ACOI

‘One Big Beautiful Bill’ Signed into Law

by ACOI

July 8, 2025

President Trump signed into law H.R. 1, the “One Big Beautiful Bill Act” on July 4 following passage of the bill by the U.S. House of Representatives and Senate along party lines.

ACOI created a table summarizing key provisions of the H.R. 1 [Public Law No: 119-21].


View the Table

Key Provisions from H.R. 1

Medicare Pay Increase

The law includes a 2.5% positive adjustment to the Medicare physician fee schedule in 2026. The Senate included the one-year pay bump in the final days of negotiations after new lobbying efforts from the physician community. An earlier version of the Senate bill left out a policy in the House version of the bill that would have tied physician pay to inflation, a policy strongly supported by ACOI. The positive adjustment is welcome news following years of stagnant or negative payment updates, but increases the urgency of Congress to move forward with an overhaul of the Medicare physician payment system.

Medicaid Cuts

The law makes distressing cuts to Medicaid spending, including restricting the Medicaid provider tax in states that have expanded Medicaid. The Congressional Budget Office estimates the law will increase by 11.8 million the number of people without health insurance by 2034.

Student Loan Program Changes

The law also makes changes to student loan programs that could discourage students from pursuing medical school. ACOI weighed in with Senate lawmakers over the changes and called upon its student members to take action.

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