Nebraskans raise concerns about health care cuts in fed budget reconciliation
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Diverging Reports Breakdown
Breaking down Trump’s ‘Big Beautiful Bill’ and its impact on the deficit and national debt
The Congressional Budget Office says, the tax cuts in this bill add up to $3.7 trillion. That’s good news, in that that’s money taxpayers could keep, but it’s also bad news because it comes out of the federal budget and potentially could add to deficits. The money saved from the cuts, the spending cuts, is $1.3 trillion.
Right.
For Republicans, this is part of answering what they see as a potential crisis, the end of the Trump tax cuts. The question is, is this something that adds to a different potential crisis, an American debt crisis?
So let’s look at the money flow in this bill, and let’s start with the tax cuts. First of all, Republicans are in fact adding some new tax cuts here. Those are the no taxes on tips, overtime, some benefits for seniors. These tax cuts are significant. However, they pale in comparison to the biggest cost in the bill. That is extending those Trump tax cuts.
All together, the Congressional Budget Office says, the tax cuts in this bill add up to $3.7 trillion. That’s good news, in that that’s money taxpayers could keep, but it’s also bad news because it comes out of the federal budget and potentially could add to deficits.
So did Republicans pay for this in the bill? According to CBO, no. The money saved in this bill from the cuts, the spending cuts, is $1.3 trillion. Now, this is a significant, historically large number of spending cuts, health care cuts, we have been talking about Medicaid, green energy, student loans. This is a big number, but it is much smaller than the amount being spent here.
So, overall, Congressional Budget Office says, this bill would add $2.4 trillion to the deficit, and that is even before you consider interest costs.
State lawmakers push back on federal proposal to limit AI regulation
A bipartisan coalition of more than 260 state legislators from all 50 states sent a letter to Congress. They oppose a provision in the federal budget reconciliation bill that would impose a 10-year ban on state and local regulation of artificial intelligence. The outcome of this legislative dispute will likely influence how the AI technology is governed across the United States. The lawmakers argue that the moratorium would hinder their ability to protect residents from AI-related harms, such as deepfake scams, algorithmic discrimination and job displacement. They advocate for the ability to enact AI regulations tailored to their communities, especially in the absence of comprehensive federal AI legislation. The debate underscores the ongoing tension between federal and state roles in regulating emerging technologies. The bill is expected to go to the Senate in early June and is likely to be approved by the end of the month or early June. The National Association of State Chief Information Officers issued a press release stating it was “concerned” about the language in the proposed bill and its potential impact to the work states have done to regulate AI use.
The lawmakers argue that the decade-long moratorium would hinder their ability to protect residents from AI-related harms, such as deepfake scams, algorithmic discrimination and job displacement.
The outcome of this legislative dispute will likely influence how the AI technology is governed across the United States. The bill is expected to go to the Senate in early June.
Proponents of the contested provision, which the House passed in May, say it aims to prevent a fragmented regulatory landscape that could hamper U.S. tech firms’ global competitiveness, particularly against China. However, state legislators contend that the moratorium would strip them of the ability to address fast-evolving AI threats and protect their constituents.
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“As state lawmakers and policymakers, we regularly hear from constituents about the rise of online harms and the impacts of AI on our communities,” the letter reads. “AI will raise some of the most important public policy questions of our time, and it is critical that state policymakers maintain the ability to respond.”.
The letter, led by South Carolina Rep. Brandon Guffey, a Republican, and South Dakota Sen. Liz Larson, a Democrat, emphasizes the importance of state autonomy in policymaking. The lawmakers advocate for the ability to enact AI regulations tailored to their communities, especially in the absence of comprehensive federal AI legislation.
“Over the past several years, states across the country have enacted AI-related laws increasing consumer transparency, setting rules for the government acquisition of new technology, protecting patients in our healthcare system, and defending artists and creators,” the letter continues. “The sweeping federal preemption provision in Congress’s reconciliation bill would also overreach to halt a broad array of laws elected officials have already passed to address pressing digital issues.”
State lawmakers are not the only ones who have pushed back against the proposed moratorium. Before the House voted in late May, dozens of state attorneys general sent a letter to Congress, urging members to reject the federal measure, calling it “irresponsible,” “sweeping and wholly destructive.”
The National Association of State Chief Information Officers issued a press release stating it was “concerned” about the language in the proposed bill and its potential impact to the work states have done to regulate AI use.
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The Senate’s Bipartisan AI Working Group last year released a roadmap on artificial intelligence, which suggested identifying key areas of consensus across Congress, but it did not lead to any legislation.
California, Colorado and Utah have passed sweeping laws targeting AI’s use in the commercial sector, while many others have narrower laws attempting to govern AI. Another 15 states have proposed similar laws, and many governors have created AI task forces or working groups to propose best practices for AI use.
Rep. Marjorie Taylor-Greene, a far-right Republican from Georgia who has fanned conspiracy theories about everything from 9/11 to Pizzagate, posted on X Tuesday that she is “adamantly” opposed to the provision that would prevent states from enforcing AI laws, though she voted for in favor of the bill. She admitted that neither she nor her staff read the bill fully before she cast her vote.
“Full transparency: I did not know about this section on pages 278-279 of the OBBB that strips states of their right to make laws or regulate AI for 10 years,” Taylor-Greene posted on X. “It is a violation of state rights and I would have voted NO if I had known this was in there.”
The provision’s inclusion in the budget reconciliation bill has also raised procedural concerns. Under the Senate’s Byrd Rule, measures that are not directly related to budgetary issues can be removed from reconciliation bills.
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The debate underscores the ongoing tension between federal and state roles in regulating emerging technologies. Some federal lawmakers and industry leaders advocate for a uniform national framework to foster innovation and competitiveness. California Rep. Jay Obernolte, a Republican and co-chair of the Bipartisan Artificial Intelligence Task Force, which issued a report last December, said the proposed moratorium on state AI regulation would be a stopgap measure.
“We have a limited amount of legislative runway to be able to get that problem solved before the states get too far ahead,” Obernolte said during House Energy & Commerce Committee hearing last March.
State legislators meanwhile have stressed the need for localized oversight to address immediate and specific AI-related challenges within their jurisdictions.
“As AI technology develops at a rapid pace, state and local governments are more nimble in their response than Congress and federal agencies,” the state lawmakers’ stated in their letter to Congress. “Legislation that cuts off this democratic dialogue at the state level would freeze policy innovation in developing the best practices for AI governance at a time when experimentation is vital.”
Broken Promises: Republicans’ Budget Reconciliation Bill Would Cut Medicare
The Republican tax bill takes direct aim at Medicare, gutting eligibility and restricting access to benefits. For low-income older adults and people with disabilities, the health and economic ramifications of these cuts would be devastating. The bill would undermine access to long-term care by shifting costs to states, likely resulting in cuts to HCBS programs. It would also make it harder for people to qualify for Medicaid coverage and avoid gaps in care. It effectively repeals the Home Minimum Staffing Rule, endangering the lives of thousands of people with Medicare due to inadequate nursing facility staffing. This publication shows how cuts to Medicare would be spread across Cuts to Cuts, a report by the Coalition on Human Needs and the Justice in Aging. This law kicks in when the legislation increases the deficit and would trigger an estimated $45 billion in Medicare cuts in fiscal year 2026, plus additional cuts to other programs that help older adults. The report is published by the coalition on human needs and the justice in Aging, a nonprofit that provides support to people in need.
Since taking control of Congress and the White House, Republican leadership and rank-and-file members have repeatedly promised not to undermine Medicare or cut Medicare benefits. With the introduction and House passage of the “One Big Beautiful Bill Act” (OBBBA), they have broken that promise.
The Republican tax bill takes direct aim at Medicare, gutting eligibility and restricting access to benefits, while also cutting Medicaid in ways that would harm people who are dually eligible for both programs. For low-income older adults and people with disabilities, the health and economic ramifications of these cuts would be devastating.
The Republican Tax Bill Would Directly Cut Medicare Eligibility
The bill would terminate Medicare coverage for many individuals with lawful immigration status who have worked and paid taxes in the US for decades. This is a significant departure from current, longstanding policy, which recognizes eligibility for everyone who has paid sufficient Social Security and Medicare taxes on wages to be considered “fully insured.” Medicare already prohibits payment for care for anyone who is undocumented, exposing that Republican lawmakers’ claims about the effect of this provision are false. Withholding or revoking Medicare eligibility from legally present older adults and people with disabilities who have paid in, and continuing to collect Medicare taxes on their wages, is deeply unfair and a betrayal of American values.
Medicare already prohibits payment for care for anyone who is undocumented, exposing that Republican lawmakers’ claims about the effect of this provision are false.
In addition, the bill would cut off these individuals’ access to Affordable Care Act (ACA) tax credits that could make buying private health insurance affordable once they are ineligible for Medicare. Because current federal law already restricts Medicaid eligibility for people with lawful status who do not have a green card, many of these individuals will likely end up uninsured.
The Bill Would Make Medicare Unaffordable for People with Low-Incomes
The bill traps people with Medicare in red tape by stopping the Streamlining Medicaid Eligibility & Enrollment Rules. These rules modernized outdated policies and made it easier for older adults and people with disabilities to enroll in and keep Medicaid and Medicare Savings Programs (MSPs) that help pay Medicare costs.
… without these rules in place, fewer people would enroll in Medicaid and MSPs despite being eligible.
The Congressional Budget Office (CBO) projects that without these rules in place, fewer people would enroll in Medicaid and MSPs despite being eligible. Nearly 1.4 million low-income people with Medicare—more than 10% of the dually eligible population—would lose critical cost-sharing assistance that covers Medicare’s $185/month Part B premium and helps them afford needed care. People who would lose this financial assistance are already living on limited incomes. Their dollars would be stretched even further, forcing some to choose between paying for health care and other basic needs like food and rent, increasing risk of evictions.
Losing Medicaid Increases Risk of Death for People with Medicare
People with Medicare whose Medicaid is terminated are also at increased risk of death. A new study examining the health consequences of losing Medicaid—and, with it, the Medicare Part D Low-Income Subsidy (LIS), which reduces prescription drug cost-sharing—found that individuals who lost Medicaid and LIS experienced 4% to 22% higher mortality than those who retained coverage. These findings build on substantial research linking prescription drug unaffordability with worse health and higher Medicare spending. Cost barriers have long been found to reduce treatment adherence, leading to poorer outcomes and the need for more costly interventions.
The Bill Puts Long-Term Care at Risk for People with Medicare
People with Medicare rely primarily on Medicaid, not Medicare, for long-term care. Medicaid paid for 61% of all long-term care in 2022 and more than 70% of Home- and Community-Based Services (HCBS). The bill would undermine access to long-term care by shifting costs to states, likely resulting in cuts to HCBS programs. It would also make it harder for people to qualify for Medicaid coverage and avoid gaps in care. The bill effectively repeals the Nursing Home Minimum Staffing Rule, endangering the lives of thousands of people with Medicare due to inadequate nursing facility staffing.
The Bill Puts Medicare’s Future at Risk
On top of these cuts, the CBO projects that the bill would trigger future massive cuts to Medicare totaling nearly $500 billion due to the Statutory Pay‑As‑You‑Go Act of 2010 (S-PAYGO). This law kicks in when legislation increases the deficit and would trigger an estimated $45 billion in Medicare cuts for fiscal year 2026, plus additional cuts to other programs that help older adults and people with disabilities. This CBO publication shows examples of how such cuts would be spread across programs.
Devastating Cuts and Broken Promises
Republicans are breaking their promise not to undermine Medicare or cut benefits.
These actions make it very clear: Republicans are breaking their promise not to undermine Medicare or cut benefits. The Republican tax bill would cut coverage and access to care for millions of older adults and people with disabilities, putting their lives, health and financial stability at risk.
Take Action
The reconciliation bill is now headed to the Senate, where it will face further deliberation and votes. Senators need to hear from the public now about the dangers of this bill. Contact your lawmakers today.
As House GOP grinds ahead, new CBO report says Trump’s big tax cuts bill will add to deficit
House Republicans are pushing to vote on their multi-trillion-dollar tax breaks package as soon as Wednesday. A fresh analysis from the Congressional Budget Office said the tax provisions would increase the federal deficit by $3.8 trillion over the decade. If the House Republicans fall in line with the president, overcoming unified Democratic objections, the package would next go to the Senate. It’s a make-or-break moment for the president and his party in Congress, who have invested much of their political capital during the crucial first few months of Trump’s return to the White House on this package. The package would impose new work requirements for many people who receive health care through Medicaid, with able-bodied adults without dependents needing to fulfill 80 hours a month on a job or in other community activities. It would also impose new new requirements for those who receive food stamps, rather than just food stamps. It also would have an estimated 8.6 million fewer people have health insurance with changes to the Affordable Care Act.
Trump himself had instructed the Republican majority to quit arguing and get it done, his own political influence on the line. But GOP leaders worked late into the night to convince skeptical Republicans who have problems on several fronts, including worries that it will pile onto the nation’s $36 trillion debt.
Watch the House Rules committee debate President Donald Trump’s ‘big, beautiful’ budget bill below.
A fresh analysis from the Congressional Budget Office said the tax provisions would increase the federal deficit by $3.8 trillion over the decade, while the changes to Medicaid, food stamps and other services would tally $1 trillion in reduced spending. The lowest-income households in the U.S. would see their resources drop, while the highest ones would see a boost, the CBO said.
WATCH: Trump pushes GOP holdouts on Capitol Hill to support his massive domestic policy bill
Republicans hunkered down at the Capitol through the night for one last committee hearing processing changes to the package. Democrats immediately motioned to adjourn, but the vote failed on party lines.
“President Trump’s ‘one, big, beautiful bill’ is going to require one, big, beautiful vote,” said Speaker Mike Johnson, R-La. “We are going to get this done.”
It’s a make-or-break moment for the president and his party in Congress, who have invested much of their political capital during the crucial first few months of Trump’s return to the White House on this package. If the House Republicans fall in line with the president, overcoming unified Democratic objections, the package would next go to the Senate.
The package comes at a daunting time as the U.S. economy faces uncertainty. Democratic Leader Hakeem Jeffries said Republicans are trying to “quickly jam this unpopular legislation through the House because they know that the longer they wait, the more will come to light about this cruel and unconscionable bill.”
READ MORE: What’s inside the House GOP’s budget bill? Here’s a look
At its core, the sprawling 1,000-plus-page bill is centered on extending the tax breaks approved during Trump’s first term in 2017, while adding new ones he campaigned on during the 2024 presidential campaign.
To make up for some of the lost revenue, the Republicans are focused on spending cuts to federal safety net programs and a massive rollback of green energy tax breaks from the Biden-era Inflation Reduction Act.
Additionally, the package tacks on $350 billion in new spending — with about $150 billion going to the Pentagon, including for the president’s new “ Golden Dome” defense shield, and the rest for Trump’s mass deportation and border security agenda.
The package title carries Trump’s own words, the “ One Big Beautiful Bill Act.”
WATCH: Credit rating downgrade triggers warning signs for U.S. economy
As Trump promised voters on the tax front, the package proposes there would be no taxes on tips for certain workers, including those in some service industries; automobile loan interest; or some overtime pay.
There would also be an increase to the standard income tax deduction, to $32,000 for joint filers, and a boost to the child tax credit to $2,500. There would be an enhanced deduction, of $4,000, for seniors of certain income levels, to help defray taxes on Social Security income.
To cut spending, the package would impose new work requirements for many people who receive health care through Medicaid, with able-bodied adults without dependents needing to fulfill 80 hours a month on a job or in other community activities.
Similarly, those who receive food stamps through the Supplemental Nutritional Assistance Program, known as SNAP, would also face new work requirements.
WATCH: Tamara Keith and Amy Walter on the battle over Trump’s ‘big, beautiful bill’
Older Americans up to age 64, rather than 54, who are able-bodied and without dependents would need to work or engage in the community programs for 80 hours a month. Additionally, some parents of children older than 7 years old would need to fulfill the work requirements; under current law, the requirement comes after children are 18.
Republicans said they want to root out waste, fraud and abuse in the federal programs.
The Congressional Budget Office has estimated 8.6 million fewer people would have health insurance with the various changes to Medicaid and the Affordable Care Act. It also said 3 million fewer people each month would have SNAP benefits.
Republicans have been racing to finish up the package by Memorial Day, a deadline imposed by Johnson as he tries to overcome objections within his own ranks.
Conservatives are insisting on quicker, steeper cuts to federal programs to offset the costs of the trillions of dollars in lost tax revenue. GOP leaders have sped up the start date of the Medicaid work requirements from 2029 to 2027.
At the same time, more moderate and centrist lawmakers are wary of the changes to Medicaid that could result in lost health care for their constituents. Others are worried the phaseout of the renewable energy tax breaks will impede businesses using them to invest in green energy projects in many states.
Plus, a core group of lawmakers from New York, California and other high-tax states want a bigger state and local tax deduction, called SALT, for their voters back home.
As it stands, the bill would triple what’s currently a $10,000 cap on the state and local tax deduction, increasing it to $30,000 for joint filers with incomes up to $400,000 a year. They have proposed a deduction of $62,000 for single filers and $124,000 for joint filers.
Trump has been pushing hard for Republicans to unite behind the bill, which has been uniquely shaped in his image, and he said after meeting with House lawmakers privately Tuesday at the Capitol that anyone who doesn’t support the bill would be a “fool.”
But it’s not at all clear that Trump, who was brought in to seal the deal, changed minds.
One of the conservative Republicans, Rep. Thomas Massie of Kentucky, said afterward he’s still a no vote.
“We’re still a long ways away,” said Rep. Andy Harris, R-Md., chair of the House Freedom Caucus.
The Committee for a Responsible Federal Budget, a nonpartisan fiscal watchdog group, estimates that the House bill is shaping up to add roughly $3.3 trillion to the debt over the next decade.