How HR-1, the “One Big Beautiful Bill Act” Could Reshape Your Benefits
6 min read
The U.S. House of Representatives just passed a sweeping bill nicknamed the One Big Beautiful Bill Act (H.R. 1), and it could mean major changes to how millions of Americans access government help. From healthcare to food to tax credits, lots of federal benefit programs could be altered by this legislation.
It hasn’t passed yet — it still needs to go through the Senate before it could be signed into law — but the implications are still important to be aware of.
We’ll tell you how it could affect the benefits you or your family rely on — broken down by category.
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Medicaid: Millions Could Lose Coverage
Medicaid is the main way low-income Americans get access to healthcare benefits. This bill proposes major structural changes that could significantly reduce who qualifies, and what they get.
What’s proposed:
Cuts of up to $1 trillion in Medicaid funding, representing one of the deepest reductions in the program’s history.
Stricter work requirements that could disqualify people who can’t prove they’re working or actively seeking work.
A ban on gender-affirming care for all ages under Medicaid and CHIP, including hormone treatments and surgeries.
Who it affects:
Roughly 87 million Americans currently use Medicaid.
The Congressional Budget Office projects that 13.7 million people could lose their coverage under this bill.
What’s been amended:
Lawmakers struck a proposal that would have cut Medicaid payments to nonprofit family planning clinics that offer abortion services.
Food Assistance: New Work Requirements for SNAP
This bill takes a complex approach to food assistance. While the House ultimately added some protective measures for vulnerable groups, the original version of H.R. 1 included deep proposed cuts to the Supplemental Nutrition Assistance Program (SNAP) and limitations on the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). These cuts would have reshaped access to food support for millions of Americans.
This bill takes a complex approach to food assistance. While the House added some protections for vulnerable groups, the original version included deep proposed cuts to SNAP and limitations on WIC.
What’s proposed:
Work requirements expanded to all able-bodied adults without dependents ages 18–64 (up from 49), requiring at least 20 hours/week of work
Time limits and benefit suspensions for those who don’t meet work reporting requirements
Reduced flexibility for states to manage SNAP during downturns
Budget caps that could force the USDA to reduce SNAP participation or cut benefit amounts
What was added to lessen the impact:
States must certify that SNAP changes won’t result in lost benefits before implementing them
Exemptions for seniors aged 55–64
Protections for caregivers of children as young as 7 during summer breaks
WIC participation is shielded from enrollment cuts regardless of funding changes
Who it affects:
Over 40 million Americans currently receive SNAP
More than 6 million people use WIC — including pregnant women and children under 5
The USDA estimates up to 2 million could lose SNAP benefits if the work rules take effect
Earned Income Tax Credit (EITC): Expanded access
The Earned Income Tax Credit helps low- and moderate-income workers get money back at tax time. The bill proposes expanding eligibility and increasing flexibility.
What’s proposed:
Lets people use the previous year’s income if it gives them a higher credit
Raises both the credit percentage and maximum amount
Expands eligibility to include more adult workers without children
Who it affects:
The EITC lifts millions of families out of poverty annually
These changes especially help people with fluctuating income or part-time jobs
Child Tax Credit (CTC): Now Fully Refundable
The Child Tax Credit is known to be one of the most effective tools for reducing childhood poverty, and this bill restores key provisions that made it a monthly lifeline back in 2021.
What’s proposed:
Makes the CTC fully refundable, so families can get the full amount even if they owe no taxes
Brings back advance monthly payments to provide consistent support throughout the year
Who it affects:
During the 2021 expansion, about 61 million children received benefit payments. Analysts credited this version of the CTC with cutting child poverty nearly in half that year.
Affordable Care Act (ACA): Larger Enrollment Windows; Price Increases
The ACA helps millions access health insurance. This bill makes it easier to enroll — but leaves out a key affordability feature.
What’s proposed:
Extends open enrollment to at least 3 months (up from 6 weeks)
Loosens restrictions on special enrollment after life events
What’s missing:
The bill does not extend enhanced premium tax credits, set to expire at the end of 2025
Without them, premiums could rise by an average of $313/month for a family of four
Some households — like those earning just over $128,000 — could lose all eligibility for subsidies
Why it matters:
Enrollment grew from 12 million to 24.2 million between 2021 and 2025
If tax credits expire, up to 8 million people could lose coverage
Medicare: Proposed Changes Unlikely to Make it Into Final Bill
Some Republican lawmakers had floated the idea of using Medicare reforms — including targeting overpayments in Medicare Advantage — to offset costs in H.R. 1. But that idea now appears to be off the table.
What was proposed (and now unlikely):
A bipartisan proposal from Sens. Cassidy (R-La.) and Merkley (D-Ore.) would have targeted overpayments in Medicare Advantage, potentially saving billions
Critics warned it could lead to higher costs or reduced benefits for seniors
GOP senators now say the measure is too politically risky
Why it matters:
Medicare changes were once floated as a major offset in the House bill
After internal GOP backlash and pressure from industry groups like AHIP, most Senate Republicans now oppose including it in the final package
Senate Finance Committee members signaled it’s better suited for separate legislation
What’s next for H.R. 1?
The bill has passed the House, but it’s far from final. The Senate is expected to revise it heavily — and many provisions, including potential Medicare reforms, may be softened or removed altogether. It would then need to be approved by both chambers and signed by the President to become law.