Industry Advocates Respond to Passing of ‘Big Beautiful Bill’

In the days following passage of President Donald Trump’s spending cuts and tax breaks bill, homecare advocates and others in health care have spoken out against it, saying it could threaten patients and access to care. 

The National Alliance for Care at Home (the Alliance) said in a released statement it is “deeply troubled” by the passing of the legislation. 

“These provisions—including work requirements, reduced provider taxes and new cost-sharing mandates—prioritize short-sighted budget savings over the health and wellbeing of our most vulnerable citizens who rely on home- and community-based services (HCBS),” said Alliance CEO Steve Landers. 

The Alliance added the homecare community advocated throughout the legislative process for Congress to mitigate the Medicaid provisions. 

“The legislation will reduce state provider tax rates, cutting funding that states rely on to support HCBS programs,” the organization said. “New work requirements and mandatory cost-sharing will also create administrative burdens for both providers and beneficiaries, likely resulting in coverage losses that extend beyond those directly targeted by these policies. Further, new limits on home equity for long-term care recipients will force older adults to sell their homes, leading to unnecessary institutionalization.”

The Children’s Defense Fund (CDF) also released a statement saying the organization is “deeply disturbed and disappointed by the bill.

“The bill has been called ‘big’ and ‘beautiful,’ but it is big only in its audacious harms to everyday people,” CDF said. “It is bad and brutal in its gutting of essential programs children and families rely on for their day-to-day needs. A budget is a statement of our values—a moral document that reveals who we choose to protect and who we leave behind. This package values the rich, wealthy and corporations. And it devalues children and youth by making historic cuts to Medicaid, the Children’s Health Insurance Program (CHIP), and the Supplemental Nutrition Assistance Program (SNAP). It devalues the families of 17 million children by deeming them ‘ineligible’ and ‘undeserving’ of the vital Child Tax Credit (CTC).” 

ANCOR, an advocacy and resources group for members of the disabled community, issued a statement condemning the bill’s passing, saying its policies will “cause direct harm to anyone who depends on Medicaid to continue living in their community.”

“The sweeping cuts to Medicaid, which amount to nearly $1 trillion, will not only force millions of Americans off their health care coverage, but will also jeopardize access to the services that make community inclusion possible for hundreds of thousands of people with intellectual and developmental disabilities (I/DD),” ANCOR said. “Furthermore, cuts of this magnitude will mean that state governments will have no choice but to make cuts to their own investments in Medicaid. At greatest risk are optional services, including the Medicaid-funded home- and community-based services that enable people to live more independently and in their communities, rather than in large, costly, state-run institutions.

“These community-based supports—funded almost exclusively by Medicaid—empower people with I/DD to live as independently as possible, in their homes and communities,” ANCOR continued. “Despite Congress’ stated intent of protecting people with I/DD, this bill cuts the very funding on which people with disabilities depend for critical supports and life-saving health care.”

ATA Action, the advocacy arm of the American Telemedicine Association, said while aspects of the bill will cause challenges for the health care system and Medicare population, they are overall pleased with the bill’s passing.

“We believe this bodes well for the future of other critical telehealth policies requiring Congressional action,” said Kyle Zebley, executive director of ATA Action and senior vice president, public policy at the ATA. “While many of the provisions in final ‘big beautiful bill’ now awaiting President Trump’s signature will create challenges for our health care system and the Medicare population, inclusion of this permanent telehealth provision clearly demonstrates the relentless bipartisan, bicameral support that telehealth has experienced over the past five years. Importantly, this legislation will give millions of American workers permanent access to coverage of telehealth services without jeopardizing their health savings account (HSA) eligibility.”