Congress Passes Budget Reconciliation Legislation

• By: Angela Westhoff
• On: 07/10/2025 07:45:20
• In: Legislative/Government Affairs

Last week, the House of Representatives passed the One Big Beautiful Bill Act of 2025 (OBBBA) meeting the Republicans' goal to pass this tax and spending cuts legislation by July 4^th.

House members reconvened last Wednesday to consider the version of the bill passed by the Senate earlier in the week. It passed an early Thursday morning House vote to open discussion on the bill, setting up a final vote. The House took a final vote Thursday afternoon, passing the legislation 218 to 214.

AHCA/NCAL has provided a high-level overview of what is included that impacts long term care providers:

Medicaid Provider Taxes
The new law makes changes to provider taxes, with specific carve outs for nursing homes and intermediate care facilities to remain at status quo. Other provider types – such as hospitals and managed care organizations – taxed in expansion states will see their allowable percentage of revenues reduced by 0.5% annually beginning in 2028 through Federal Fiscal Year 2032, and no state is allowed to establish any new provider taxes as of the passage of the bill. Provider taxes are a necessary tool in supporting states' abilities to fund services covered by Medicaid. The reduction in resources within the overall healthcare continuum will have serious impacts as Medicaid remains underfunded.

Retroactive Coverage 
Retroactive coverage for Medicaid beneficiaries other than expansion new adults is revised from 90 days to?60 days. An earlier version of the bill had aimed to reduce retroactive coverage to 30 days.  

Staffing Mandate 
There is a 10-year delay of the federal staffing mandate for nursing homes.  

AHCA/NCAL is developing a detailed summary of the legislation for members that will be available soon. 

Staff contact: awesthoff@mehca.org