H.R. 1 — the “One Big Beautiful Bill” Act
Passed by Republicans in July 2025, H.R. 1 carries roughly $1 trillion in Medicaid cuts and raises health-care costs for millions of working families — hitting rural hospitals, nursing homes, ACA coverage, and Medicare. At the time of the vote, CBO estimated that the bill would add $4.1 trillion to the deficit and trigger $490 billion in Medicare cuts over the next decade. The full impact was deliberately delayed until after the 2026 midterms.
- —Higher health-care costs for millions of working families
- —A $4.1 trillion increase to the federal deficit.
- —At the time of the vote, an estimated $490 billion in Medicare cuts over the next decade.
Why these actions?
We score the final House passage of H.R. 1 because it was the decisive House vote on the reconciliation package. Earlier procedural and amendment votes are not scored.
