’s upgrading your EMR system or expanding your practice footprint with acquisitions of equipment, technology or office improvements.

4. Ripple Effects: Income Redistribution & Patient Mix

Trump’s bill also shifts wealth upward. While high-income earners see a tax break, lower-income households face cuts to SNAP, student aid, and housing subsidies, all of which reduce disposable income for patients and clients in lower brackets.

If your practice depends on volume or low-cost service delivery, you may see a drop in demand or slower payment turnaround.

Pro Tips for Private Practice Owners

Strategy	Action
Review Entity Status	C-Corp may offer better deductions under SALT changes
Rebuild Pricing Tiers	Introduce or expand sliding scales, cash pay, or memberships
Invest Now	Use bonus depreciation to upgrade facilities or tech
Monitor Payer Mix	Track Medicaid/ACA reliance and plan for potential attrition
Stay Active Politically	Join your trade association’s advocacy efforts—many are fighting to restore key deductions

Final Thoughts

Trump’s “Big Beautiful Bill” offers real benefits to well-positioned private practices, but hidden within are provisions that could significantly disrupt cash flow, client retention, and insurance reimbursements.

The smartest practice owners won’t wait to see how it plays out. They’ll act now—strategically and proactively—to protect and grow their practice.

The final version of the bill is subject to change. Senate Republicans are proposing revisions to the House tax bill, including permanent business tax breaks and Medicaid cuts. The Senate aims for passage next week, targeting a final deal by July 4, but faces challenges from various factions. Key differences include SALT deduction caps, clean-energy credit timelines, and Medicaid tax policies.

How can you fight and win this battle? With an effective billing company like In Touch Billing.

What You Should Do Next

At In Touch Billing, we evaluate the clinical documentation for our clients, and help clients determine which codes to bill. We are your built-in compliance, ethics and reimbursement team all rolled into one. You can use any EMR / billing software of your choice, or we can make recommendations if you want to switch.

If you have In Touch Billing do your billing, and if we don’t increase your revenue by 15-20%, you don’t pay us for the first month.

How can we make such a bold promise?

We know how to boost your revenue, because we’ve done exactly that for over 1000 private practice owners across the country.

We’ll handle all your billing, benefit verification and credentialing and we’ll deploy our own AI tools for you, against payers.

You get everything done for you. All you have to do right now is schedule a call to learn more. Let’s explore your options.

No contracts, no setup fees, no cancellation fees. Pay as you go and make us an extension of your clinic.

You have nothing to lose, and everything to gain by working with In Touch Billing. There’s a reason why we’ve been called the county’s #1 billing service for private practice owners. We know exactly how to beat the payers at their own game, and maximize your revenue.

In Touch Billing is a doggedly determined company that fights for every single client with an arsenal of over 200 AAPC certified billers and coders, a highly organized and skilled team to help you get paid. We don’t see ourselves as your ‘vendor’ or ‘biller’, we are your warriors who will fight for every dollar, every claim on your behalf.

Here are FOUR things we do for our clients that other billing companies don’t:

AAPC-certified coders carefully review your documentation and provide feedback to make sure your documentation aligns with each payer’s guidelines.
We renegotiate contracts and encourage payers to pay you more every year (high success rate).
We can handle payer credentialing for new and existing providers.
We can verify benefits and help you with pre-authorizations.

The result - you get paid more, faster.

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Schedule a call with us to learn more. No contracts, no setup fees, no cancellation fees. Pay as you go and make us an extension of your clinic.