Part II: The Fintech Nobody Has Built Yet: Why the One Big Beautiful Bill's Medicaid Provider Tax Phase-Down and Directed Payment Caps Create a Bridge Lending, Copay, and Coverage-Churn Business

The One Big Beautiful Bill puts Medicaid supplemental payments on a step-down schedule written into federal law. No hospital CFO in an expansion state needs to guess when the cash hole arrives. They can model it today.

Provider taxes in expansion states drop from 6% to 3.5% of net patient revenue between FY2028 and FY2032. State directed payments step do…