In a dramatic and closely watched vote, the U.S. House of Representatives passed H.R. 1, the One Big Beautiful Bill Act reconciliation package, by a razor-thin margin of 215–214, with one member voting present. The bill now advances to the Senate, where it is expected to undergo significant changes. The outcome of this legislative package could have far-reaching implications for senior living providers, caregivers, and the millions of older adults who rely on long-term care services.
What’s in the Bill: Major Provisions and Policy Shifts
Officially named the One Big Beautiful Bill Act, the reconciliation package combines a wide array of policy initiatives intended to reduce the federal deficit, reform entitlement programs, and address growing concerns about healthcare access and workforce shortages. Among the provisions attracting the most attention:
- Medicaid Work Requirements: One of the most controversial elements in the bill, the proposed Medicaid work requirements have been accelerated, moving up the effective date from January 2029 to December 2026. This change reflects pressure from fiscally conservative Republicans to reduce Medicaid rolls and incentivize employment among able-bodied adults. Critics argue this could create barriers to care for vulnerable populations, including caregivers themselves.
- Coverage Restrictions for Undocumented Individuals: The bill expands the criteria under which states could lose a portion of federal Medicaid payments if they offer coverage to undocumented individuals. While this provision is likely to undergo scrutiny in the Senate, its inclusion signals growing debate over how public resources are allocated.
- State and Local Tax Deduction (SALT) Increase: In a notable compromise to attract votes from representatives in high-tax states, the package increases the SALT deduction cap from $10,000 to $40,000 per household. However, it applies only to households earning up to $500,000 annually.
Good News for Senior Living: No Medicaid Cuts and New Incentives for Caregivers
Importantly for the senior living industry, the package—at least in its current House-passed form—does not include cuts to Medicaid funding for assisted living programs. Argentum and other senior advocacy organizations have voiced strong opposition to any provisions that would reduce access to care or destabilize provider reimbursements.
In fact, the bill includes measures that align closely with Argentum’s federal policy priorities. Most notably:
- A Senior Tax Deduction
The legislation provides a $4,000 deduction per eligible filer aged 65 or older, subject to income thresholds of $75,000 for single filers and $150,000 for joint filers. Available to both itemizers and non-itemizers, this deduction would apply for tax years 2025 through 2028. While it falls short of the more robust Credit for Caring Act (R. 2036 and S. 925)—which Argentum has actively supported and which would provide a refundable $5,000 tax credit for long-term care expenses—this deduction represents meaningful progress toward easing financial burdens on seniors and their families. - Investment in Workforce Development
Also included is language supporting career savings incentives for the caregiving workforce. Through collaboration with the Tomorrow’s Workforce Coalition, Argentum has championed the Freedom to Invest in Tomorrow’s Workforce Act (H.R. 1151 & S. 756). This bipartisan legislation would allow 529 education savings plans to cover expenses related to workforce credentialing—such as those required for certified nursing assistants, personal care aides, and executive directors of assisted living communities.These changes are particularly significant given the senior living sector’s ongoing workforce crisis. By reducing barriers to training and professional development, these provisions could help bolster the pipeline of qualified caregivers and promote retention in a field where turnover remains a major challenge.
What Happens Next: Senate Consideration and Reconciliation Rules
As the bill moves to the Senate, it will be subject to the stringent rules that govern budget reconciliation—a process that allows passage with a simple majority but limits the scope of permissible provisions. Several items, including the SALT cap adjustment and immigration-related restrictions, may face procedural challenges under the Byrd Rule, which prohibits “extraneous” provisions unrelated to budgetary concerns.
Senators from both parties have signaled their intent to amend or strip out certain provisions, and negotiations are expected to be intense. With such a slim Republican majority—and Vice President Vance potentially casting tie-breaking votes—the Senate version may look very different from the House-passed bill.
Advocacy Matters: How You Can Help Shape the Future of Senior Living
As the legislative landscape continues to evolve, the voice of the senior living industry has never been more essential. Policymakers need to hear directly from those on the front lines—providers, caregivers, residents, and advocates alike. That’s where you come in.
Argentum’s advocacy efforts help ensure that legislation like the One Big Beautiful Bill Act includes critical provisions that support senior living communities and the people who depend on them. But we can’t do it alone. There are several meaningful—and often simple—ways you can get involved:
- Join the “I Love Assisted Living” Campaign
Help to continue to shape the narrative around senior living by sharing real stories from your community. Submit testimonials, photos, or videos from residents, family members, and caregivers that showcase the connection, purpose, and joy found in assisted living. These stories help counter negative media portrayals and build public trust—no cost required, just your authentic voice. - Become an Argentum Advocate
Join our growing grassroots network to receive timely alerts, advocacy tools, and messages you can send to lawmakers. It takes just a few minutes to make your voice heard, and every message makes a difference. - Host a Visit with a Lawmaker in Your Community
Invite your elected officials to tour your community, meet with residents and staff, and see firsthand the value of senior living. Argentum can help coordinate these visits to make sure they’re impactful and easy to organize. - Support the Argentum Advocacy Fund
Your contributions support essential policy research, education campaigns, and outreach that keep senior living priorities front and center with policymakers. - Take Part in the Cobb Cup Competition – Happening Now!
The Cobb Cup is a spirited competition among authorized companies and individuals that recognizes outstanding engagement in advocacy efforts and support of Silver PAC. Now underway, it’s a fun and motivating way to rally around a common cause. Contact Cyndi Bade at [email protected] to confirm your eligibility and get involved.
The senior living industry is navigating one of the most consequential periods in its history. From legislation to leadership, from storytelling to technology—how we show up today will shape the care and communities of tomorrow. Let’s continue to lead with purpose, advocate with unity, and build the future our residents and workforce deserve.
