Key Decisions Loom as Congress Continues Work on Major Reconciliation Bill

Back from a two-week recess, House Republicans took concrete steps this week towards crafting a reconciliation bill. The chamber hopes to clear the legislation this month, sending it to the Senate with a goal of final passage by July 4.

To that end, House committees have begun writing and holding hearings on their portions of the bill. This process has exposed some divisions within the caucus, and many major decisions—including on health care cuts—remain outstanding.

The Energy & Commerce Committee, which has jurisdiction over Medicaid and Medicare, is targeting next week for its markup. While this timing may slip, the hearing will require them to lay out the specific Medicaid cuts they plan to pursue to achieve $880 billion in savings. The policy options said to be on the table include several that would shift costs to states and otherwise undermine the program, as outlined below.

Restricting Federal Funding for the Medicaid Expansion Population

The Affordable Care Act’s Medicaid expansion allows states to cover adults with incomes up to 138% of the Federal Poverty Level ($21,597 for an individual in 2025). The federal government covers 90% of these costs; states are responsible for the remaining 10%.

https://www.medicarerights.org/medicare-watch/2025/05/01/key-decisions-loom-as-congress-continues-work-on-major-reconciliation-bill