H.R. 1, or the Big Beautiful Bill, has brought substantial change to the managed care pharmacy landscape, particularly for managed care organizations (MCOs) with managed Medicaid lines of business.
One Big Beautiful Bill
On July 4, President Trump signed H.R. 1, often referred to as the One Big Beautiful Bill Act, into law. The massive budget reconciliation package marks a significant shift in federal health care policy. Along with a $5 trillion hike of the national debt limit, an extension of the 2017 Tax Cuts and Jobs Act, elimination of taxes on tipped and overtime income for some earners, and increased border security and defense spending, the law is offset by significant cuts to spending on federal programs including Medicaid, the Supplemental Nutrition Assistance Program, student loan support, and green energy initiatives.
Featured One Big Beautiful Bill Related Resources
On July 4, President Trump signed H.R. 1, often referred to as the One Big Beautiful Bill Act, into law.
On July 4, President Donald Trump signed H.R. 1, the One Big Beautiful Bill Act, into law.
On September 9, 2025, the Make America Healthy Again (MAHA) Commission released the “Make Our Children Healthy Again (MOCHA) Strategy,” which follows an earlier report that assessed key drivers of childhood chronic disease, including poor diet, chemical exposure, lack of physical activity and chronic stress, and overmedicalization. Executive Order 14212, signed by President Trump on February 13, tasks the commission with providing government-wide recommendations on policy and strategy to address the identified contributing causes and end the childhood chronic disease crisis.
On August 28, Chairman Crapo announced that Secretary Kennedy would testify before the Senate Finance Committee to preview the Trump administration’s 2026 health care agenda, including the Make America Healthy Again (MAHA) initiative.
Published One Big Beautiful Bill Related Resources
On September 9, 2025, the Make America Healthy Again (MAHA) Commission released the “Make Our Children Healthy Again (MOCHA) Strategy,” which follows an earlier report that assessed key drivers of childhood chronic disease, including poor diet, chemical exposure, lack of physical activity and chronic stress, and overmedicalization. Executive Order 14212, signed by President Trump on February 13, tasks the commission with providing government-wide recommendations on policy and strategy to address the identified contributing causes and end the childhood chronic disease crisis.
On August 28, Chairman Crapo announced that Secretary Kennedy would testify before the Senate Finance Committee to preview the Trump administration’s 2026 health care agenda, including the Make America Healthy Again (MAHA) initiative.
Join us for One, Big Beautiful Webinar, a timely and essential session exploring the sweeping implications of H.R. 1 on the managed care landscape.
President Trump signed H.R.1, Republicans’ “big, beautiful” reconciliation bill, into law on July 4, 2025. Starting from that date, the law lays out effective dates and implementation dates for its numerous health provisions over the next few years, and beyond.
H.R. 1, or the Big Beautiful Bill, has brought substantial change to the managed care pharmacy landscape, particularly for managed care organizations (MCOs) with managed Medicaid lines of business.
Today, Senator Josh Hawley (R-MO) introduced legislation that would rollback some of the impending cuts to federal Medicaid funding as mandated by H.R. 1.
On July 4, President Trump signed H.R. 1, often referred to as the One Big Beautiful Bill Act, into law.
H.R. 1 will result in less preventive care and more preventable emergency room visits, increasing costs for everyone across the health care system and threatening hospitals with closure, which will further reduce access to critical care for American patients.
Academy of Managed Care Pharmacy (AMCP) issued a statement from CEO Susan A. Cantrell, MHL, RPh, CAE, following passage of the budget reconciliation bill that includes large-scale changes to Medicaid, the Affordable Care Act (ACA), Grad PLUS loans, and other programs.
Other Resources
- Modern Medicaid Alliance: Medicaid Provisions and Implementation of the One Big Beautiful Bill
- Modern Medicaid Alliance: Medicaid Dashboard
- Georgetown Center for Children and Families: Webinar: Budget Reconciliation (HR 1) Medicaid and Marketplace Provisions
- Congressional Budget Office: Analysis on the Passed H.R. 1
- KFF: Allocating CBO’s Estimates of Federal Medicaid Spending Reductions Across the States: Enacted Reconciliation Package
- Impact on Rural Health:
- KFF: How Might Federal Medicaid Cuts in the Enacted Reconciliation Package Affect Rural Areas
- Urban Institute: Rural Hospital Revenue Could Drop by $87 Billion over 10 Years Because of the Reconciliation Bill and Expiring Enhanced Tax Credits
- American Hospital Association: Rural Hospitals at Risk: Cuts to Medicaid Would Further Threaten Access
- SHVS: Medicaid Cuts and States: Tracking State-Specific Estimates of the Impacts of Proposed Changes
