Infosheet: Key Provisions in the House-passed Reconciliation Bill—H.R. 1, the ‘One Big Beautiful Bill Act’
An infosheet provides analysis of key health, philanthropy, and nonprofit provisions in H.R. 1, the budget reconciliation bill passed by the U.S. House of Representatives on May 22, 2025. Changes include an estimated $715 billion reduction in federal Medicaid spending including work requirements, new eligibility requirements to the Affordable Care Act that will reduce access to the ACA’s Advanced Premium Tax Credits, $300 billion in reductions to Supplemental Nutrition Assistance Program (SNAP) benefits, an excise tax on foundations, and new authority for the Secretary of the Treasury to remove the tax-exempt status of nonprofits the administration deems as “terrorist support organizations.”
From Recovery to Resilience: Investing in Collaborative Infrastructure for Health and Equity
After the 2018 Camp Fire – the most destructive and deadly wildfire in California’s history – the California Accountable Communities for Health Initiative (CACHI) understood that the community needed more than programming to recover. In response, the region’s Accountable Community for Health (ACH) was created – a community-rooted, cross-sector collaborative that invests in local leadership to shift systems, influence policy, and address both long-standing inequities and urgent crises.
Broken Triangle: A Framework for Reparative Philanthropic Relationships
Traditional philanthropic practices have often created imbalanced power dynamics and barriers for Black-led, Black-serving organizations. When the REACH Healthcare Foundation performed a portfolio review in 2018 that revealed this same exclusion within the foundation’s grantmaking investments, REACH committed to reshaping their funding approach, which aims to repair previously neglected —and in some cases, damaged —relationships.
Race to the Top: Is Children’s Health in the Running?
The Race to the Top-Early Learning Challenge (RTTELC), jointly administered by the U.S. Departments of Education, and Health and Human Services, is the latest federal opportunity for states to receive grants to transform education systems and improve achievement outcomes for children.
Effective Behavioral Health Funding in an Era of Health Care Reform
Health funders today operate in an environment of change and uncertainty as policy changes driven by federal health care reform affect health care at state and local levels – often in ways that are hard to predict. Meanwhile, health funders increasingly recognize that addressing behavioral health challenges is central to promoting healthy individuals, families, and communities.
Health Care Reform: Promises and Pitfalls for Maternal and Child Health
In 2009 health care spending in the United States reached an all-time high of nearly $2.5 trillion, representing an almost two-fold increase in spending on a per capita basis since 1997 (NIHCM Foundation 2011).
Integrating Primary Care and Public Health: Opportunities for Oral Health
As health philanthropy considers how to address the current individual and community burdens of increases in chronic diseases, I am optimistic when I reflect on the new and promising collaborations that are developing to better manage and prevent oral disease.
Health Insurance Exchange Planning: Philanthropy Leading the Way
Health insurance exchanges are the cornerstones of the
Affordable Care Act (ACA). By 2014, each state will
need to establish two health insurance marketplaces,
known as exchanges, one to serve individuals and one to serve
small employers of up to 100 employees (the SHOP
exchange).