LeadingAge National Government News: June 11, 2025

On June 4, the non-partisan Congressional Budget Office (CBO) released an updated score for the House-passed budget reconciliation package, the One Big Beautiful Bill Act (OBBB). The score updates the total fiscal impact by adding analysis of some previously unscored provisions and amendments to the bill made immediately prior to its May 22 passage in the House. These changes include sooner implementation of work requirements and more frequent eligibility determinations.  

Overall, the CBO score estimates that 10.9 million people will lose their health insurance coverage because of the bill: almost eight million will lose Medicaid coverage, and the remainder will lose ACA Marketplace coverage. In addition to that 10.9 million, CBO provided a separate June 4 estimate on additional coverage loss changes in its baseline if the Trump administration’s Marketplace rule, which would be codified by the OBBB, is implemented and if the enhanced premium tax credits, which expire at the end of 2025, are not extended. In combination, the Marketplace rule and the loss of the enhanced premium tax credits would cause 5.1 million people to lose health insurance, CBO says.  

Across the reconciliation bill and the expiration of the enhanced premium tax credits, the total coverage loss estimates add up to 16 million people. As anticipated, CBO noted higher savings from changes made in the House Rules Committee before final passage that moved the implementation dates for community engagement / work requirements and enhanced eligibility checks. Overall, CBO estimates that $1 trillion dollars will be cut from federal healthcare spending over the next 10 years, including over $800 billion from federal Medicaid funding. The full score can be downloaded here. 

The House Oversight and Government Reform Subcommittee Delivering on Government Efficiency (DOGE) held a June 4 hearing, “Public Funds, Private Agendas: NGOs Gone Wild.” In her opening statement, Subcommittee Chair Marjorie Taylor Greene (R-GA) said that nonprofit organizations (aka non-governmental organizations (NGOs)) are part of a scheme.  

“This scheme works in a cycle. Democrat Administration officials work with leftist NGOs to implement programs in a manner that ensures those NGOs receive massive grants and contracts. The leaders of those recipient groups then turn around and donate to Democrat political campaigns,” Chair Greene said.  

Subcommittee Ranking Member Melanie Stansbury (D-MN), in her opening remarks, said “This Subcommittee lacks any credibility at this point” and said the Subcommittee was on a “wild journey of baseless conspiracy theories.” “Nonprofits are at risk and under attack,” Ranking Member Stansbury said.  

LeadingAge is advocating to protect nonprofits and the hearing shed light on why some in Congress are wary of nonprofits, as evidenced by the House passage of legislation in the last session of Congress, the Stop Terror-Financing and Tax Penalties on American Hostages Act (H.R. 9495), which many nonprofits saw as a threat to the tax status of nonprofits who disagreed with the policies or goals of the executive branch. Majority witnesses focused on grants and funding to nonprofits by the 2022 Inflation Reduction Act’s climate programs and what they see as the role of nonprofits in supporting illegal immigration into the United States.  

As Chair Greene put it, nonprofits are “pushing fake environmental justice and illegal immigration” to be a part of an unchecked funding cycle supporting Democrats and their interests, saying her goal is to “drain these slush funds dry.”  

“[S]o many nonprofits are addicted to government cash,” witness Scott Walter, president, Capital Research Center, said. “No reasonable person should fall for these sob stories. Business-as-usual with federal tax dollars sent unaccountably to big nonprofits disserves both government and the nonprofit sector. The deficit-plagued federal government needs to waste a lot less of our money, and a nonprofit sector addicted to government funding needs to leave the political trenches and learn to refocus on real acts of charity,” Mr. Walter said.  

Mr. Walter, in an unusual move for a congressional hearing, attacked the hearing’s Minority witness, saying Diane Yentel, president and CEO, National Council of Nonprofits, “provides further examples of nonprofits serving Big Government” and gave examples of Ms. Yentel’s opposition to the inclusion of the Stop Terror-Financing and Tax Penalties on American Hostages Act in an early version of the House reconciliation bill (which has since been removed from the House-passed bill) and NCN’s suing of the Trump administration over illegally frozen federal funding.  

During his time to ask witnesses questions, Representative Brandon Gill (R-TX) pressed Ms. Yentel seven times on whether she is “a covert white supremacist.” After additional questions by Representative Gill, Ranking Member Stansbury interrupted, saying the questioning breached the hearing’s decorum and attacked the witness. Chair Greene responded that she was extending Representative Gill’s time because he had been interrupted by the Ranking Member. Read witness testimony and watch the hearing here. Keep up with LeadingAge news about federal policy’s impact on nonprofits here. 

LeadingAge is urging a “no” vote on OBBB in the Senate. In order to help members understand why, and also provide talking points about the impacts of OBBB, we released a suite of new materials and talking points on June 5. Contained in these talking points are also specific asks for changes — our approach is to both oppose the bill but also try to mitigate the impacts on older adults and those who serve them. The new resources are: 

• General Medicaid Talking Points and Asks:  H.R. 1 Medicaid Talking Points  

• Medicaid Retroactive Eligibility: Talking Points: H.R. 1 Medicaid Retroactive Eligibility 

• Affordable Housing: Talking Points: H.R. 1 Affordable Housing 

• Tax Policy:  Talking Points: H.R. 1 Tax Provisions 

• Artificial Intelligence: Talking Points: H.R. 1 Artificial Intelligence 

Our summaries of what is in the legislation and other updates can be tracked in our budget reconciliation serial post. 

Here is your Affordable Housing Weekly Recap. 

Here is your Home Health Weekly Recap. 

Here is your Hospice Weekly Recap.  

Here is your Life Plan Community Recap. 

Here is your Medicaid, HCBS, and PACE Weekly Recap. 

Here is your Nursing Home Weekly Recap.