An act to provide for reconciliation pursuant to title II of H. Con. Res. 14.

This law, signed on July 4, 2025, is a major budget reconciliation package that affects millions of Americans across multiple areas. The law permanently extends individual tax rates from 2017 that were set to expire, increases the child tax credit to $2,500 per child through 2028, and raises the standard deduction. It also increases the state and local tax deduction cap to $40,000 for lower-income taxpayers and creates new tax deductions for tips, overtime pay, and auto loans.

The law makes significant changes to healthcare programs. It reduces federal Medicaid funding by over $1 trillion over ten years and is projected to result in approximately 10 million more uninsured individuals. The law requires more frequent Medicaid eligibility checks every six months instead of annually, implements work requirements for certain Medicaid recipients, and restricts eligibility for non-citizens. It also delays minimum staffing standards for long-term care facilities until 2035 and caps home equity at $1 million for Medicaid long-term care eligibility. For Medicare, the law increases physician payments by 2.5 percent for 2026 and provides a $6,000 annual tax deduction for adults over 65 with incomes up to $75,000.

The law cuts approximately $1.15 trillion in federal health care spending and makes deep cuts to the Supplemental Nutrition Assistance Program (SNAP). It also overhauls the federal student aid system and rolls back accountability measures meant to protect students from fraud. Additionally, the law increases excise taxes on certain private college and university endowments, expands the tax on excess compensation for tax-exempt organizations to apply to all employees earning over $1 million, and permanently increases the estate tax exemption to $15 million starting in 2026.

The law includes numerous agricultural provisions, including increases to payment limits for commodity programs, changes to sugar support programs, and extensions of programs from the 2018 farm bill. Various provisions take effect on different dates, with some Medicaid changes beginning in late 2025 and others phasing in through 2027. The law was passed using the budget reconciliation process, which allowed it to pass the Senate with a simple majority rather than the usual 60-vote threshold.