How H.R. 1 Affects You

It was called the One Big Beautiful Bill, a name which belies the ugly truth contained within. I shall simply call it H.R. 1. Rammed through the chambers and signed into law July 4 to meet an arbitrary deadline imposed by the president, H.R. 1 contained numerous provisions that would directly affect residents of Anne Arundel County.

As chair of the Public Health and Minority Health Disparities Subcommittee, I spent most of the summer interim working to understand the state level implications of the various proposals before H.R 1 passed into law. Contained within the bill’s 330 pages are provisions that make permanent the 2017 tax cuts for individuals and businesses (primarily for the highest earners), provide temporary income tax deductions for qualified tips (up to $25,000) and qualified overtime pay (up to $12,500), temporarily raise the SALT (state and local tax) deduction cap, and retroactively end the Employee Retention Tax Credit.

The bill includes a provision to increase the federal government’s statutory debt limit by $5 trillion and allocates an additional $170.7 billion to the Department of Homeland Security (DHS) for immigration and border enforcement, creating the largest private law enforcement organization under the oversight of the White House in our nation’s history.

H.R. 1 also terminates several energy-related tax incentives, such as tax credits for clean vehicles and clean electricity, which have directly impacted Maryland as we work to meet our green energy goals.

I will focus my attention on the impact on health care.

Unlike Medicare, which is a federal program, Medicaid is a state-run program that leverages state dollars to receive federal match dollars. Medicaid and CHIP (Children’s Health Insurance Program) cover insurance for approximately 25% of Marylanders, nearly 50% of our children. That includes about 40% of births, one in three people with disabilities, and five out of eight nursing home residents.

H.R. 1 creates stricter requirements for state Medicaid financing and eligibility, imposes mandatory community engagement requirements, and alters how states can use provider taxes to fund the program. Though that may sound like accountability, the reality is that Medicaid is one of the most efficient programs in the country with an overheard of just 4% on average.

Anyone who has ever owned a business and tried to navigate overly burdensome regulation understands that it is a time-consuming and costly endeavor. According to Kaiser Family Foundation, 72% of adult Medicaid beneficiaries are employed, and many of them are underemployed so they would be eligible under the new employment requirements, but by creating more hurdles for eligibility and requiring redetermination every six months, H.R. 1 creates an administrative burden that will cost participating states and result in nearly 230,000 Marylanders losing their health care coverage. In Anne Arundel County, that translates to approximately 9,279 people.

H.R. 1 ends the health care tax credits that have stabilized our insurance market and kept premiums down, the impact of which we are already seeing as our insurance regulators announced an average increase of 13.4% in individual insurance rates, the highest increase since 2017, when Maryland took multiple steps to stabilize the market and expand the healthy pool of insured Marylanders.

Although we will see the increase in our health care costs immediately, the full impact of H.R. 1 will not be felt until 2026, following the midterm elections.

However, one provision that will be felt immediately is the cuts to SNAP, the Supplemental Nutrition Assistance Program, which will begin October 1. The projected impact for Anne Arundel County is 5,005 residents who will be disenrolled, but that doesn’t just affect families and that isn’t just children going hungry; it also impacts the bottom line of our businesses that accept SNAP. So how much money will we save with these draconian policies?

The Congressional Budget Office (CBO) projected that the law will increase federal deficits by $3.4 trillion over the next decade. I will continue to stand up for Marylanders, but we need everyone to speak up and call on Congress to restore our funding and protect our health care.