On June 4, 2025, the Congressional Budget Office (CBO) released its full score of H.R. 1, the One Big Beautiful Bill Act, which House Republicans passed on a 215-214 party-line vote on May 22. CBO estimates that H.R. 1 would add $2.4 trillion to the federal deficit over the ten-year budget window. This reflects a $3.67 trillion decrease in expected revenues and a $1.25 billion decrease in spending through 2034, relative to baseline projections.
The CBO score also shows that the House-passed legislation would result in 10.9 million people going without health insurance coverage in 2034, including 1.4 million without verified citizenship, nationality, or satisfactory immigration status. Of the 10.9 million, 7.8 million people are attributable to Medicaid, and the rest to Affordable Care Act reforms.
Earlier CBO estimates evaluated each House Committee's contribution to the Bill independently, but this new full estimate reflects interactions between Committee products which are now packaged together as H.R. 1. The score does not account for so-called "dynamic" effects that enacting H.R. 1 could generate, like changes in economic growth or other indicators, which could offset some of the revenue losses.
Background
H.R. 1 encompasses much of President Trump's domestic policy agenda, with provisions geared towards "driving massive economic growth, unleashing American energy, [and] strengthening border security and national defense." It includes extensions and modifications of expiring 2017 Tax Cuts and Jobs Act provisions, new corporate and individual tax provisions, and would provide new benefits he promised during the campaign trail, including eliminating taxes on tips, overtime, and Social Security through 2028. It also raises the cap on the federal deduction for state and local taxes (SALT) to $40,000 from $10,000.
H.R. 1 is offset by various federal spending cuts, including repeal and modification of Inflation Reduction Act (IRA) energy tax provisions, modification of commercial health insurance rules, and establishing new work requirements for Medicaid enrollees and new guidelines for the Supplemental Nutrition Assistance Program.
Next Steps
The White House has called on lawmakers to pass H.R. 1, which includes an increase in the statutory debt limit, by the July 4 congressional recess. Treasury is projected to exhaust its ability to use "extraordinary measures," accounting maneuvers that keep borrowing within the debt ceiling, by mid-August.
The Senate will develop its own version of H.R. 1 that meets Senate reconciliation instructions and is compliant with the Senate's Byrd rule, a multi-pronged test to ensure the Bill is primarily budgetary in nature. This is necessary to maintain the Bill's privileged status as a reconciliation measure, which allows for expedited consideration with a simple majority threshold for passage. Because Senate Republicans are making changes, CBO will need to score the cost of each component of the new version, followed by another full estimate of the entire package. The non-partisan Senate parliamentarian will review the CBO score as part of determining whether the legislation meets Senate reconciliation instructions and complies with the Byrd rule.
Senators may also make potentially substantial policy changes in order to secure the 51 votes necessary for Senate passage. Fiscal hawks want the Bill to do more for deficit reduction, and Senators Rand Paul (R-KY) and Ron Johnson (R-WI) in particular have raised concerns that the Bill raises the debt ceiling by $4 trillion, extending federal borrowing authority past the 2026 midterm election. President Trump, conversely, is asking Senate Republicans to entirely eliminate the debt limit. Senate Republicans also aim to make three business tax cuts permanent: full upfront research and development expensing, bonus depreciation, and interest expensing. H.R. 1 would extend these provisions only for five years, so making them permanent could further dampen revenues.
Senate Republicans have publicly floated a variety of new policies and modifications that could improve the bill's score, including modifying the Medicaid provider tax freeze, limiting eligibility for administration priorities like "no tax on overtime," and expanding the measure to address fraud, waste, and abuse in the Medicare program, potentially including Medicare Advantage coding intensity. Senate Republicans have also expressed interest in a bicameral "compromise" on the SALT deduction cap, which has limited impact on their home states. House moderates from New York, New Jersey, and California have said they will not support the package without significant SALT relief.
As the Bill winds its way through the legislative process, it is imperative to stay informed and engaged. The attorneys and government relations professionals at Buchanan Ingersoll & Rooney PC will continue to monitor and provide additional analysis, as well as personalized guidance on navigating its complexities. Our government relations professionals are actively working to advance our clients' goals with respect to this legislation.
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