Pennsylvania Responds to the “One Big Beautiful Bill”

Last week, the long-debated and hotly contested “One Big Beautiful Bill” cleared both chambers of Congress. Its passage marks a big win for President Trump, with the contents of the bill made up of a signature legislative agenda that the president has been advocating for since returning to office. Pennsylvania’s lawmakers have been quick to highlight their positions in the aftermath. This week, we’re breaking down the major figures in the bill and the reactions to its passing in order to frame the true impact, and determine what to look out for as implementation begins. 

The Bill’s PA Impact

According to a report from City & State PA, Pennsylvanians will see new deductions at tax season that might help them save—and they’ll also see some major losses. Pennsylvanians will be able to deduct up to $25,000 in tips from their taxes, but there’s a catch: non-cash tips are still subject to tax (think credit card tips for restaurant workers—these are taxed the same as income), and the deduction is set to expire in 2028. Similarly, the provision of the bill that allows a deduction up to $12,500 for overtime and $6,000 tax deduction for seniors all expire in 2028. 

Despite the good-on-the-surface temporary savings, Pennsylvania will still see a $53 billion decrease in federal Medicaid funding over the next 10 years, and 310,000 could lose health coverage as a result of the bill’s changes to Medicaid spending and the Affordable Care Act. 

Supporters are Saying: 

Republican House member Rep. Ryan Mackenzie said in his press release: 

“As we began this term, we understood what the people of the Greater Lehigh Valley were counting on: lower costs, a stronger economy, secure borders, and policies that put America First,” said Mackenzie. “In the face of relentless opposition from those who advocated for the largest tax increase in American history and a return to open borders, we’ve passed a budget that holds firm and keeps our promise to the American people.”

And Republican Senator Dave McCormick took to X to congratulate the president and fellow legislators for “putting his vision into action” and tout tax relief, border security, “energy dominance,” defense, and school choice as wins. 

Senate President Pro Tempore Kim Ward wrote, “Don’t let the media gaslight you. PA’s Medicaid programs are spiraling out of control — and taxpayers are stuck with the bill. Enrollment has more than doubled to over 3 million residents, despite the state experiencing out-migration & population growth.”

Despite the widespread Republican advocacy for the bill, Representative Brian Fitzpatrick was one of only two House Republicans who voted against the bill. 

Critics are Warning: 

House Majority Appropriations Chairman Jordan Harris held a press conference in Harrisburg to state that the bill is “a direct attack on the health and wellbeing of Pennsylvanians”, and warned that the state cannot absorb the damage that the bill will cause. 

Pennsylvania House Speaker Joanna McClinton, D-Philadelphia, wrote in a strong statement, “I am disgusted that on the eve of our nation’s celebration of independence and triumph over tyranny, that Republicans in Congress have risked American freedom by thrusting us back under the control of an authoritarian leader; pledging their allegiance to Donald Trump and ignoring the people they represent.”

Former ER doctor Rep. Arvind Venkat said, “Without a doubt, the Big Bad Bill will decimate health care access and increase health care costs in our state”. In a joint statement by the Pennsylvania House Democrats, they state that while the financial impacts of the bill will likely not impact the passage of the 2025-26 budget, “the effect on the 2026-27 budget could be catastrophic”. 

Governor Shapiro has been a staunch opponent of the bill, taking to social media and press conferences in the past week to decry the bill’s contents and criticize the Pennsylvania legislators who voted for it. Shapiro said, “I hope that the representatives wake up and see the negative impact that they are having on our commonwealth.”

PoliticsPA has a breakdown of the PA legislators that have released statements on the bill here. 

What Comes Next

While the legislation contains about $4.5 trillion in tax cuts, it’s also expected to add $3 trillion to the national deficit in the coming years. 

A main concern for Pennsylvania, and many other states, are the rural hospitals that will see major impacts. Most smaller, rural hospitals rely on Medicaid reimbursement, and local economies could see the impact in the form of eliminated jobs for care workers and administrative staff alike. That said, it’s still unclear how these cuts will be implemented, which leaves room to advocate for innovative approaches like telehealth, flexible co-location rules, and value-based contracting—where funding is tied to outcomes rather than services delivered.

When it comes to predicting what’s next, we’ll be seeing the focus shift from Capitol Hill to Harrisburg—and other state capitals—to see how state budgets and constituents react to the bill’s implementation. Stay tuned in as we watch what kind of impact this will have on the Commonwealth in real time. 

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