Budget Reconciliation Process Advances with House Floor Vote Expected this Week

On May 14, 2025, the House Energy and Commerce Committee voted 30-24 to advance the health title of its budget reconciliation portion, proposing major reforms to Medicaid, the Affordable Care Act and provider payment systems—projected to reduce the deficit by at least $625 billion over 10 years. The House Ways and Means Committee also advanced its portion of the package, which focuses on President Trump’s tax bill. Internal GOP debates continue over provisions such as the State and Local Tax (SALT) deduction cap, with SALT Caucus members pushing for an increase and some conservatives arguing the bill does not go far enough in cutting the deficit. The Energy and Commerce, Ways and Means, and Education and Workforce bills were merged into a larger reconciliation package and narrowly passed the House Budget Committee late Sunday by a 17-16 vote, after four Republicans changed their votes to “present” to move it forward. The House Rules Committee is set to review the package Wednesday morning, with final House consideration expected before the Memorial Day recess. The Senate is expected to take up the measure next, where it will likely face further obstacles.

AACOM continues to advocate against provisions that would negatively impact the OME community, including the elimination of the Grad PLUS loan program, federal borrowing caps and risk-share payment requirements for institutions of higher education, including osteopathic medical schools. We are collaborating with stakeholders within and outside osteopathic medicine to promote congressional changes. We encourage the OME community to continue to advocate with your House and Senate members in support of these goals.