H.R. 1, or the Big Beautiful Bill, has brought substantial change to the managed care pharmacy landscape, particularly for managed care organizations (MCOs) with managed Medicaid lines of business.
One Big Beautiful Bill
On July 4, President Trump signed H.R. 1, often referred to as the One Big Beautiful Bill Act, into law. The massive budget reconciliation package marks a significant shift in federal health care policy. Along with a $5 trillion hike of the national debt limit, an extension of the 2017 Tax Cuts and Jobs Act, elimination of taxes on tipped and overtime income for some earners, and increased border security and defense spending, the law is offset by significant cuts to spending on federal programs including Medicaid, the Supplemental Nutrition Assistance Program, student loan support, and green energy initiatives.
Featured One Big Beautiful Bill Related Resources
On July 4, President Trump signed H.R. 1, often referred to as the One Big Beautiful Bill Act, into law.
On July 4, President Donald Trump signed H.R. 1, the One Big Beautiful Bill Act, into law.
Enhanced premium tax credits for individual marketplace plans are set to expire on December 31. View the latest update from Tiber Creek Group for the current state of extension talks.
Enhanced Patient Protection and Affordable Care Act (ACA) premium tax credits (PTCs) will expire on Dec. 31, 2025, threatening a loss of health insurance coverage and increased premium rates for millions of Americans. Congress established PTCs to assist eligible households with reducing their premium payments for qualified health plans offered through health insurance exchanges. Originally limited to households with incomes between 100% and 400% of the federal poverty level (FPL), the premium tax credit was expanded in 2021 by eliminating the maximum income limit of 400% and reducing the applicable percentage utilized in calculating the premium contribution, leading to increased support to cover the cost of their insurance.
Published One Big Beautiful Bill Related Resources
Enhanced premium tax credits for individual marketplace plans are set to expire on December 31. View the latest update from Tiber Creek Group for the current state of extension talks.
Enhanced Patient Protection and Affordable Care Act (ACA) premium tax credits (PTCs) will expire on Dec. 31, 2025, threatening a loss of health insurance coverage and increased premium rates for millions of Americans. Congress established PTCs to assist eligible households with reducing their premium payments for qualified health plans offered through health insurance exchanges. Originally limited to households with incomes between 100% and 400% of the federal poverty level (FPL), the premium tax credit was expanded in 2021 by eliminating the maximum income limit of 400% and reducing the applicable percentage utilized in calculating the premium contribution, leading to increased support to cover the cost of their insurance.
Join us for One, Big Beautiful Webinar, a timely and essential session exploring the sweeping implications of H.R. 1 on the managed care landscape.
President Trump signed H.R.1, Republicans’ “big, beautiful” reconciliation bill, into law on July 4, 2025. Starting from that date, the law lays out effective dates and implementation dates for its numerous health provisions over the next few years, and beyond.
H.R. 1, or the Big Beautiful Bill, has brought substantial change to the managed care pharmacy landscape, particularly for managed care organizations (MCOs) with managed Medicaid lines of business.
Today, Senator Josh Hawley (R-MO) introduced legislation that would rollback some of the impending cuts to federal Medicaid funding as mandated by H.R. 1.
On July 4, President Trump signed H.R. 1, often referred to as the One Big Beautiful Bill Act, into law.
H.R. 1 will result in less preventive care and more preventable emergency room visits, increasing costs for everyone across the health care system and threatening hospitals with closure, which will further reduce access to critical care for American patients.
Academy of Managed Care Pharmacy (AMCP) issued a statement from CEO Susan A. Cantrell, MHL, RPh, CAE, following passage of the budget reconciliation bill that includes large-scale changes to Medicaid, the Affordable Care Act (ACA), Grad PLUS loans, and other programs.
Other Resources
- Modern Medicaid Alliance: Medicaid Provisions and Implementation of the One Big Beautiful Bill
- Modern Medicaid Alliance: Medicaid Dashboard
- Georgetown Center for Children and Families: Webinar: Budget Reconciliation (HR 1) Medicaid and Marketplace Provisions
- Congressional Budget Office: Analysis on the Passed H.R. 1
- KFF: Allocating CBO’s Estimates of Federal Medicaid Spending Reductions Across the States: Enacted Reconciliation Package
- Impact on Rural Health:
- KFF: How Might Federal Medicaid Cuts in the Enacted Reconciliation Package Affect Rural Areas
- Urban Institute: Rural Hospital Revenue Could Drop by $87 Billion over 10 Years Because of the Reconciliation Bill and Expiring Enhanced Tax Credits
- American Hospital Association: Rural Hospitals at Risk: Cuts to Medicaid Would Further Threaten Access
- SHVS: Medicaid Cuts and States: Tracking State-Specific Estimates of the Impacts of Proposed Changes
