08/21/2025

House Republicans Float Second Budget Reconciliation; Health Policy Ideas Surface

Some House Republicans are preparing a second budget reconciliation push this fall—often dubbed another “big, beautiful bill”—but prospects appear uncertain without the kind of deadline pressure that moved the first package. Even within the GOP, senators have voiced reservations about using reconciliation again, noting both the political lift and the potential strain on bipartisan cooperation. For a concise look at the Capitol Hill dynamics, see this overview of congressional sentiment.

Parallel staff briefings have begun to sketch health policy options that could be incorporated into a follow-on package. Discussion items include site-neutral hospital payments, a scaled-back renewal of ACA marketplace tax credits, Medicare Advantage changes targeting overpayments, and scrutiny of PBM and 340B policies. For context on the topics circulating in those meetings, see a summary of the policy areas under discussion.