On May 22, the House passed the “One Big Beautiful Bill Act,” H.R. 1, on a party line vote of 215-214.

Two Republican representatives who say they would have voted yes missed the vote (Representatives Andrew Garbarino (NY) and David Schweikert (AZ)).

The manager’s amendment, which was released late night May 21, moved up the implementation of three Medicaid policies. The change to retroactive eligibility coverage from three months to one month, the work requirements and the increased eligibility checks moved to December 31, 2026 (or earlier at the discretion of the state). For work requirements and increased eligibility checks, these moves reflect less time for states to implement these policies; for the retroactive eligibility, states were given two additional months.

“If enacted, the policies in the House-passed bill will have a devastating impact on millions of older adults and their families who rely on Medicaid and Medicare for health care and long-term care and services, and on our nonprofit provider members who serve them,” said Katie Smith Sloan, president and CEO, LeadingAge, in a statement following the vote.

Adding that “LeadingAge will continue to work with the Senate to oppose the House’s purposeful removal of at least 10 million people from their health insurance, cutting $500 billion from Medicare, and the slashing of $800 billion in federal Medicaid funding to states–actions that will shred the health safety net for older adults and ultimately drive up healthcare costs,” Sloan urged a recognition of the bill for “what it is: cold-hearted legislation that will have ugly consequences, essentially eliminating for vulnerable people the support they rely on, leaving them with few options. The Medicaid and Medicare programs, and the aging services infrastructure they support, help older Americans age with dignity, not desperation. They must be protected. We urge the Senate: do not follow in the House’s footsteps.”

Members can follow all Budget Reconciliation 2025 developments through this serial post.