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The House of Representatives passed the President Donald Trump-backed “One Big Beautiful Bill” in a 215-214 vote on 22 May after debating for hours overnight on the controversial legislation that includes significant cuts to Medicaid.

Healthcare revisions to the multitrillion-dollar legislation include a two-year acceleration of Medicaid work requirements for able-bodied people ages 18-64 no later than 31 December 2026. The work requirements were originally set for 2029, but have been accelerated to generate faster savings. 

Gender transition procedures will no longer be covered by ACA plans beginning 1 January 2027.

The bill, which President Trump and GOP leaders argue is aimed at tackling “waste, fraud and abuse,” now heads to the Senate, where Republicans hold a 53-47 majority. However, it is not clear when the vote will be held. 

The bill’s revisions have also resulted in backlash from several healthcare advocacy groups. 

America’s Essential Hospitals President and CEO Bruce Siegel, MD, MPH, said that their organisation “strongly opposed” the “deep Medicaid cuts” in the bill, highlighting that the cuts would “threaten the health and well-being of millions of Americans.” 

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Source: Becker's Hospital Review, 22 May 2025

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