June 17, 2025

Bringing you the latest news impacting our network from Congress and the Administration.

SENATE RELEASES BUDGET RECONCILIATION BILL WITH DEEPER MEDICAID CUTS THAN HOUSE BILL 

THE LATEST

On June 16, the Senate released their version of the budget reconciliation bill that pushes for larger Medicaid cuts than the House bill does.  Highlights of the bill include:

• Medicaid: imposes more stringent work reporting requirements than the House; lowers the allowable rate for state provider taxes for some provider types; prohibits implementation of the SNF minimum staffing regulation.
• Refugees: Institutes a permanent ban on refugees and other humanitarian-status immigrants from getting Medicaid.  
• Nonprofit tax issues: More favorable to the charitable sector than the House bill. Includes a stronger, permanent non-itemizer deduction; omits several harmful tax hikes 

TIMELINE

Senate Majority Leader John Thune (R-SD) continues to assert his plans to hold a floor vote on the Senate bill before the body leaves for the July 4th district work period.  That could look like this:

• Week of June 16: Senate releases its legislative package and prepares for floor vote.
• Week of June 23: Senate debate and expected floor vote. 
• Week of June 30: The House and Senate work to reconcile  differences between their respective versions of the reconciliation bill and reach consensus. 

IMMEDIATE ACTION REQUESTED

Quick action is needed given the short timeline for the Senate to complete their work.

• NOTE: All senators should be engaged/contacted, but please refer to our Senate target list where most immediate outreach is needed.

THE DETAILS: Key Provisions

While we are still analyzing the full content of this major legislation, key details are as follows:

• Side by side comparison of the Senate and the House bills, including impact
• Medicaid/SNAP:
  • Work requirements:
    • Only parents/guardians of dependent children up to age 14 are exempt, rather than all parents/guardians as in the House bill.
    • Applies to adults aged 19 to 64 enrolled in ACA Medicaid expansion coverage
    • Goes into effect on January 1, 2027, unless a state seeks and the Health and Human Services Secretary grants a temporary exemption to delay implementation for no more than two years. 
  • Provider taxes:
    • Freezes provider taxes at current rates for non-Medicaid expansion states.
    • Lowers the provider tax threshold from 6% to 3.5% for all provider types except nursing homes and intermediate care facilities in Medicaid expansion states.
  • Prohibits the implementation and enforcement of HHS’s final rule establishing minimum staffing standards for long-term care facilities. 
  • Limits retroactive coverage in Medicaid to two months before an individual's application date, rather than the long-standing three-month period.
  • Requires most states to pay part of SNAP food benefit costs for the first time. If states couldn’t pay the required amounts, they would have to shrink the number of SNAP recipients or even opt out of SNAP entirely
 
• Refugees:

  • Institutes a permanent ban on refugees and other humanitarian-status immigrants from getting Medicaid.  (This is a change from language which would have barred them from receiving Medicare.) 

  • The Senate proposal adopts the SNAP exclusion of refugees, people granted asylum, survivors of trafficking and domestic violence for the Medicaid program as well. 

  • In the case of Medicaid, the provision will end federal matching funds to cover these groups (states would have to fully pay for them to continue to provide Medicaid to them). 

   
• Nonprofit tax issues
  • Creates a permanent non-itemizer deduction for charitable donations of $1000 for individuals and $2000 for couples.
  • Omits a provision reinstating UBIT taxes on parking and transportation benefits. 
   

What You Can Do Now: Outreach to the Senate is at a Critical Stage

Here We Stand. For People. For Care. For Medicaid.

• Use the messaging toolkit for our “Here We Stand” campaign which includes templates to use for outreach to members of Congress and the media.
• The recording of our recent webinar which includes a walk-through of the messaging and how to use the communications resources.
• Our Community Mobilization Resources webpage.

• Reach out to your Senators and ask them to vote "NO" on cuts to Medicaid.
• You can identify your lawmakers and find their contact information in our directory.
• As states also fund a significant share of Medicaid funding, please communicate with your governor’s office about the impact of any Medicaid cuts. 

Stay Tuned

• Register now to join us for the next webinar in our “Capitol Conversations” series on July 17 at 1 p.m. ET. We will be sharing the latest updates on the budget reconciliation process and the impact on Medicaid and nonprofits, as well as expert insights on pursuing federal funding opportunities.

For more information, please contact Sarah Dobson, Senior Director of Public Policy and Advocacy.

Lutheran Services in America is one of the nation’s largest national networks of health and human service providers with a mission to cultivate caring communities that advance health and opportunity for all. With 300 nonprofit organizations across 1,400 U.S. communities and more than $26 billion in combined annual services, the Lutheran Services in America network advances equitable outcomes for children, youth and families, improves independence and choice for older adults, champions meaningful services and support for people with intellectual and developmental disabilities, and strengthens stability and purpose for veterans and others. Formed in 1997, Lutheran Services in America brings together a network of leaders, partners and funders to catalyze innovation, strengthen organizational capacity and advance public policy.