One Big Beautiful Bill

Enhanced Patient Protection and Affordable Care Act (ACA) premium tax credits (PTCs) will expire on Dec. 31, 2025, threatening a loss of health insurance coverage and increased premium rates for millions of Americans. Congress established PTCs to assist eligible households with reducing their premium payments for qualified health plans offered through health insurance exchanges. Originally limited to households with incomes between 100% and 400% of the federal poverty level (FPL), the premium tax credit was expanded in 2021 by eliminating the maximum income limit of 400% and reducing the applicable percentage utilized in calculating the premium contribution, leading to increased support to cover the cost of their insurance.

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.