Key Medicaid provision in Trump’s big tax cut and spending bill is found to violate Senate rules
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Key Medicaid provision in Trump’s big tax cut and spending bill is found to violate Senate rules
The guidance from the parliamentarian is rarely ignored. Senate leaders could try to revise it or strip it from the package. The outcome is a setback as Senate Republicans hoped to launch votes by the end of the week. The House-passed bill would freeze the provider taxes at current levels, while the Senate proposal goes deeper by reducing the tax that some states are able to impose on the Medicaid program. But some GOP senators said that was too high, while others, including Sen. Susan Collins of Maine, wanted at least $100 billion for the new fund. The Senate Finance Committee is expected to vote on the bill on Thursday, with a vote on whether to pass it or not on Friday.
WASHINGTON (AP) — The Senate parliamentarian has advised that a key Medicaid provider tax overhaul that is central to President Donald Trump’s big tax cut and spending bill does not adhere to procedural rules, delivering a crucial blow to Republicans rushing to finish the massive package this week.
The guidance Thursday from the parliamentarian is rarely ignored, and it forces GOP leaders to consider options. Senate leaders could try to revise it or strip it from the package. Otherwise, the provision could be challenged during floor votes, requiring a 60-vote threshold to keep it, a tall order in the narrowly split 100-member Senate. Democrats are unified against the Republican president’s bill.
Republicans scrambled to respond, some politically attacking the nonpartisan parliamentarian, while Democrats said it would be devastating to the GOP package.
Sen. Ron Wyden, the top Democrat on the Senate Finance Committee, said the GOP proposal would have been as much as a $250 billion cut to the health care program, “massive Medicaid cuts that hurt kids, seniors, Americans with disabilities and working families.”
The outcome is a setback as Senate Republicans hoped to launch votes on the package by the end of the week, to meet Trump’s Fourth of July deadline for passage. Republican leaders are relying on the Medicaid provider tax change to save billions of dollars in the GOP package, to offset the cost of trillions of dollars in tax cuts, which are their top priority.
Some Republicans even called for challenging, or firing, the parliamentarian, who has been on the job since 2012 as the nonpartisan chief arbiter of the chamber’s historic and often complicated rules.
But GOP leaders had already been struggling to rally support for the change. Several GOP senators warn it would harm rural hospitals that depend on the funds. Hospital organizations have been warning it could wipe out their balance sheets and lead to hospital closures.
Sen. Josh Hawley, R-Mo., who’s among those fighting the change, said he had spoken to Trump late Wednesday as the president returned from the NATO meeting in the Netherlands. Hawley said Trump told him to revert back to an earlier proposal from the House.
States impose the taxes as a way to help fund Medicaid, largely by boosting the reimbursements they receive from the federal government. Critics decry the system as a type of “laundering,” but almost every state except Alaska uses it to help provide the health care coverage.
The House-passed bill would freeze the provider taxes at current levels, while the Senate proposal goes deeper by reducing the tax that some states are able to impose.
One plan Republicans had been considering to win over GOP senators opposed to the provider tax cut was to create a new rural hospital fund, with $15 billion, to help defray any lost revenue to the hospitals and providers. But some GOP senators said that was too high, while others, including Sen. Susan Collins of Maine, wanted at least $100 billion.
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Associated Press writer Kevin Freking contributed to this story.
Lisa Mascaro, The Associated Press