The House Budget Committee voted on May 18 to advance the “One Big Beautiful Bill Act,” which includes sweeping Medicaid cuts and other healthcare provisions, in a 17-16 vote, according to The Hill.
Five things to know:
1. The legislation, aligned with President Donald Trump’s policy agenda, aims to extend tax cuts, increase border security funding and implement significant changes to Medicaid and food assistance programs.
2. The proposed changes include implementing work requirements for childless adults aged 19 to 64, restricting states from using provider taxes to fund Medicaid, imposing penalties for covering unauthorized immigrants, shortening the ACA open enrollment period, and prohibiting the use of Medicaid and CHIP funds for gender transition procedures for minors.
3. The bill’s advancement is a key step for House Republicans, signaling potential compromise between deficit-focused conservatives and moderates from high-tax states. Texas Rep. Chip Roy, a Republican lawmaker who previously opposed the bill, indicated that negotiations resulted in a potential earlier implementation date for Medicaid work requirements and an accelerated phaseout of green energy incentives, according to The Hill.
4. The legislation now moves to the House Rules Committee, where further revisions are anticipated. As talks unfold among lawmakers, potential areas of contention include the proposed Medicaid work requirements, the restriction on using provider taxes to fund Medicaid and the penalties for covering unauthorized immigrants. Lawmakers will also likely face pressure to address the potential impact on low-income patients and essential hospitals, as well as concerns about the shortened ACA open enrollment period.
5. The bill faces a tight timeline as Speaker Mike Johnson pushes for a House floor vote before the Memorial Day deadline.
