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.
Faith in Action: Taking Caregiving to Scale
Over the course of the past fifteen years, the Faith in Action program has provided roughly 1,700 seed grants of up to $35,000 to help start local, interfaith volunteer caregiving programs. These programs are designed to provide free volunteer services to the large and growing number of elderly and disabled individuals who need help with simple, everyday tasks in order to be able to stay in their homes.
Strong Ethics Policy Creates a Culture of Transparency
Almost daily, we are faced with making ethical decisions in our personal and professional lives. This is particularly true for those of us who work at foundations. Foundation board members and staff are often subject to intense pressure to provide funds for particular organizations.
A Foundation Helps Launch a FQHC
For the past decade, free-market thinking has all but dominated the national discussion of health care. New kinds of coverage have resulted, including health savings accounts, along with new players in delivery, like the urgi-care clinics at Wal-Mart.