House passes "One Big Beautiful Bill," including health care changes

House Republicans passed the One Big Beautiful Bill Act (H.R. 1) on Thursday, including provisions to link Medicare physician payments to the Medicare Economic Index (MEI), impose new limits on student loans, and enact significant changes to Medicaid.

Why it matters: The scope of these changes, if passed by the Senate, could affect patients and physicians for years to come.
The CAP is reviewing the massive bill, but a few notable provisions include:

Medicaid
As widely anticipated, H.R. 1 contains changes to Medicaid, such as work requirements and mandates to verify citizenship status.

• The CAP previously signed a letter outlining concerns about proposed changes to Medicaid.

Student loans
In an effort to reduce the cost of higher education, including medical school and residency, the bill introduces loan caps and other limitations.

• The CAP has long supported issues in this space including interest-free deferment for student loans during residency and is concerned about these new restrictions.

Medicare payment
The CAP has been advocating for an inflationary update for Medicare physician payment. The bill takes a step toward structural reform by linking Medicare payment to the MEI in the long-term.

• However, the numbers contained in H.R. 1 (75% of MEI for 2026, 10% of MEI 2027 and beyond) need to be a down payment on a much larger gap in payment, particularly since a cut to Medicare went into effect on January 1.

Taxes
The bill includes a number of extensions and changes to current tax law, including provisions affecting small businesses.

By the numbers: If enacted, the bill would extend tax cuts and reduce federal spending but increase the deficit by $2.3 trillion over 10 years.

• The Congressional Budget Office (CBO) projects that these growing deficits would trigger sequestration cuts, including potential 4% reductions to Medicare in 2026.

The big picture: Senators say they want to revise the House bill. The final outcome remains a work in progress, with Republicans in both chambers working to send the bill to President Trump's desk by July 4.