How to Read Funding Bills: The Truth About Healthcare Cuts
Congress hides healthcare cuts in funding bills to pay for tax breaks. Here’s a plain-English guide to read them and see what’s at stake.
TL;DR: As of Oct 1, 2025, the federal government began a shutdown after the Senate failed to pass either the House Republican’s short-term funding bill (H.R. 5371) or a Democratic alternative (S. 2882).
The House bill kept funding levels through Nov 21 but didn’t include extensions of Affordable Care Act subsidies; the Democratic bill did.
Beyond the immediate shutdown, a new law passed in July (the “Big Horrible Bill”) makes significant, longer-term Medicaid and other health care cuts.
Nonpartisan estimates say those provisions reduce federal health spending by $1+ trillion and increase the uninsured by about 10 million over time — savings many in Washington expect to use as offsets in the impending 2025 tax-cut debate. (CBS News)
Reading these bills can feel like slogging through a swamp of legal jargon. I’ll walk you through the big picture first — and then share a quick 60-second cheat sheet you can bookmark for next time Congress decides to play chicken with our healthcare.
What Just Happened (And Why it Matters)
Government shutdown at midnight (Oct 1). After days of political fighting and a flurry of racist videos from President Trump on Truth Social, the government entered a partial shutdown when the Senate could not advance either party’s stopgap bill. (CBS News)
The House GOP bill (H.R. 5371): A “clean” continuing resolution to Nov 21 at current funding levels. It passed the House (217–212) but failed in the Senate (55–45) because it needed 60 votes. (Congress.gov)
The Senate Democratic bill (S. 2882): A rival CR that kept the government open and would permanently extend enhanced ACA premium tax credits and add some Medicaid funding. It also failed to meet the 60-vote threshold. (Congress.gov)
Why We Should All Care
The immediate fight is about more than keeping the lights on.
The deeper fight is about what gets funded (or cut) next — especially in health care — and how to pay for the large, pending tax-cut extensions set to expire at the end of 2025. (Bipartisan Policy Center)
The Longer Game: Health Care Cuts Already Enacted This Summer
In July 2025, Congress passed and President Trump signed a sweeping budget law (nicknamed the “One Big Beautiful Bill”) with major health policy changes.
Independent analysis from KFF summarizing Congressional Budget Office (CBO) estimates finds:
Medicaid work requirements (ages 19–64) and more frequent eligibility redeterminations will reduce federal Medicaid spending by hundreds of billions and increase the number of uninsured (e.g., ~5.3 million more uninsured by 2034 from work requirements; 700,000 more from semiannual redeterminations). (KFF)
Across all health provisions (Medicaid, Medicare, ACA), CBO projects over $1 trillion in reduced federal health spending and ~10 million more uninsured overall in the long run. (KFF)
Separate nonpartisan budget groups note that extending the expiring 2017 tax cuts could cost ~$4–$4.5 trillion over 10 years, creating intense pressure in Washington to find “offsets” — often via spending cuts.
That’s why you’ll hear arguments that health cuts help “pay for” tax-cut extensions. (Bipartisan Policy Center)
How to Read a Funding Bill (Without a Law Degree)
Here’s a simple, repeatable checklist you (or your friends and family) can use on Congress.gov to read these archaic funding bills:
Start with the official page. Search the bill number (e.g., H.R. 5371, S. 2882). Skim the “Summary” tab (usually by CRS) and the “Actions” tab for vote history. (Congress.gov)
Check the “What, When, How Long.” Is it a CR (temporary funding) or a full-year appropriations bill? What’s the end date? Are there “anomalies” (exceptions that change specific programs)? H.R. 5371 funded to Nov 21 with certain exceptions. (Congress.gov)
Hunt for policy riders. CRs sometimes sneak in policy changes (not just money). In S. 2882, Democrats added a permanent extension of ACA premium subsidies — a policy shift inside a funding bill. (Congress.gov)
Follow the money words. “Appropriated,” “authorized,” “rescission,” “emergency designation,” “CHIMPs (Changes in Mandatory Programs).” Rescissions and CHIMPs can lower the score on paper without cutting day-to-day operations immediately. (Congress.gov notes and committee summaries will flag these.) (Congress.gov)
Check CBO and JCT numbers. For costs/savings and who pays/benefits, look for CBO cost estimates on the bill page and JCT for tax changes. For the 2025 health law, CBO tallies big Medicaid savings and higher uninsured; JCT pegs tax-cut extensions near $4T+. (Congress.gov)
Look for delayed effects. Many “cuts” phase in later (e.g., work requirements start no later than Dec 31, 2026). Scan effective dates—this is where near- vs. long-term impact hides. (KFF)
Distribution matters. If a bill affects taxes or subsidies, find distributional tables (who gains/loses by income level) — typically via JCT or CBO letters. (Bipartisan Policy Center)
Cross-check neutral health experts. For Medicaid/ACA details, use KFF and Georgetown CCF explainers to translate legalese. (KFF)
Confirm the latest vote math. Senate bills often need 60 votes. Verify the roll-call outcome and date before sharing. (Example: H.R. 5371 failed 55–45 on Sept 30.) (Congress.gov)
Context is king. Ask: Is this a bridge (CR) or the destination (full-year bill)? Are savings being lined up to offset future tax policy? Tie provisions back to that bigger picture. (Bipartisan Policy Center)
⚡ The 60-Second Bill Decoder (Bookmark This!)
1️⃣ Go to Congress.gov → type the bill number.
2️⃣ Skim the Summary + Actions tabs (they’re the plain-English bits).
3️⃣ Look for the end date → is it a quick patch (CR) or the real deal?
4️⃣ Check for riders → things slipped in (like ACA cuts or extensions).
5️⃣ Find the CBO/JCT estimate → that’s where the real $$$ shows up.
6️⃣ Always read the effective dates → that’s when the hammer actually falls.
💡 Do this once and you’ll never get lost in “DC speak” again.
What to Watch Next
Here’s what to keep tabs on:
If/when a new CR emerges, look for whether it adds health provisions (ACA subsidy extensions, Medicaid tweaks) or strips them out to win votes. (Senate Democratic Leadership)
Appropriations “minibus” talks: The Senate already advanced a three-bill package (Veterans/Ag, Leg Branch) earlier this summer; differences with the House still have to be reconciled. (Congress.gov)
Tax-cut endgame (late 2025): With TCJA pieces expiring, expect intense negotiations over which provisions to extend and how to pay for them — a core reason health cuts are front and center. (Bipartisan Policy Center)
From “Saving Democracy” to “Saving Lives”
For once, it looks like some Democratic leaders have decided to fight fire with fire.
Instead of sticking with the lofty but distant message of “saving democracy” — important, yes, but not what someone worried about next month’s rent is thinking about — they’re finally saying what’s really at stake: Republicans want to take away your healthcare so their rich friends can get richer.
And if that means people suffer or die along the way?
That’s the cost Republicans are willing to accept.
This shift matters.
It’s raw, it’s real, and it connects directly to people’s lives.
It’s the kind of clarity I was calling for in my post, What We Must Demand From the Political Left.
Because when the stakes are your health, your family, and your future, plain English wins.
If Democrats keep leaning into this message — making it clear that your healthcare is on the chopping block so billionaires can have another yacht — they’ll not only sharpen the contrast, they’ll show people whose side they’re really on.
You don’t have to go it alone when the headlines feel like chaos. That’s why I write The Pathfinder Chronicles — to give you clarity, tools, and a little solidarity. If you’re not subscribed yet, now’s a good time. Join us and let’s keep finding our way forward.
Sources (readable & credible)
Shutdown status & the two failed Senate votes (Sept 30–Oct 1, 2025): CBS News; Senate vote wrap-up; Congress.gov bill pages. (CBS News)
House GOP CR details (H.R. 5371): Congress.gov (status, summary, vote history). (Congress.gov)
Democratic CR details (S. 2882): Congress.gov summary + text; Senate Dem wrap; committee PDF. (Congress.gov)
Health cuts enacted in July 2025: KFF overview & Medicaid section with CBO estimates. (KFF)
Medicaid/CHIP provision deep-dive: Georgetown CCF explainer with CBO figures. (Center For Children and Families)
Cost of extending 2017 tax cuts: Bipartisan Policy Center summary of JCT estimates (~$4T–$4.5T). (Bipartisan Policy Center)