AMTA Government Relations Update 6-28-25

DESCRIPTION OF THE ISSUE

Congressional activity surrounding what the President is calling his ‘One Big Beautiful Bill” can be confusing and lead to many questions.  To better understand how this reconciliation bill is moving quickly through Congress, this week’s update outlines the process

Overview:

A reconciliation bill and the traditional appropriations process are both used by the U.S. Congress to manage federal spending and revenue, but they differ significantly in purpose, process, and legislative rules.

Purpose

• Reconciliation Bill:
  • Primarily used to change existing spending, revenues (taxes), or the federal debt limit to align with the instructions set in a budget resolution.
  • Not used to fund the day-to-day operations of the government, but to modify laws related to budgetary matters.
• Traditional Appropriations Process
  • Used to fund the federal government’s operations and agencies for a fiscal year (e.g., health, education, defense).
  • Divides funding among 12 appropriations bills that cover various federal departments and functions.

Process

• Reconciliation Bill:
  • Begins with a budget resolution passed by Congress, which includes "reconciliation instructions" directing committees to achieve specific fiscal goals.
  • Committees submit legislation to meet those goals, which is then combined into one bill and fast-tracked.
• Appropriations Bills:
  • Annual process that begins with the President's budget request.
  • The House and Senate Appropriations Committees draft and approve 12 individual appropriations bills.
  • These must be passed by both chambers and signed by the President before the start of the fiscal year (Oct 1).

Senate Rules and Debate

• Reconciliation Bill:
  • Cannot be filibustered (a Senate tactic used to delay or block action on a bill by refusing to end debate on the matter)
  • Passes with a simple majority (51 votes).
  • Subject to the Byrd Rule (a procedural Senate rule--named after Sen. Robert Byrd (D-WV) in the 1980s---that governs what can be included in a budget reconciliation bill).
• Appropriations Bills:
  • Subject to filibuster—requires 60 votes to advance in the Senate.
  • Allows more open amendments and debate.

Frequency and Use

• Reconciliation Bill:
  • Can be used once per year for each of three categories: spending, revenue, and debt limit.
  • Has been used for major legislation like the Bush tax cuts, Affordable Care Act amendments, and parts of the American Rescue Plan.
• Appropriations Bills:
  • Must occur annually to keep the government funded.
  • Failure to pass leads to government shutdowns or temporary funding through continuing resolutions.

As of Friday evening, June 27th, some of the bill's provisions have been rejected by the Senate Parliamentarian because of the Byrd Rule. The provisions identified would be subject to the 60-vote threshold if they remain in the bill. The Senate has not yet released the final legislative language and it is unclear if a vote will occur before the scheduled June 30th-July 4th state work period.

HOW YOU CAN HELP: 

Even with the Parliamentarian’s rejection of some of the reconciliation bill’s provisions, the bill itself still contains damaging cuts to Medicaid and other important federal programs that millions of Americans depend upon.  PLEASE call your U.S. Senators (even over the weekend) and ask them to vote NO on this reconciliation bill.  Ask them to vote for their constituents healthcare and not for billionaires’ tax cuts. This bill will negatively impact all states, red and blue; and all citizens, regardless of political affiliation. Ask your Senators to vote NO and defend the 60-year old Medicaid program (as of 7-30-25) that insures 71.4 million Americans.
 

Find the phone numbers for your two U.S. Senators
OR
Call the U.S. Capitol Switchboard and ask to be to connected
to your Senators’ offices: (202) 224-3121 
 
Find Your State Legislators

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