Updated summary of the key health provisions in the 2025 budget reconciliation legislation reflecting changes to the draft Senate bill language released late Friday, and more.
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KFF today updated its side-by-side summary of the key health provisions in the 2025 budget reconciliation legislation to reflect changes to the draft Senate bill language released late on Friday, June 27, by the Senate Budget Committee. The Senate today is considering amendments to the bill and is expected to vote on a version this week.


The summary compares details of the updated draft Senate bill and the version passed by the House on May 22 with current law in four areas: Medicaid, the Affordable Care Act, Medicare, and Health Savings Accounts. KFF will continue to update the resource as needed as the legislation, known as the “One Big Beautiful Bill Act,” moves through Congress.


The summary is part of KFF’s broader efforts to track the reconciliation bill and its potential impacts on health care through policy analysis, polling, and journalism. Highlights from our other recent work include:

Public Opinion

  • KFF Health Tracking Poll: Views of the One Big Beautiful Bill
  • From Drew Altman: Clues From Polling About How Opinion Might Change If We Had More Informed Health Policy Debate?
  • KFF Health News: ‘MAGA’ Backers Like Trump’s ‘Big Beautiful Bill’ — Until They Learn of Health Consequences
  • Quick Take: Working Medicaid Enrollees Value Work But Are Wary About Work Requirements When Told About Paperwork Burden

Impact on the Uninsured Rate

  • How Will the One Big Beautiful Bill Act Affect the ACA, Medicaid, and the Uninsured Rate?
  • KFF Health News: In a First, Trump and GOP-Led Congress Prepare To Swell Ranks of U.S. Uninsured
  • Quick Take: The Biggest Rollback in Federal Support for Health Coverage Ever

Impact on Medicaid and Its Enrollees

  • Senate Finance Language Would Further Cut Federal Spending for Medicaid Expansion States
  • Different Data Source, But Same Results: Most Adults Subject to Medicaid Work Requirements Are Working or Face Barriers to Work
  • Which States Might Have to Reduce Provider Taxes Under the Senate Reconciliation Bill?
  • KFF Health News: Federal Proposals Threaten Provider Taxes, Key Source of Medicaid Funding for States
  • Implications of Medicaid Work and Reporting Requirements for Adults with Mental Health or Substance Use Disorders
  • Cost Sharing Requirements Could Have Implications for Medicaid Expansion Enrollees with Higher Health Care Needs
  • KFF Health News: Too Sick To Work, Some Americans Worry Trump’s Bill Will Strip Their Health Insurance
  • 5 Key Facts About Medicaid and Veterans
  • From Drew Altman: The Mystery of How Many People Are on Medicaid

Additional Impact on People with Low Incomes

  • The Implications of Federal SNAP Spending Cuts on Individuals with Medicaid, Medicare and Other Health Coverage

Impact on Rural Communities

  • How Might the Reconciliation Bill’s Medicaid Cuts Affect Rural Areas?
  • 5 Key Facts About Medicaid Coverage for People Living in Rural Areas
  • KFF Health News: ‘One Big Beautiful Bill’ Would Batter Rural Hospital Finances, Researchers Say

Impact on ACA Coverage

  • How Might Changes to the ACA Marketplace Impact Enrollees with Mental Health Conditions?
  • Fraud in Marketplace Enrollment and Eligibility: Five Things to Know
  • Explaining Cost-Sharing Reductions and Silver Loading in ACA Marketplaces
  • KFF Health News: Four Ways Trump’s ‘One Big Beautiful Bill’ Would Undermine Access to Obamacare
  • Quick Take: How the Reconciliation Bill Limits States’ Authority Over ACA Insurance Markets
  • Quick Take: Policy Uncertainty is Creating Challenges for ACA Marketplace Insurers

Impact on Older Adults and People with Medicare

  • What Could the Health-Related Provisions in the Reconciliation Bill Mean for Older Adults?
  • Seven Million People with Medicare Spend More Than 10% of Income on Part B Premiums – The Reconciliation Bill Could Drive the Number Higher
  • Medicaid Changes in House and Senate Reconciliation Bills Would Increase Costs for 1.3 Million Low-Income Medicare Beneficiaries
  • 5 Key Facts About Medicaid Coverage for People Ages 50 and Older

Impact on Hospitals

  • Reconciliation Language Could Lead To Cuts in Medicaid State-Directed Payments to Hospitals and Nursing Facilities
  • What are the Implications of the 2025 Budget Reconciliation Bill for Hospitals?

Impact on Immigrants

  • Potential Impacts of 2025 Budget Reconciliation on Health Coverage for Immigrant Families
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Visit Medicaid Watch for the latest on the financing debate, including possible impacts on state budgets, debates about waste, fraud, abuse, and improper payments, considerations of work requirements, and news stories about legislative developments and how people may be affected.

CONTACT:

 

Craig Palosky | 202.654.1369 | CraigP@kff.org 

 

KFF should be cited as a nonprofit health policy research, polling, and news organization. 

 

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