Reconciliation Review: Congress Passes the Big, Beautiful Bill

• By: GHCA
• On: 07/14/2025 14:18:22
• In: News

On Tuesday, July 1, 2025, the U.S. Senate passed H.R. 1, the One Big Beautiful Bill Act (OBBBA), by a narrow 51 to 50 vote, with Vice President Vance casting the tie-breaking vote. The House approved the Senate-amended package two days later on July 3, and President Trump signed the legislation into law on July 4. This sweeping reconciliation bill includes more than $900 billion in Medicaid-related reductions over ten years and ushers in significant changes to Medicaid eligibility processes, state financing tools, long term care requirements, and federal oversight of managed care structures.

For long term and post-acute care providers, the bill's provisions will have material implications. These include a ten-year moratorium on CMS enforcement of the minimum staffing rule for nursing facilities, restrictions on state provider tax and directed payment arrangements, and narrowed retroactive eligibility protections. The legislation also codifies new compliance thresholds for Medicaid enrollment verification, long term care asset limits, and community engagement requirements.

AHCA/NCAL is providing the following member resources to help facilities, affiliates, and consultants understand the most consequential provisions of OBBBA and prepare for phased implementation over the coming years.

• OBBBA Reconciliation Legislative Text | This document provides the health provisions, as published on Congress.gov.
• OBBBA Detailed Summary | This resource is intended to provide a deeper dive into key health-related provisions of the Act.
• OBBBA One-Page Summary | This resource provides a two-sentence summary of key health-related provisions of interest to long term and post-acute care providers.
• Timeline of Key Health-Related Provisions | This resource is a table arranged by each provision's effective date.

GHCA will keep members apprised of any new updates or notices.