U.S. House of Representatives Passes Budget Reconciliation Bill: What's Next?
Early this morning, the U.S. House of Representatives voted to pass the budget reconciliation bill, called the “One, Big, Beautiful Bill Act”, in time for their self-imposed Memorial Day deadline. This act brings Congress one step closer to making the most sweeping cuts to Medicaid in the program's history and leaving millions without access to healthcare.
While details about the House’s final version of the bill and the breadth of its impact are still emerging following last-minute additions aimed at appeasing hardline Republicans, the bill includes Medicaid cuts that will have significant impacts on Pennsylvanians if ultimately passed into law. Here are just some of the ways the bill will hurt Pennsylvanians:
- Imposes harmful work reporting requirements that penalize those who lose their job or are unable to work, including people with disabilities, older adults, students, and others meant to be exempt, all while costing Pennsylvania millions and doing nothing to address unemployment. See what happened in Georgia, for example.
NEW: The final House bill moved up the timeframe to implement work reporting requirements by two years. States will be forced to make hasty systems changes under tight deadlines, increasing the likelihood of eligibility mistakes and system errors and increasing the number of people who will lose coverage erroneously. The final House bill also further restricts exceptions and exemptions from work requirements.
- Takes healthcare away from low-income adults in the Medicaid Expansion group, many of whom are working, battling cancer or other serious health conditions, caring for a child or family member, or attending school, by imposing new and higher out-of-pocket costs, more frequent eligibility checks, and burdensome reporting requirements that will cause people to lose coverage.
- Takes billions of dollars of federal funding away from states. This puts pressure on already-strained state budgets and leaves lawmakers on the hook to either find enough money to make up for the lost federal revenue—which Gov. Shapiro has already said PA cannot do— or remove people from Medicaid and cut services. History has shown that all states have cut services for seniors and people with disabilities when federal Medicaid funding is cut. At the same time, the bill does even more damage by curtailing states’ ability to impose provider taxes, which Pennsylvania and 48 other states rely on to fund their share of the Medicaid program.
- Guts access to reproductive healthcare, especially in rural areas, by defunding Planned Parenthood, even for primary care services like cancer screenings, prenatal care, STI testing, and birth control.
- Puts even more hospitals at risk of closure. The increased number of uninsured patients means more uncompensated care for hospitals. This will force even more hospitals to close their doors in rural areas and other parts of PA. With hospitals across the state already struggling, these cuts will only exacerbate an already dire crisis, further diminishing our communities’ access to care and hurting local economies and job opportunities.
- Bans gender-affirming care for Medicaid patients of any age. The prior version of the bill banned this coverage only for minors.
- Ends provisions that help people on Medicare access the Medicare Savings Programs and qualify for Extra Help. programs critical to helping low income seniors and people with disabilities afford their Medicare premiums and copays. For more about the bill’s impact on Medicare beneficiaries, click here.
What Happens Next?
There is still time to stop these cuts. The Senate will begin considering the bill the first week in June, with Senate leadership aiming to pass their version by July 4th. Some Senate Republicans have expressed concern over the House’s bill and its sweeping cuts; not only to Medicaid, but to other safety net programs like Medicare and food assistance (SNAP).
PHLP will continue to monitor the bill’s progress in the Senate and provide further updates about how Pennsylvanians will be impacted by potential cuts and other changes.
