Despite an onslaught of fearmongering from Democrats, who carpeted the media with claims that because of the One Big Beautiful Bill “tens of millions” to lose health insurance and people would “literally die,” Republicans stood firm and passed common sense reforms to our broken healthcare system. But Democrats are unlikely to abandon their scripted and knowingly false claims. No doubt they hope to sustain these narratives through the midterms.
Republicans can’t afford to quit the field after winning this battle. Having made much-needed reforms that improve our health-care system and protect taxpayers from wasteful and fraudulent spending, Republicans must press the offensive. As they return to their districts, Republican lawmakers can't shy away from talking about the healthcare provisions of the OBBB. They have every reason to do so proudly.
One provision, hardly mentioned in the press, protects nursing homes from an onerous regulation the Biden Administration issued last year. Under existing federal law, nursing homes must have a registered nurse present at least eight hours per day. But the Biden regulation mandated – that nursing homes receiving Medicare or Medicaid funds triple that coverage. Less than 1 in 5 nursing homes were meeting that standard.
With our health-care system already facing a nursing shortage, multiple healthcare associations and even one of Schumer’s Democratic colleagues opposed this one-size fits all regulation. “This final rule could lead nursing homes to reduce capacity or close outright, including those that are otherwise high performers on quality and safety metrics,” said American Hospital Association Vice President Stacey Hughes. Sen. Tester of Montana said: “I have serious concerns that the Biden Administration’s one-size-fits-all staffing mandate will be unworkable for rural nursing homes.”
The OBBB addressed these concerns by suspending enforcement of the Biden regulation until 2034, keeping thousands of seniors from being thrown out of nursing homes.
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It also took a significant step to improving health care in rural areas by allocating $10 billion per year over the next five years to support rural hospitals and health care providers, redirecting resources where they are needed most.
The OBBB also increases the usefulness of Health Savings Accounts (HSAs), which allow individuals to use before-tax income to cover healthcare expenses. Before the OBBB, these accounts could only be used by individuals enrolled in High Deductible Health Plans (HDHP) to pay for healthcare expenses not covered by the plan. Now, Americans will be able to use their HSA to pay for uncovered healthcare expenses in a bronze-level or catastrophic plan in the Affordable Care Act health insurance exchange or to pay for Direct Primary Care.
Further, the OBBB better incentivizes research and development on treatments for rare diseases. The Inflation Reduction Act — passed without a single Republican vote — created the Medicare Drug Price Negotiation Program. The program's price setting mechanism carved out a narrow exemption for “orphan drugs,” defined as drugs “intended to treat a condition affecting fewer than 200,000 persons” or “which will not be profitable within 7 years following approval by the FDA.”
This program — with its narrow exemption – created a disincentive for pharmaceutical companies to develop drugs that would treat rare diseases but might not qualify for the exemption. The OBBB removed that disincentive by amending the exemption to include drugs that are used to treat more than just one rare disease and delaying application of the price-negotiation requirement until a medication has lost its “orphan drug” status. The result is that more Americans and notably children with rare diseases, can maintain hope that American innovators will develop new treatments that otherwise wouldn’t have been economically viable.
And importantly, while the OBBB does not deny Medicaid coverage to qualified beneficiaries, the central falsehood Democrats have advanced, it will slash waste, fraud, and abuse.
The Inspector General for the Department of Health and Human Services revealed in a report published in 2022 that state Medicaid programs all across the country were paying for beneficiaries in managed care programs in their state despite being simultaneously enrolled in another state.
Thus, taxpayers were funding not one, but two, Medicaid plans for one person.
To fix this, the OBBB requires CMS to create a national system that states can use to determine if a Medicaid beneficiary is enrolled in more than one state at the same time. The Congressional Budget Office has calculated this provision will save taxpayers $17.4 billion over ten years simply by limiting beneficiaries to Medicaid enrollment in one state at a time.
The OBBB also requires states to check the Social Security Administration’s Death Master File every quarter to make sure someone who has died is no longer enrolled in a Medicaid-funded health plan.
And it makes illegal aliens — but not refugees or those granted asylum — ineligible for Medicaid. This, according to CBO, will save taxpayers $6.2 billion over ten years.
The evidence is clear: the OBBB won’t harm America’s safety net healthcare system; it will preserve it for years to come. It will protect our most vulnerable citizens, while eliminating unnecessary government spending, and in so doing will save lives. These are accomplishments Republican lawmakers should be talking about proudly in their home states and districts.
Joe Grogan is the former director of the Domestic Policy Council and now president and co-founder of Public Policy Solutions.
Editor's Note: President Trump is leading America into the "Golden Age" as Democrats try desperately to stop it.
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