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.
Strengthening Social Connection and Opportunities in Rural Communities
This brief describes an unfolding learning journey intended to strengthen social connection, resident voice, and agency to address inequities in rural health and well-being. Along the way, we have come to realize the important lessons for each of our institutions and ways in which we are better off for having taken this approach to our work.
Rhode Island’s Health Equity Zones: Rethinking Community Investing to Create Measurable, Sustainable Gains in Health Equity
In 2015 the Rhode Island Department of Health (RIDOH) launched a project called the Health Equity Zones (HEZ) initiative, with the goal of creating a new public health approach. Rather than prioritizing specific health outcomes, Rhode Island’s HEZ initiative was designed to shift investments upstream to improve the social, environmental, and economic determinants of health by intentionally investing in community infrastructure and resident empowerment. The HEZ initiative has grown over the past seven years to become an internationally recognized model for operationalizing health equity, and during that time we have learned a lot about the role of community investments and how our approach needs to be rethought if we are truly going to invest in health equity.
Centering Racial Justice to Address Climate Change: Learning What it Takes
In 2018, the Kresge Foundation launched the Climate Change, Health, and Equity (CCHE) initiative as a 5-year, $22 million commitment to accelerate action on climate change and climate-related inequities in health. Since its inception, the CCHE network has worked in distinct, yet aligned strategies that focus on health institutions, practitioner and professional societies, and community-based organizations. The priority was to bring together diverse grant-funded partners at different points along their equity journey, with initiative partners providing evaluation, technical assistance, and support to sustain the network.
Children’s Environmental Health Day: Actions Needed Now to Protect Our Children’s Health
It has been over a decade since the World Health Organization raised the alarm that chronic diseases—including cardiovascular, cancer, diabetes, obesity, and metabolic syndrome—are rapidly becoming an epidemic in developed nations, and increasingly, in developing nations. Escalating rates of neurocognitive, metabolic, autoimmune, and cardiovascular diseases cannot be solely attributed to lifestyle, genetics, and nutrition. Prenatal, early life, and ongoing exposures, along with bio-accumulative toxicants, are playing a large role in the increased incidence of chronic disease. In fact, we need only look at the statistics to see that chronic disease rates in children are on the rise, and this can often be linked to toxic exposures.
Rural Road Trip Showcases Resiliency, Collaboration, Innovation, and the Need for a Shared Vision for Rural Health in the United States
Last month I had the distinct pleasure of visiting Georgia and North Carolina with key partners in rural health. Our “rural road trip” was a refreshing journey that provided inspiration for philanthropy’s work and a reminder that ensuring better health for all must engage all rural communities.
