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.
Reconnecting and Recommitting to a Future Focused on Better Health for All through Better Philanthropy
Much has changed since Grantmakers In Health (GIH) last convened in 2019. Over the past three years, more than 1 million Americans have lost their lives due to COVID-19. Large cracks are apparent in our public health infrastructure, health care systems, and safety net programs. In addition, pervasive inequities across all facets of society have increased. The country is divided, and this division continues to hamper our ability to address one of the greatest health challenges our modern world has ever faced.
Reflecting on the Intersections Initiative
For organizations like the St. Joseph Community Partnership Fund (the Fund) and Prevention Institute (PI), GIH conferences have served as a critical space to bring together advocates across sectors and spark new ideas to address complex health issues. Inspired by a PI-led session on upstream prevention and health equity at GIH’s March 2016 annual conference, the Fund noted the promising landscape for a grantmaking initiative that could focus on root causes of poor health and dismantling systems of inequity, and a partnership was born.
Will We Hear the Voices of the LGBTQ Community?
Across the United States we are seeing a coordinated campaign to restrict lesbian, gay, bisexual, transgender, and queer (LGBTQ) rights and limit access to affirming, lifesaving health care. According to the Equality Federation, nearly 400 anti-LGBTQ bills were introduced across the country in 2021, and over 240 bills have already been filed in 2022. These policies directly impact the health and safety of members of the LGBTQ community. Recent data from The Trevor Project show that 66 percent of LGBTQ youth, including 85 percent of transgender and/or nonbinary youth, report that recent debates around state laws to restrict the rights of transgender people have negatively affected their mental health.
It’s Time to Converge on Narrative Change for Racial Justice and Health Equity
Philanthropy is increasingly embracing narrative change as a tool for building public and political will to advance equitable policies and structural change. Yet philanthropic narrative investments to advance racial justice and health equity are still relatively new and disparate. The work is often siloed, lessons and insights are not often shared across efforts, and there is also a wide range of definitions of narratives, perspectives, and approaches on how to shift them.
Building a Better Bridge Between Funders and Communities
We are experiencing a watershed moment for philanthropy-funded social change efforts in the United States. The partnerships, knowledge, and resources that funders leverage have never been more important in contributing to the conditions that communities need for everyone to thrive, without exceptions. With such a rapid pace of change happening all around us, how can funders make the most of their role in supporting and advancing large-scale, transformative impact? The answer is to look forward with the benefit of hindsight and with partners who understand where and how to take those next steps.
The Ethel and James Flinn Foundation: June 2022
The Ethel and James Flinn Foundation is accepting proposals from nonprofit organizations that deliver mental health care and services in southeast Michigan (Wayne, Oakland, Macomb, and Washtenaw).