Reconciliation Becomes Law: Now What?

Decoding the significance

Reconciliation Becomes Law: Now What?

On July 4th, President Trump signed the One Big Beautiful Bill Act into law, after a 218-214 House vote that codified the Senate’s protracted negotiations.

A new analysis by Manatt Health projects the law’s Medicaid policy changes will result in Medicaid covering 8.7 million fewer people over the next decade.

Our previous analyses examined the law’s contours as it came together.

It ended up largely following those outlines, with last-minute negotiations to secure passage while retaining the underlying cuts of nearly $1T to Medicaid over 10 years.

Senator Josh Hawley (R-MO) expressed plans to push to prevent key Medicaid cuts from taking effect in 2027; this dynamic will inform much of the midterm elections.

The Legislative Year Ahead

U.S. House Speaker Johnson has reportedly indicated interest in two more budget reconciliation bills over the next year, with one this fall.

That ambitious timeline would be difficult with the appropriations process for Fiscal Year 26 ramping up, since it begins on October 1.

As CWW Senior Contributor Doug Steiger has recently broken down, there’s a very non-zero probability of a government shutdown there.

Speaking of things taking effect on October 1st, we’ve got a new rundown for you on implementation of the new child welfare law enacted at the start of this year.