Republicans’ plans to fast-track the budget bill hit a speedbump when the Senate parliamentarian determined that changes to how states can tax Medicaid providers do not comply with rules to pass the legislation with a simple majority, The Wall Street Journal reported June 26.
The nonpartisan parliamentarian’s ruling means that Republicans will likely have to rewrite or drop portions of the legislation, according to the report. Senate Republicans said they believe some slight changes to the wording of some proposed Medicaid cuts would be enough to break the impasse.
The parliamentarian’s ruling would also toss a provision that lowers federal funding for states that use state money to provide Medicaid to undocumented immigrants, according to the report.
Republicans are aiming to use the fast-track procedure called budget reconciliation to pass the budget bill, according to the report. The reconciliation process allows a bill to be passed through the Senate with a simple majority, but the bill must be focused on fiscal policy. Changes that only have incidental federal budget effects are not permitted, according to the report.
Senate parliamentarian Elizabeth MacDonough, who has held the role since 2012, serves as the Senate’s official advisor on rules and procedures, according to the report. She hears arguments from both parties about whether bills comply with the reconciliation process’ rules and advises legislators on which provisions meet the requirements for a simple majority rather than the 60-vote threshold that is typically required.
White House Press Secretary Karoline Leavitt said that the parliamentarian’s ruling is part of the process and Republicans are keeping the July 4 deadline to get the bill to President Donald Trump’s desk, according to the Journal.
The Senate version of the budget bill proposes deeper and broader cuts to Medicaid than its House counterpart. The bill has been criticized by hospital groups such as the Federation of American Hospitals. The group’s president and CEO Chip Kahn said, “[R]ural communities across the country will be the hardest hit, with struggling hospitals compelled to face difficult decisions about what services to cut.”
The bill’s effect on rural healthcare has also been a concern for some Senate Republicans. On June 25, the Senate Finance Committee proposed a rural hospital stabilization fund that would direct $15 billion over a five-year period to states in need, NPR reported. However, Sen. Susan Collins, R-Maine, said closer to $100 billion in funding is needed.
