Select each title below to read more:
Reconciliation Update; More Medicaid Cuts Still Being Discussed
The House Rules Committee is still expected to meet tonight starting at 1:00 AM on May 21. Rules will make amendments to the reconciliation bill (aka the One Big Beautiful Bill Act). There are a number of amendments listed on the House Rules site but the manager’s amendment — which will contain the agreed upon changes to the underlying bill that came out of the House Budget Committee on May 19 — has not yet been posted. The manager’s amendment is what will be voted on; it is most likely that there will not be votes on the other amendments offered, but we are monitoring the process. It seems very likely that the implementation date for work requirements will be moved up (from 2029 to 2027 or late 2026). The House Freedom Caucus continued to push for FMAP cuts but President Trump, in a meeting today with the House Republicans, seemingly shut down that path forward. Since that meeting this morning, the House Freedom Caucus has seemingly switched their focus from FMAP changes to more provider tax cuts targeted specifically at expansion states. LeadingAge will monitor what happens in Rules and timing for a full House vote.
New Action Alert
LeadingAge is urging members to ask their Representatives to vote NO on the reconciliation package. We have a new action alert that will go out on May 21. It can be found here: https://www.votervoice.net/LeadingAge/Campaigns/126944/Respond.
Ill-conceived MA Reform Bill Claims to Improve MA, Could End it Instead
A bill introduced by Congressman David Schweikert (R-AZ), H.R. 3467, proposes Medicare Advantage (MA) reforms to: eliminate consumer choice of how to receive their Medicare benefits by auto-enrolling all Medicare beneficiaries, require hospice care to be included within MA plan benefits, reduce MA plan competition and accountability, and place providers in an untenable financial position of not being able to refuse MA capitated payment contracts. The bill was originally introduced on Thursday, May 15 and is being offered as an amendment to the Budget Reconciliation Package in the House Rules Committee. The Rules Committee is scheduled to meet on Wednesday, May 21 at 1:00 AM; LeadingAge does not expect this amendment will be taken up but will be monitoring it carefully and have done outreach to Rules Committee members to discuss our opposition. The bill’s provisions would take effect January 1, 2028. This LeadingAge article contains further details of the bill’s provisions.
Changes to Tax Provisions in House Budget Reconciliation Bill: Some Known, Some Unknown
As we shared earlier, House Republican leaders plan to convene the House Committee on Rules at 1:00 AM on May 21 with the goal of finalizing their budget reconciliation package. Along with many other issues, LeadingAge will be watching closely for changes to tax provisions. An updated version of the legislation released May 19 shows that two positive changes have already been made:
First, lawmakers have removed provisions that would have granted broad authority for the Treasury Department to suspend the tax-exempt status of any organization it deemed to have supported a designated terrorist organization which raised concerns about the potential for targeting of specific organizations based on the type of work they do or their missions, and without sufficient processes to protect organizations from inaccurate or improper designations.
Second, the bill no longer includes a revenue-generating provision that would have taxed income earned by nonprofits from a sale or licensing of its name or logo. Beyond these and other known revisions to the Ways & Means portion of the bill, other changes are widely expected but with details unknown – such as additional changes relating to the deductibility of state and local taxes or to green energy-related tax credits – as leadership works to assemble a reconciliation package that will secure enough Republican votes to pass off the House floor. LeadingAge will provide a recap of developments when the Rules Committee completes its work.
