VGMHealthcare MSO
Full Menu

Senate Narrowly Passes HR1, Sending It Back to House for Final Approval

Published in VGM Government Relations on July 01, 2025

President Donald Trump’s sweeping legislative package, formally titled the One Big, Beautiful Bill Act, now referred to as HR1., cleared the Senate today in a dramatic 51–50 vote, with Vice President JD Vance casting the tie-breaking vote. The bill now returns to the House, where lawmakers must decide whether to adopt the Senate’s revised version or negotiate further changes before it can reach the president’s desk. 

Among the bill’s many provisions, several have significant implications for the DMEPOS industry, particularly through changes to Medicare and Medicaid. 

Key Provisions Affecting the DMEPOS 

  1. Medicare Reimbursement Cuts. The legislation includes a 4% across-the-board cut to Medicare reimbursement rates, including those for home medical equipment (HME). These reductions are tied to the PAYGO (Pay-As-You-Go) rules, which automatically trigger spending cuts when legislation increases the federal deficit. This could place additional financial strain on providers already operating on thin margins. 
  2. Medicaid Overhaul. The bill imposes new work or education requirements for Medicaid enrollees aged 19–64. According to the Congressional Budget Office, these changes could result in millions losing coverage over the next decade. For the DMEPOS industry, this may translate into a decline in demand for equipment and services among Medicaid beneficiaries. 
  3. Broader Financial Impact. The bill’s overarching goal is to curb federal healthcare spending, with projected cuts to Medicaid, SNAP, and clean energy programs helping offset tax reductions and defense spending increases. For DMEPOS providers, this could mean tighter state budgets, reduced reimbursement rates, and increased administrative burdens. 

These policy shifts could potentially present serious challenges for both providers and patients who depend on DMEPOS products for daily living and chronic care management. Providers may need to reassess their business models, while patients—especially those in vulnerable populations—could face new barriers to accessing essential equipment. 

As the bill heads back to the House, VGM and other industry stakeholders are closely watching for potential amendments or compromises that could soften the impact on healthcare. 

From Our Experts

Showing Up...It Matters! thumbnail Showing Up...It Matters! We've all heard the phrase, "Showing up matters." That can mean a lot of different things at different times in our lives, even changing daily. Perhaps it means leaving work early to attend your children's event. Maybe it means not missing that important meeting at work. No doubt, both of those things are important. For us here in the Government Relations corner of VGM Group, it means something additional. Matthew Flatt: A Champion for Change in Home Medical Equipment thumbnail Matthew Flatt: A Champion for Change in Home Medical Equipment In every industry, there are people who do more than simply lead organizations. They inspire progress, build relationships, and create lasting change. In the home medical equipment (HME) industry, Matthew Flatt, CEO of Medicap Home Medical (formerly NuCara Home Medical) and President of the Midwest Association for Medical Equipment Services (MAMES), is one of those individuals... Full Legislative Text Released for Bipartisan Ostomy and Urological Supply Bill- H.R. 10787 thumbnail Full Legislative Text Released for Bipartisan Ostomy and Urological Supply Bill- H.R. 10787 Representatives Brad Schneider (IL-10) and Greg Murphy, M.D. (NC-03) have introduced the bipartisan Access to Medical Supplies Act, legislation designed to protect Medicare beneficiaries who rely on ostomy and urological supplies. The bill would... Action Alert: Support H.R. 10787 to Protect Patient Access to Urological and Ostomy Supplies thumbnail Action Alert: Support H.R. 10787 to Protect Patient Access to Urological and Ostomy Supplies The DMEPOS community has an important opportunity to protect access to vital urological and ostomy supplies for Medicare beneficiaries. Rep. Greg Murphy (R-NC) and Rep. Brad Schneider (D-IL) have introduced H.R. 10787, bipartisan legislation that would amend Title XVIII of the Social Security Act to exclude urological and ostomy supplies from Medicare competitive acquisition programs for five years... CMS Announces Registration and Bid Window Dates for Round 2028 of the DMEPOS Competitive Bidding Program thumbnail CMS Announces Registration and Bid Window Dates for Round 2028 of the DMEPOS Competitive Bidding Program Yesterday, CMS announced the Round 2028 bidding details with registration opening December 1, 2026, and the bid window opening January 5, 2027. The new Round 2028 timeline is as follows... Congratulations to CAMPS On This Important Legislative Victory thumbnail Congratulations to CAMPS On This Important Legislative Victory The signing of AB 1794 is another reminder of the critical role state associations play in shaping healthcare policy, removing barriers to patient care, and ensuring providers have a seat at the table when important decisions are made. Legislative successes like this do not happen by accident. They are the result of engaged members, strong advocacy efforts, and collaboration with policymakers to address real-world challenges facing providers and the patients they serve. S.247, Choices for Increased Mobility Act of 2025, Passes U.S. Senate thumbnail S.247, Choices for Increased Mobility Act of 2025, Passes U.S. Senate S.247, Choices for Increased Mobility Act of 2025 has passed in the Senate through unanimous consent. It now heads to the President to be signed into law. Introduced in the Senate by Sen. Tammy Duckworth (D-IL), The Choices for Increased Mobility Act of 2025 would... August Recess Recap: Building Relationships, Advancing Advocacy thumbnail August Recess Recap: Building Relationships, Advancing Advocacy As Congress worked through the August recess, the VGM Government Relations team remained actively engaged in securing meetings and building relationships with legislators, candidates, and key congressional staff across the country. This summer, the team made a strategic decision to focus getting a strong balance between Republican and Democratic offices, recognizing the importance of broadening support for DMEPOS priorities and ensuring policymakers from both parties understand the challenges..