The Senate returns from its Memorial Day recess this week, and lawmakers will begin a pivotal four-week sprint leading up to the July 4th holiday. At the center of the agenda: the much-anticipated budget reconciliation package, formally titled the One Big Beautiful Bill Act (H.R. 1).

Passed narrowly in the House by a 215–214 margin just before the break, the bill now moves to the Senate, where Republican leadership faces a tightrope walk. With only a few votes to spare, GOP senators are expected to propose significant changes to the House-passed version.

According to the latest estimates from the Joint Committee on Taxation, H.R. 1 would result in an estimated $3.94 trillion price tag.

Major Healthcare Impacts

On the healthcare front, the House Ways and Means Committee's proposed changes to the Affordable Care Act (ACA) are projected to save over $150 billion. However, these savings may come at a steep cost: a preliminary analysis from the Congressional Budget Office (CBO) on May 18 indicated that approximately 2.1 million people could lose health coverage if these provisions are enacted. A full CBO analysis is still pending and will be critical to understanding the bill’s broader implications.

Currently, the reconciliation package does not include a Medicare “Doc Fix” for 2025. Instead, it defers any meaningful adjustment until 2026 and fails to address the -2.83% cut in physician reimbursement this year. For five consecutive years, Medicare physician payments have been cut, amounting to a 33% decrease when adjusted for inflation since 2001. Without action, access to care will continue to erode. 

Recently, Sen. Roger Marshall (R-KS) introduced S. 1640, the Medicare Patient Access and Practice Stabilization Act of 2025—the companion bill to H.R. 879—which would increase Medicare physician reimbursement by 8.51%. This increase reflects a prorated reversal of the -2.83% Medicare cut physician practices have faced since the beginning of 2025, combined with an inflation-based update. This bill represents a critical step toward stabilizing practices and protecting patients’ access to care.  You can take action in just a few seconds by texting ZPFIX to 50457 or clicking here.

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