On July 4, 2025 President Trump signed H.R. 1 or One Big Beautiful Bill Act (OBBBA) into law. This massive piece of legislation impacts all kinds of industries across the USA. This summary focuses solely on a few key healthcare provisions of the law and specifically the ones that impact interventional cardiologists.   

 The most relevant provision of the bill is Section 71202 Temporary payment increase under the Medicare physician fee schedule to account for exceptional circumstances. For fiscal year 2026 physicians will get a 2.5% one-year fix to their Medicare reimbursement rate. SCAI is happy that this provision was included in the final version of the bill that was enacted into law. But Congress needs to go further than just a one-year fix on this issue. This provision, viewed in conjunction with the proposed Physician Fee Schedule Rule, however, increases reimbursement for the first time in decades.  

Physician reimbursement has decreased by over 20% over the last 2 decades. A more permanent and sustainable long-term solution is needed to ensure that physicians are compensated fairly for the services they provide. It is critical that private practices are able to remain open and that they are able to continue taking on new Medicare patients. For more information on this issue see our other articles on Medicare payment.   

 The final version of H.R. 1 also contains Section 71020 Limitation on Individual Deductions for Certain State and Local Taxes, etc. In the House version of the bill, a reduction for the amount of money that could be deducted from the pass-through entity tax (PTET). SCAI and other groups sent a letter to House and Senate leadership encouraging them to keep the deduction as it currently is to allow private practices to remain open. The final version of the bill does not contain any restrictions on PTET. Keeping this deduction in place will help small private practices to stay in business.   

 Two other provisions that SCAI supports were in the House version of the bill but were ultimately removed from the final version of the bill. The Senate’s Bryd Rule dropped a number of House provisions. That is, reconciliation bills, under this rulee only allow provisions that are considered spending mechanisms and not policy-oriented provisions. For example, the Accelerating Kids Access to Care Act, which would have allowed children enrolled in Medicaid or CHIP to access specialists across state lines when none are available was removed because it was seen as non-budgetary rider. Also, the REDI Act, which would have allowed medical residences to defer interest on their medical student loans while enrolled in a residency program, was similarly dropped.  

SCAI will continue working to get these and other legislative priorities passed individually or as part of a larger health care package later this Congress.