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House Passes ‘Big Beautiful Bill,’ Advancing Key Tax and Medicaid Proposals

The U.S. House of Representatives has passed the “One Big Beautiful Bill,” a wide-ranging package that includes changes to federal taxes, health care programs, and government spending.

The legislation passed on May 22 by a narrow vote of 215–214, and all but two of Kentucky’s congressmen, Representative Thomas Massie (R) and Representative Morgan McGarvey (D), voted in favor.

Tax Changes

The bill builds on the 2017 tax reform law by making several provisions permanent and expanding them. Key components include:

Medicaid Reforms
The legislation would also make major updates to Medicaid, which currently covers approximately one in three Kentuckians. Proposed changes include:

What’s Next

The bill moves to the Senate, where changes could be made before a final vote.

Last week, the Kentucky Chamber visited members of the Commonwealth’s congressional delegation in Washington, D.C. to discuss key issues including taxes, tariffs, and workforce.

Kentucky Chamber Senior Vice President of Public Affairs Kate Shanks, Chamber President and CEO Ashli Watts, Chairman Brett Guthrie, Chamber Chair Scott Davis, and Chamber Director of Public Affairs John Hughes

The Chamber will continue monitoring this legislation closely. With significant implications for taxes, health care costs, and workforce access, the final version could directly affect Kentucky’s employers and economy.

Stay tuned to The Bottom Line for updates on federal legislation and policy changes.

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