by Kristin Rowan, Editor

House passes bill in early-morning vote. The House of Representatives, predictably split along party lines, passed the “Big, Beautiful Bill” in a 215-214 narrow win. All but three Republican representatives cheered at its passing. Republicans who previously stated they would not vote for a higher deficit caved and voted along party lines. The House expects an uphill battling getting the bill passed through the Senate.

All House Democrats and two House Republicans voted against the bill. One Republican voted “present.” Democrats were vocal in their opposition.

One controversial change in Medicaid is the community engagement requirement for eligibility. Eligibility is at least one of the following:

• Working at least 80 hours in a month
• Completing at least 80 hours of community service
• Participating in a work program for at least 80 hours
• Enrolling at least part-time in an educational program
• Any combination of the above totaling at least 80 hours
• Having a monthly income greater than minimum wage for 80 hours per month

This rule applies to all eligible individuals at least 19 years old and is under 65 years old, is not pregnant, does not have children under age 7, and is not enrolled in or eligible for Social Security benefits. Mandatory exceptions to the community engagement requirement are:

• Indian, Urban Indian, California Indian, or eligible as an Indian for the Indian Health Service
• The parent, guardian, or caretaker of a disabled individual or dependent child
• A veteran with a total disability rate
• Medically frail or has special medical needs including those who:
  • are blind or disabled
  • have a substance use disorder
  • have a disabling mental disorder
  • live with a physical, intellectual, or developmental disorder that impairs 1 or more activities of daily living
  • live with a serious and complex medical condition
  • have any other medical condition approved, but not listed here
• In compliance with requirements imposed by the State
• The member of a household receiving SNAP benefits
• Participating in a drug or alcohol rehabilitation program
• An inmate of a public institution
• Meet other criteria deemed appropriate

After the vote, the Senate made it clear that it will not send the bill to the President without “major changes.” The problem, however, is that different members of the Senate are calling for different changes. Some want even more spending reductions, others want to keep more of Biden’s green-energy incentives, and still others want to soften the Medicaid cuts. Here is some of the feedback from Senators:

Ron Johnson, Senator (R-Wis.) wants to take the bill “line by line” to find $6.5 trillion in cuts over 10 years.

Rand Paul, Senator (R-Ky.) supports the tax agenda, but not the debt ceiling hike.

Lisa Murkowski, Senator (R-Alaska) is expecting significant changes and wants to address the Medicaid cuts, call them “challenging.”

Patty Murray, Senator (D-WA) called the bill a “scam” and urged Republican senators to vote against it.

Because of the way the House presented the bill, designed to prevent a filibuster, there are constraints on what can be included.

First, everything included in the bill has to be about the budget. Challenges to parts of the bill and whether they are directly related to the budget go to the Senate parlimentarian. A non-partisan advisor, the parlimentarian advises the Senate if a provision is challenged. Elizabeth MacDonough is the current Senate parlimentarian and has served under Senate Majority Leaders from both parties.

Second, the Senate gets to make its own changes to the bill. If the House does not accept those changes, the debt ceiling will not go up. An impasse means the government defaults on its debt. Congress has to raise the debt ceiling by the summer to avoid default. This could put pressure on the House to accept whatever changes the Senate makes.

This is an ongoing story and The Rowan Report will continue to provide updates as they become available. Read our accompanying article this week on organizations and courts attempting to stop Trump’s sweeping changes.

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Kristin Rowan has been working at The Rowan Report since 2008. She is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news, and speaker on Artificial Intelligence and Lone Worker Safety and state and national conferences.

She also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing.  Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com