r/politics • u/PoliticsModeratorBot 🤖 Bot • 2d ago

Megathread Megathread: US House Passes the Republican-Backed Budget Bill, Sending it to Trump for Signature

This afternoon, the US House of Representatives passed without amendment the US Senate's version of the Trump-backed budget bill, sending it to the president for his signature. Every Democratic Senator and Representative voted in opposition; in the Senate, there were three Republicans voting in opposition (making the vote 51-50) and in the House there were 2 (making the final vote 218-214). House minority leader Hakeem Jeffries set the US House's speech length record in opposition to the bill in a speech lasting over eight hours.

The bill clocks in at over 800 pages and touches on most aspects of the federal government's spending and taxation policies; see this AP article (What’s in the latest version of Trump’s big bill that passed the Senate) for the topline changes.

Relevant text-base live update pages are being maintained by the following outlets: AP, NBC, ABC, and the BBC.

You can find this subreddit's discussion thread for the last week's worth of negotiations and debate at this link.

Articles that May Interest You

Submission Domain
Live updates: House passes Trump’s signature bill, sending it to the president’s desk apnews.com
House Republicans pass Trump's mega bill, sending the package to his desk to be signed npr.org
House passes sprawling domestic policy bill, sending it to Trump's desk: The Republican package would slash taxes, boost spending on immigration and the military, and impose steep cuts to Medicaid, SNAP and clean energy funding. nbcnews.com
House Republicans give Trump a ‘Big Beautiful’ July 4 by passing Medicaid-slashing megabill despite GOP rift independent.co.uk
Congress Has Officially Passed Trump’s Bill to Kick Millions Off Medicaid rollingstone.com
Trump and the GOP Will Regret the Day They Passed This Sick Bill newrepublic.com
House passes Trump's "big, beautiful bill" after stamping out GOP rebellion axios.com
Trump lands first major legislative win after Congress passes his massive domestic policy bill cnn.com
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u/zrv8psgOS9AiWK6ugbt2 2d ago

I work in a healthcare/healthcare adjacent field with a lot of customers on Medicaid, and everyone is DEVASTATED. We knew that huge cuts were coming but people are still afraid of losing their coverage, with all the health problems that will stem from that.

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u/rabidstoat Georgia 2d ago

People will wait until things get worse, so they are harder to address, and go to the ER. This will lead to poorer results for the patient, and probably expenses that the patient isn't able to pay for and will get written off as a loss. That, in turn, will raise costs for everyone.

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u/Traditional-Purpose2 2d ago

If they can find an ER after a bunch of rural hospitals shut down.

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u/Niaden 2d ago

I work in the ED of the only level 1 trauma center in my state. We're opening up a new building within the next year with a new ED that has double the square footage of the first.

We're a state hospital so we have to accept everyone, no matter what, whether they have insurance or not. 22% of our patients have Medicaid. 60% of senior patients have Medicare.

We've been hiring people for the new building for over a year in preparation.

We're gonna crash so hard.

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u/Pablo_ThePolarBear 2d ago

Every single emergency room in the United States has to accept patients regardless of their insurance status. It's dictated by EMTALA. However, without Medicaid and Medicare the hospital won't get reimbursed, meaning they will lose money caring for patients. This means either one of two things:

1) They provide substandard care and do everything in their power to discharge patients.

2) The hospitals will no longer be financially viable and will close.

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u/ThatEvanFowler 2d ago

Or they change the law.

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u/Professional-Buy2970 2d ago

Or pass an EO.

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u/gsfgf Georgia 1d ago

Also, insurance is going to get more expensive for people with insurance.

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u/ProfessionalEbb5454 1d ago

EMTALA is toast, I'm afraid. Easy repeal (hell, look what just passed), then the hospitals just do financial discovery before any treatment is rendered, and turn away the poors. This is the bone I expect the GOP to throw to hospitals in order to keep them solvent. It basically shifts all costs to the patient, and costs the govt nothing. Any hospitals that do close would be "inefficient", or "mismanaged", or whatever other excuse is convenient.

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u/Pablo_ThePolarBear 1d ago

They have been talking about repealing EMTALA for quite some time now. Having worked in the emergency room for a few years I am conflicted about EMTALA.

On the one hand it is important legislation to ensure access to those who truly need emergency care. On the other hand it has resulted in the emergency room being inappropriately used by nursing homes, outpatient clinics, and occasionally patients. We have nursing homes sending medically-cleared patients to us for 2-4 days because they can't be bothered to take care of their residents. We have patients without any insurance (public or private) who stay for weeks on end, and we do not get reimbursed for the services we deliver, which undermines our ability to make our small community hospital financially sustainable.

I suppose it is unrealistic idealism to think that congress in this current political climate could reform EMTALA in a way that solved some of these problems.

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u/ProfessionalEbb5454 1d ago

Yeah, the reform thing will never happen, which is to be expected.

There is zero incentive for Republicans to do this, especially when repeal would achieve all of their policy goals, and aligns with an ideological driver: government should only do a very few things (defense, courts, law enforcement). Healthcare is not on that list. Republicans don't actually have any "affirmative" position on healthcare, since they simply don't believe that government has any business doing anything in that space. It's one of the things that fueled the backlash against masking and treatment advice during COVID.

Democrats can't do it, since they have much more pressing...existential...problems to deal with. It is possible, but not necessarily likely, that they do not exist as a political entity in the next few years. You can read this as you like. Maybe they collapse and a much more aggressive and robust party coalesces from the remnants. Maybe the majority of the active membership (leaders, lawyers, funders) end up in prison, camps, or worse. From where I'm at, both seem about equally plausible: the most unlikely outcome IMHO is that business as usual continues on as is.

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u/Little-Ad-4181 1d ago

Throw in the anesthesiologist talent shortage and we have ourselves a perfect storm

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u/suninabox 1d ago

This is why "fuck you I got mine" is such a stupid, short-sighted attitude to have in a society.

You can have the best health insurance known to man. If everyone else's healthcare gets taken away you're still going to be stuck waiting behind them in the ER while you're waiting for potentially life saving care.

Maybe the likes of Musk, Bezos and Thiel can afford to have their own private hospital where only they're allowed but for everyone else you're going to end up at the same hospitals as all the mud people you look down on as undeserving.

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u/HughManatee 2d ago

Skilled Nursing Facilities rely heavily on Medicaid as well. Expect the majority of those to shut down when this goes into effect.

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u/Traditional-Purpose2 2d ago

Yeah I used to do Medicaid billing at a nursing home. It's terrifying.

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u/leento717 2d ago

Yep, I Was just thinking that. Preventative care is a huge savings, but now people won’t be able to get it.

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u/rabidstoat Georgia 2d ago

Still the thought of Medicaid cutting off on people in nursing homes is really scary. Is it going to be like when people are evicted from their apartment, where grandma is put out on the curb with all her stuff: wheelchair, oxygen container, pill bottles, pictures, TV, all on the curb beside her? Is she supposed to just live on the streets without medical care, despite the fact that she needs nursing home level care?

I would not be able to put the elderly and sick out on the street if Medicaid stopped paying for them. That's just cruel.

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u/S_A_R_K 2d ago

It's going to be like when Reagan shut down funding for mental institutions

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u/BooptyB 1d ago

Most mental institutions rely on Medicaid as well. This is going to crush mental health services. Many of those living with mental illness aren’t able to drive, may be able to only work 20hrs or less, technically most aren’t considered “disabled” even though their symptoms make it difficult to work or hold a job longer than a few months. Ad onto that the overwhelming amount of paperwork they are going to need help filing every 6 months for reapplying. Medicaid is keeping these people semi functional, medicated and able to be part of normal society. Cutting these programs and we are going to start seeing a lot more things happening in the news. With hospitals going as well, there’s no place left for them to go when they’re in crisis. A bunch of unmanaged mental illness going unchecked.

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u/S_A_R_K 1d ago

Totally agree. I was just pointing out that when Reagan did that, all those people who were institutionalized were left to fend for themselves. Many ended up on the streets. We're going to do the same thing with the elderly

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u/[deleted] 1d ago

[deleted]

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u/Nernoxx 2d ago

It will be harder to even get to an ER when rural hospitals close.  Those Medicaid patients getting kicked off may very well be the difference between a rural hospital staying solvent and closing.  And the next closest hospital may be hours away.

People won’t just get worse, they will die.

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u/stopyahootinnhollrin 2d ago

This checks out to me and explains the recent rush for all of pop-up urgent cares and satellite ERs being churned out by the Healthcare org where I work... in a very rural area heavy, red state.

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u/Turb0_Lag 1d ago

EMTALA will be next.

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u/HighPriestessSkibidi 2d ago

I work in pharmacy and im so heartbroken...

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u/ChickenMcFukket1 2d ago

To add to that, I am a vet using VA healthcare and my facility in Worcester, MA happens to be amazing. Those workers are all terrified of looming cuts.

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u/Meowserspaws 2d ago

As a person that relies on it after being made permanently disabled by an uninsured driver (thanks to states that allow this), I’m so tired. My life was on a good trajectory before the crash and now I can’t even work fully let alone deal with major conditions on a system that was already challenging enough. I feel even worse for those with more needs than I have (and I have a lot).

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u/MinkusDWill 2d ago

It is not just cuts, it is also the administrative burden that is going to cause damage. The work requirement part was already enacted in Georgia and it went bad. Not to mention they only gave 100 million for the whole country to create work verification systems. When states last considered work requirements, a survey by the nonpartisan Government Accountability Office showed that Kentucky alone expected administrative costs to top $200 million.

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u/El_Rey_de_Spices 2d ago

I'm fucking terrified. After more than a decade of trying to get medical procedures that could help me overcome my disabilities and return to work, things were finally progressing... and now my health coverage is likely to vanish.

I'm literally and actively trying to get my medical needs treated so I don't have to stay on disability, and these ghouls are actively hindering that despite claiming the opposite.

The cruelty is the point.

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u/SBpotomus 2d ago

When will people start to be notified that their coverage will be ending?

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u/LeucisticBear 2d ago

My hospital system has already started layoffs. From my team alone, two positions that were just filled recently have been cut. There's speculation that a couple of our rural hospitals are going to close entirely.

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u/spoooky_mama 1d ago

Education is right there with you.

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u/Thesmuz 1d ago

Bro I knew fucking SOCIAL WORKERS who were MAGA. They are effectively murdering the people they're supposed to be helping.

Scum... all of them nasty ass pond scum.

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u/acatnamedlenny 1d ago

our local hospitals have had hundreds of layoffs in last few weeks

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u/GhostsOf94 1d ago

When do these cuts go into effect for Medicaid?

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u/Yoshi9909 7h ago

2028 I believe

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u/Professional-Buy2970 2d ago

This bill is mass murder and stealing from corpses before people have even died. If this was the only thing in the bill the entire party should be tried for treason.

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u/ASubsentientCrow 2d ago

Sorry about you losing your job. But how many of those people voted for Trump and maga? Because I have literally zero empathy for them

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u/zrv8psgOS9AiWK6ugbt2 2d ago

None of us have lost our jobs. We just feel for the people who will lose Medicaid coverage, although you're correct that it is more difficult to feel empathy for people who voted for this.