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- What’s in the Senate's "One Big Beautiful Bill"
After several days of negotiations and votes on amendments, the Senate passed the One Big Beautiful Bill Act early Tuesday afternoon.
Where it stands: The legislation now heads back to the House, which is scheduled to take up the Senate version this week.
- If the House can't pass the bill, both chambers will need to reconcile their differences, and they'll likely miss a July 4 target date for President Trump to sign the bill.
A key difference: The Senate bill removed the House provision to tie future Medicare physician payments to an inflation index.
- Instead, senators added a one-time 2.5% Medicare pay bump for physicians in 2026.
- A temporary pay increase would provide some relief, but the CAP will continue to advocate for stabilization of the Medicare payment system through long-term reform.
The bill included Medicaid cuts of about $1 trillion, although senators did add a $50 billion fund for rural hospitals.
- Student loans: Similar to the House version, the Senate bill eliminates Grad PLUS loans and caps unsubsidized borrowing for professional degrees (eg, law, medicine) at $50,000 per year ($200,000 lifetime). The CAP remains concerned with this proposal.
- The final Senate bill did not include the provisions that would prevent medical residencies from counting toward Public Service Loan Forgiveness or allow for interest-free loan deferment for four years during medical residency.
The big picture: Members of the House will need to decide whether to accept these and other changes, as lawmakers are under pressure to pass the bill by the deadline.