Work Continues on the Reconciliation Bill in Congress

The Situation Report | June 30, 2025

As of the writing of this article, the Senate is in the midst of voting on amendments to the reconciliation bill being proposed in Congress and supported by the President. Results of the bill are expected in the Senate by close of business on Monday. Should the bill pass, it will then need to go back to the House to be voted on again sometime Wednesday.

The Reconciliation bill as currently constituted would provide for approximately $4.2 trillion for continuation of tax cuts, plus new tax breaks sought by the President and Congress (such as “no taxes on tips,” expanded child tax credit, expanded deduction for seniors) over 10 years, while reducing federal spending by approximately $1.4 billion.

As part of the cuts to spending, the bill would reduce Medicaid spending by approximately $800 billion and $268 billion from the ACA Marketplace over 10 years. New York is projected to see a reduction of approximately $10 billion a year in Medicaid spending over 10 years.

Several provisions, that would have further reduced Medicaid spending, were removed from the bill due to rules applicable to this type of reconciliation legislation, but may well resurface later in another form, such as changes to the Federal Medicaid Provider Tax allowances (by capping the amount of federal Medicaid funding states could generate through provider taxation) and eliminating Medicaid coverage for undocumented noncitizens.

There could still be significant changes to the bill through the amendment process that is currently underway. HCANYS will report on any other provision that may affect home care as the information becomes available.