Health Provisions in the 2025 Federal Budget Reconciliation Bill

Updated: July 8, 2025

On July 3, the House passed the same version of the budget reconciliation bill passed by the Senate on July 1. On July 4, President Trump signed the legislation into law . This summary describes the health care provisions in the law (described as the Senate-passed bill) in four categories: Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs). It also compares the provisions to a earlier draft of the bill passed by the House on May 22.

In addition to the changes included in the law, if Congress takes no further action, the increase in the deficit would trigger mandatory spending cuts, also known as sequestration, under the Statutory Pay-As-You-Go Act of 2010. These cuts would total approximately $500 billion to Medicare over 2026–2034, according to the Congressional Budget Office, based on an increase in the deficit of $2.3 trillion over 10 years. The required spending cuts to Medicare could be larger based on the Senate-passed bill that was enacted into law, which is estimated to increase the deficit by $3.4 trillion over 10 years.