Protect Medicare From H.R. 1's Automatic Cuts

In July, Republicans in Congress passed H.R. 1, the so-called “One Big Beautiful Bill” Act, that included $1 trillion in cuts to Medicaid as well as numerous other provisions impacting nearly all sectors of the health care system: rural hospitals, nursing homes, CHIP, Affordable Care Act marketplaces, employer-based insurance premiums, and Medicare.

Despite consistent promises by Trump and Republicans that they would not touch Medicare, H.R. 1’s drastic increase to the federal deficit sets the stage for an estimated $490 billion cut to Medicare over the next decade. The 2010 Pay-As-You-Go Act (PAYGO) is a budget rule that requires any tax cuts or mandatory spending increases be offset by spending cuts or revenue increases. Because H.R. 1 will roughly increase the federal deficit by $3.4 trillion, it will trigger PAYGO, and the Office of Management and Budget will then be required to issue automatic cuts or “sequesters” by January 2026. While certain programs, like SNAP and Society Security, are protected from sequesters, Medicare is not. This PAYGO sequestration will result in a 4% cut in Medicare payments to hospitals, doctors, and providers.

Congress could have included a PAYGO waiver in H.R. 1, but then the bill would have required a bipartisan 60 votes to pass instead of 50. Now, it is up to lawmakers to pass new legislation to exempt Medicare from these automatic cuts and protect seniors from the dangerous impact of H.R. 1.