Special Advocacy News

• Congress sends mega bill to president's desk

By a 218-214 vote, the One Big Beautiful Bill Act cleared the House on Thursday.

Up next: President Trump is scheduled to sign the bill into law on July 4 at 5 PM ET. 

What happened: On Tuesday, the Senate passed the bill after making several changes, such as striking a provision to tie future Medicare physician payments to an inflation index.

• In its place, senators added a one-time 2.5% Medicare pay bump for physicians in 2026.
• A temporary pay increase provides relief, but the CAP will continue advocating to stabilize and reform the Medicare payment system.

A favorable vote in the House was required to advance the bill to the White House.

Other key provisions

Medicaid: The bill includes cuts of about $1 trillion in Medicaid, though lawmakers added a $50 billion fund for rural hospitals. The CAP remains concerned about the impact of these cuts.

Student loans: The legislation eliminates Grad PLUS loans and caps unsubsidized borrowing for professional degrees (eg, medicine) at $50,000 per year ($200,000 lifetime). The CAP remains concerned with this provision. 

• The bill does not include provisions to prevent medical residencies from counting toward Public Service Loan Forgiveness or allow for interest-free loan deferment for four years during medical residency. 

What's next: We'll provide more details in various forums, including at CAP25.