Following extended negotiations in both the House and Senate, Congress narrowly passed a major reconciliation package, titled the One Big, Beautiful Bill Act (OBBBA), on July 3, which was signed into law by President Trump on July 4. The legislation includes significant fiscal and health policy changes.
Key Provisions of the Legislation
- Permanently Extends the 2017 Tax Cuts
- Cuts Medicaid Funding by Nearly $1 Trillion
- Adds $3.3 Trillion to the National Debt (over the next decade, per CBO projections)
Impact on Medicare Physician Payments
The bill includes a 2.5% one-year Medicare payment increase for Calendar Year 2026 (CY2026). However, this is a temporary measure. Without further action from Congress, CMS will be required to remove the adjustment from the Conversion Factor for CY2027.
Major Reductions in Medicaid & Coverage Losses
According to the Congressional Budget Office (CBO):
- Medicaid faces $1 trillion in cuts, exceeding the House-passed version by $200 billion
- The bill does not extend ACA enhanced premium tax credits
- It introduces strict work requirements and provider tax restrictions
- Estimated 17 million people could lose health coverage
Physician Community Advocacy Contributes to Legislative Outcome
Thanks to coordinated advocacy efforts, the final package includes no new restrictions on Pass-Through Entity Taxes (PTET), a positive outcome for independent physician practices.
Federal Student Loan Cap Raises Concerns
The legislation imposes a lifetime borrowing cap of $200,000 for medical and law school students. However:
- A recent AAMC survey shows 27% of medical students carry over $300,000 in debt
- This cap could limit access to medical education and worsen the projected shortage of 86,000 physicians nationwide
SVS Advocacy Efforts Continue
The Society for Vascular Surgery (SVS) remains fully engaged with Congress, coalition partners, and federal agencies to advocate for:
- Immediate relief from looming Medicare payment cuts
- Structural payment reforms to ensure long-term stability
- Ongoing investment in the physician workforce and patient access to specialty care