S 2749119th CongressIntroduced

A bill to exempt Medicare from any sequestration under Statutory PAYGO that is caused by the One Big Beautiful Bill Act.

Introduced: Sep 9, 2025

Economy & TaxesHealthcare

Standard Summary

Comprehensive overview in 1-2 paragraphs

S. 2749 would shield the Medicare program from any automatic spending reductions triggered by the Statutory Pay-As-You-Go (PAYGO) sequestration that arise from the budget effects of the One Big Beautiful Bill Act (OBBB Act). In effect, if a sequestration order under PAYGO is issued on or after the bill’s enactment and is attributable to the budgetary impact of the OBBB Act, Medicare underTitle XVIII of the Social Security Act would not be reduced to meet PAYGO deficit targets. The bill thus creates a targeted carve-out for Medicare from a specific type of automatic spending cut tied to the OBBB Act. The measure is narrow in scope: it codifies an exemption only for Medicare payments and only in the sequestration context tied to the OBBB Act’s budget effects. It does not change other PAYGO rules or sequestration for other programs.

Key Points

1Exempts Medicare (Title XVIII, Social Security Act) from PAYGO sequestration reductions.
2Applies to sequestration orders issued on or after enactment.
3The exemption is limited to sequestration attributable, in whole or in part, to the budgetary effects of the One Big Beautiful Bill Act (Public Law 119-21; 139 Stat. 72).
4The exemption falls under the PAYGO framework established in the Statutory PAYGO Act of 2010 (2 U.S.C. 934, section 5).
5The act references and relies on the OBBB Act for causation of the sequestration, tying Medicare relief to a specific reconciliation bill.

Impact Areas

Primary group/area affected: Medicare program beneficiaries and the Medicare system (Title XVIII of the Social Security Act). Exemption means Medicare would not face automatic reductions that would otherwise occur under PAYGO sequestration related to OBBB Act costs.Secondary group/area affected: Federal budgetary and health care financing administration, including entities responsible for implementing PAYGO sequestration.Additional impacts: Potential implications for overall deficit/deficit-reduction narratives tied to PAYGO, since exempting Medicare from this specific sequestration could affect the distribution of automatic cuts across programs and the perceived budgetary effect of the OBBB Act. It does not alter PAYGO procedures for other programs or sequestration unrelated to OBBB Act costs.

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