Source: United States House of Representatives – Congressman Mark Amodei (NV-02)
Washington, D.C. – Today, Rep. Mark Amodei issued the following statement after voting in favor of H.R. 1, the One Big Beautiful Bill Act:
“The House of Representatives delivered on its promise to rein in out-of-control spending, unleash American energy dominance, drive economic growth, and secure our borders after 4 years of mismanagement under the previous administration,” said Rep. Mark Amodei.
“While the talking heads will try to have you believe that the One Big Beautiful Bill Act is only a handout to the wealthy, the truth is this historic piece of legislation was crafted with everyday, working-class Americans and their families at the forefront. Let me set the record straight on what is really being delivered for the American people:
- Without this bill, the average taxpayer would see a 22% tax hike. Instead, this bill makes the 2017 Trump tax cuts permanent, which have benefited Americans over the last 8 years.
- Small businesses and Made-in-America investments are also supported by new incentives in domestic manufacturing and investments in research and development to shore up our nation’s supply chain needs.
- This bill also provides additional tax relief for seniors and delivers on President Trump’s promises of no tax on tips, overtime pay, and U.S. manufactured car loan interest.
- The One Big Beautiful Bill Act also strengthens the long-term viability of Medicaid for those who truly need it by rooting out waste, fraud, and abuse and requiring able-bodied adults without young dependents to meet common sense work requirements.
- Americans are made safer under this bill, which provides over $175 billion to secure the border, which is the largest border security investment in our nation’s history. This will allow completion of the southern border wall and hire 8,000 people to support border and customs security. Further, the bill invests nearly $150 billion to modernize our military and strengthen our national defense.
- Claims that this bill harms veterans are nothing more than political scare tactics and gaslighting. The legislative text contains no provisions explicitly targeting veterans, and veterans receiving VA benefits will continue to do so without interruption. Veterans who are over 64, physically or mentally disabled, caring for a dependent under 14, supporting a disabled child or aging parent, in school, enrolled in a job training program, or participating in a substance abuse program remain fully exempt from SNAP and Medicaid work requirements. Shame on those who distort the facts to mislead the public for political gain.
“As with any major reform bill, the One Big Beautiful Bill is a balancing act. I have long believed that we can’t let perfect be the enemy of good, and our work won’t stop here in getting Nevadans the relief they need. As you may know, discussions surrounding Medicaid have been a key focus of this bill. While this bill takes a significant step in helping modernize our healthcare system, I believe that more work will be done this Congress on the issue.”
Medicaid in Reconciliation
When Medicaid was initially established in 1965, the program was intended to cover a smaller, more vulnerable part of the U.S. population including children, pregnant women, people with disabilities, and low-income families. Since the enactment of the Affordable Care Act (ACA), Medicaid has shifted away from its original mission of serving the traditional low-income population, evolving instead into a de facto state-run universal healthcare system. During COVID-19, Medicaid growth exploded by adding 23 million people to the program in just three short years from 2020 to 2023, which cost American taxpayers approximately $184 billion per year.
Prior to the passage of ACA in 2010, only 21% of the U.S. population under the age of 65 was covered by a form of government-funded health insurance. In 2023, the number dramatically increased to 37.4% of the population.
Specific to Medicare and Medicaid, about 15% of the U.S. population was enrolled in Medicaid or CHIP (Children’s Health Insurance Program) in 2009. By 2023, the percentage has nearly doubled to 28%.
There are currently 20 states and the District of Columbia that operate their own state-based health insurance marketplaces including Nevada. In 2025. More than 7 million individuals enrolled in health coverage through state-based marketplaces, including more than 1.2 million new enrollees.
In general, Medicaid accounts for a significant portion of state spending, with averages around 18% of total state expenditures, and even higher percentages of general fund spending. Some states spend even more, with figures reaching 29.8% of total state expenditures. In FY23, the State of Nevada spent $5.6 billion to fund state Medicaid expenditures, or approximately 30% of its entire budget.
Between the rapid expansion of the Medicaid population and the growth of state-based health insurance marketplaces, Medicaid costs have nearly doubled every decade over the last 50 years. In 2023, the program cost taxpayers a whopping $870 billion, up 8% from the year before.
The One Big Beautiful Bill addresses and reins in these excessive Medicaid costs by establishing commonsense work requirements for able-bodied adults without young dependents. In addition, the bill strengthens program integrity measures that protect Medicaid resources for the most vulnerable such as children, pregnant women, people with disabilities, and low-income families.
With that said, this has become a balancing test between reining in out-of-control Medicaid spending and protecting Nevada’s Hospitals and Health Clinics. The bill currently gives us two more years for the State to help prepare for adjustments to the Medicaid Provider Tax. The Rural Hospital Stabilization Fund will provide $50 billion in relief from 2028 through 2032 for rural hospitals.
A perfect solution to healthcare costs has eluded us again, but it will be interesting to see what the Centers for Medicare & Medicaid Services (CMS) do with implementation of these new Medicaid policies and future rules and regulations. I look forward to continuing to work with CMS, the Nevada Health Authority, and our local stakeholders on these issues.