House Approves Controversial Budget Bill
The House of Representatives passed the fiscal year 2025 budget reconciliation bill, known as the One Big Beautiful Bill Act, on May 22 by a vote of 215-214. The legislation has significant implications for Medicaid and the Health Insurance Marketplaces, sparking concerns among hospitals and health systems.
Rick Pollack, President and CEO of the American Hospital Association (AHA), expressed strong reservations about the bill in a statement released before the vote. “Our hospitals and health systems have significant concerns regarding the harmful Medicaid and Health Insurance Marketplace provisions currently included in the bill,” Pollack said. He warned that the substantial reductions to Medicaid could affect all patients, not just Medicaid beneficiaries, across the nation.
The AHA is particularly concerned about the bill’s impact on Medicaid financing programs, including provider taxes and state-directed payments. These programs are crucial for offsetting chronic underpayments for Medicaid patients. The proposed changes could reduce federal support for Medicaid by over $700 billion in the next decade, potentially leaving millions without health insurance.
The bill’s immediate enactment would give states little time to prepare for the significant financial impact on their budgets. The AHA urges the House to reconsider the dismantling of vital programs in the One Big Beautiful Bill Act and to preserve healthcare access for vulnerable and working families.
The bill will now be considered by the Senate, where it is likely to undergo changes before a vote is held. The AHA has sent a Special Bulletin to its members, highlighting changes made to the bill and providing resources for advocacy efforts. A Legislative Advisory was also issued, summarizing provisions in the bill that impact hospitals and health systems.
