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House Republicans’ budget bill, officially called the One Big Beautiful Bill Act, contains several provisions aimed at tightening eligibility requirements for federal benefit programs beyond the widely reported tax and Medicaid changes. The legislation targets what supporters characterize as fraudulent or improper benefit claims across multiple government programs.
The bill requires the Federal Employees Health Benefits program to verify marriage and birth certificates to ensure people listed on employee policies are legitimate family members. The Government Accountability Office estimates this measure will save approximately $1.5 billion over ten years by removing thousands of ineligible beneficiaries. One notable case involved an enrollee who kept an ex-spouse on benefits for 24 years after their 1993 divorce, costing the government over $150,000.
Medicaid faces significant changes under the legislation. The bill prohibits government payments for gender transition procedures, which according to one study affected about 25% of nearly 50,000 patients who underwent such surgeries. Republicans also seek to eliminate duplicate enrollment by implementing name and address matching systems, claiming 1.6 million people are improperly enrolled in multiple states simultaneously. Some state agencies have even made payments to deceased enrollees.
The bill increases Medicaid eligibility verification frequency from annually to twice yearly for coverage expanded under the Affordable Care Act, beginning in late 2027. The Congressional Budget Office projects this will save $3.8 billion over the next decade by removing people whose incomes rise after enrollment. However, the Urban Institute warns this could create harmful “churn,” with people repeatedly losing and regaining coverage, potentially worsening health outcomes and increasing administrative costs.
Education benefits also face restrictions. The legislation would prevent people with special immigration statuses, including Cuban parolees, refugees, and trafficking victims, from receiving student aid. Pell Grant requirements would become more stringent, requiring applicants to report foreign income and increasing full-time student requirements from 12 to 30 credit hours annually. About 50% of affected students would maintain lower course loads but receive reduced funding, while only 20% would increase their academic workload. This change alone is projected to save over $7 billion in the coming decade.
The bill implements work requirements for able-bodied unemployed adults on Medicaid and blocks states from covering undocumented immigrants. Democrats estimate these combined changes would remove 13.7 million people from Medicaid rolls over the next ten years. While some provisions, like the Federal Employees Health Benefits verification, received bipartisan support in committee, others remain deeply controversial. Rep. Alexandria Ocasio-Cortez criticized the legislation as robbing people to benefit the wealthy.
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