H.R. 1 Explained: What the One Big Beautiful Bill Act (OBBBA) Means for Doctors, Business Owners, Tech Professionals, and Retirees
On July 4, 2025, H.R. 1, officially titled the “One Big Beautiful Bill Act” (OBBBA), was signed into law. It does a bunch of things. Some parts change taxes, some parts change health care, and some parts change student loans. This blog tells you how it affects:
Doctors and Dentists
Business Owners
Tech Professionals
Retirees
Help for Doctors & Dentists
A. More Money from Medicare
Doctors who treat older adults receive payment from Medicare. OBBBA provides them with a 2.5% pay increase for a full year—from January 1, 2026, to January 1, 2027. This helps ensure that doctors earn enough money to continue caring for patients.
B. Student Loans for Future Doctors
Many doctors have substantial student loan debt. OBBBA says:
Caps (or limits) on new medical school loans:
You can borrow up to $50,000 per year, for a total of $200,000 in federal loans.
Changes to repayment rules:
Starting on July 1, 2028, you can choose either the old “Income‑Based Repayment” (IDR) plan or a new “Repayment Assistance Plan.”
This means fewer new loans, but also new ways to repay them.
C. Rural Health & Loan Help
The law also:
Gives $50 billion from 2026 to 2030 to help doctors, hospitals, and clinics in rural areas.
Says time spent as a rural doctor or dentist counts toward Public Service Loan Forgiveness. That means serving in a rural area can help you get your loans forgiven sooner.
Help for Business Owners
A. Tax Breaks for Businesses
For those who own businesses or are self-employed, OBBBA includes many tax changes that help them, such as:
100% Bonus Depreciation
If you buy new equipment (like computers or servers), you can deduct the full cost in the same year instead of over several years.
Higher 1099 threshold
Starting in 2026, businesses will only need to send a 1099 form for payments exceeding $2,000, up from the current threshold of $600.
Section 179 Deduction Limits
Increase from $1 million to $2.5 million in aggregate total cost, and $2.5 million in total Section 179 property to $4 million.
B. Tax Help for Families & Home Offices
The State and Local Tax (SALT) deduction increases to $40,000 (from $10,000) for individuals who itemize their taxes.
The Child Tax Credit is now permanent and will grow with inflation after 2026.
Higher Dependent Care FSA: Families with children (or those caring for elderly relatives) can now save up to $7,500, up from $5,000.
C. Health Savings Accounts (HSAs) & Telehealth
Tech professionals often have High-Deductible Health Plans (HDHPs) and use Health Savings Accounts (HSAs). OBBBA makes these better:
Telehealth Visits Count Early:
You can use your plan for telehealth before hitting your deductible.
Direct Primary Care (DPC):
If you pay a small monthly fee (up to $150 per person, or $300 for family plans), it won’t break your HSA eligibility.
Bronze & Catastrophic Plans Can Be HSA-friendly:
These plans are now allowed for HSA savings.
Help for Tech Professionals
A. ISO Stock & the AMT (Alternative Minimum Tax)
Some tech workers—especially those with incentive stock options (ISOs)—run into a surprise tax called the Alternative Minimum Tax (AMT). Here’s how OBBBA helps:
Higher AMT Exemption Amounts:
You now get to keep more of your income before AMT kicks in. This helps ISO holders who exercise options but don’t sell the shares immediately.
Better Phaseout Thresholds:
The income limit at which AMT starts phasing out is now higher. Fewer people get hit with this extra tax, especially if you’re in a high-growth startup or get big stock grants.
B. More Tax Savings with Qualified Small Business Stock (QSBS)
If you own shares in a startup or small business, you might qualify for a big tax break under the Qualified Small Business Stock (QSBS) rules. OBBBA:
Makes 100% Tax-Free Gains:
If you sell QSBS you’ve held for at least 5 years, you can now exclude 100% of the gain from federal taxes—permanently. That means no capital gains tax on up to $10 million (or 10x your investment, whichever is greater).
Helps Startup Founders & Early Employees:
Many startup shares qualify for QSBS treatment, especially if the company has less than $50 million in assets when the stock is issued.
C. Charitable Donations
Here’s what’s new with charitable donations:
There’s a 0.5% Adjusted Gross Income (AGI) floor on charitable contribution deductions for individuals and couples:
You must donate more than 0.5% of your AGI in a year before any of your charitable donations become deductible.
The floor is 1% for corporations.
Standard Deduction Doesn’t Block You:
Even if you don’t itemize your taxes, you can now deduct part of your charitable giving—$1,000 for single filers and $2,000 for joint filers for cash donations.
What Retirees & Older Adults Should Know
A. Good News for Seniors & Medicare
Doctors receive higher Medicare pay (2.5%)—this helps keep doctors in the system.
But OBBBA also removes some benefits for others:
Medicaid expansions end in 2026.
Work rules for Medicaid start in December 2026.
Extra help for undocumented people ends in October 2026.
B. HSAs & Retirement Spending
If you're retired and still have an HSA, now you can use it for:
Direct Primary Care fees ($150/month per person).
Telehealth services, even before the deductible.
C. Estate & Gift Tax
People who pass away in 2025 or later have a very high limit on how much wealth they can pass down without paying estate tax:
The limit is $15 million per person, and it grows with inflation .
This rule does not expire, which helps planned giving and family inheritance .
D. New $6,000 Senior Deduction
OBBBA adds a new tax break just for older adults:
$6,000 Standard Deduction for Seniors:
Starting in 2025, individuals age 65 or older can claim an additional $6,000 deduction on top of the regular standard deduction (including the current age 65+/Blind deduction of $1,600).
For Married Couples:
If both spouses are 65 or older, that’s a total of $12,000 in extra deductions.
No Itemizing Required:
You don’t need to itemize your taxes to get it—this is added automatically when you file.
Other Important Tax Rules (for Everyone)
OBBBA also locks in a few key tax benefits that affect almost all filers:
Permanent Tax Rates:
The income tax brackets from 2017—10%, 12%, 22%, 24%, 32%, 35%, and 37%—are now permanent.
Standard Deduction Stays High:
The larger standard deduction, also from 2017, will remain in place moving forward.
For the 2025-2028 tax year, OBBBA lets you deduct up to $10,000 per year in interest on a car loan—even if you don’t itemize your taxes.
To qualify, the car (or SUV, van, pickup, or motorcycle under 14,000 pounds) must be brand new, made in the U.S., and financed with a loan where you’re the original owner and the vehicle is used for personal driving.
The deduction phases out once your income hits $100,000 (single) or $200,000 (married filing jointly), so the time of both your purchases
Clean energy credits are going away.
Several popular clean energy tax credits are being phased out under OBBBA. The Residential Clean Energy Credit and the Energy-Efficient Home Improvement Credit both end after 2025.
Credits for new and used clean vehicles (including commercial ones) expire after September 30, 2025.
If you’re a homebuyer or builder, the New Energy-Efficient Home Credit is also set to end for homes acquired after June 30, 2026.
The charitable deductions discussed above apply to everyone.
The new SALT tax discussed above applies to everyone.
Final Thoughts
While OBBBA introduces some notable updates—such as Medicare payments, charitable deductions, and expanded child and family tax breaks—many of its tax changes build on or extend policies that were initiated with the Tax Cuts and Jobs Act (TCJA) of 2017. In fact, some of the most headline-worthy parts of this new law are really just making existing provisions permanent:
The 2017 tax brackets (10% to 37%) and the larger standard deduction are no longer set to expire—they’re here to stay.
Business-friendly tools, such as 100% bonus depreciation, expanded Section 179 limits, and the Child Tax Credit inflation adjustment, all mirror elements from the TCJA, with a few updated thresholds.
However, while OBBBA secures certain benefits, it also leaves other changes temporary or unclear. For example:
The 2.5% Medicare pay bump for doctors only lasts one year.
Student loan repayment reforms don’t begin until 2028—and could still change by then.
And although retirees get a new $6,000 senior deduction, other social safety net programs (like Medicaid expansions) are being rolled back starting in 2026.
In short, this bill may seem comprehensive, but upon closer examination, it doesn’t significantly alter the tax or healthcare system. Instead, it fine-tunes what’s already there—and adds a few targeted incentives for specific groups. The most significant benefit might be the predictability it offers, knowing that the current tax rates are here to stay.
Are you unsure what these changes mean for your situation?
Whether you’re a doctor, business owner, tech employee, or retiree, the best next step is to map out how these changes affect you. If you’d like help understanding your options or planning ahead, let’s connect. We’re here to help you turn this “big beautiful bill” into a personalized strategy for your future.
Feraud Calixte, J.D., CFP®
