Senate Republicans are facing major new issues with their domestic policy megabill after the chamber’s parliamentarian advised senators that several provisions they are counting on to reap hundreds of billions of dollars in budget savings won’t be able to pass along party lines.
Those include major pieces of Medicaid policy, including a politically explosive plan to hold down Medicaid costs by cracking down on a state provider tax — a provision that is expected to have a nine-figure impact on the bill. Republicans now will have to try to rewrite major sections of their Finance bill or potentially leave out key policies.
The decisions were detailed in a Thursday morning memo from Democrats on the Senate Budget Committee. Other provisions now at risk include several GOP proposals to exclude undocumented residents from Medicaid, including by withholding federal funds from states that make them eligible for benefits.
The rulings come at a critical time for Senate Majority Leader John Thune and other GOP leaders, who are already facing a revolt inside their conference from members wary of the practical and political impacts of the Medicaid changes. They have proposed reverting to a less drastic House plan, which would merely freeze the existing provider taxes, though it’s unclear if that provision could also pass muster under Senate rules.
Republicans will try to rework the provider tax language to get it back into the Senate bill, according to two people granted anonymity to discuss internal strategy. The revised language will still have to be blessed by the parliamentarian as complying with the chamber’s rules.
“We’ll continue our work and find a solution to achieve the desired results,” one of the people said.
Some House Republicans are calling for Senate leadership to overrule the parliamentarian, an unprecedented step.
“The Senate Parliamentarian is not elected. She is not accountable to the American people,” Rep. Greg Steube (R-Fla.) posted on X. “Yet she holds veto power over legislation supported by millions of voters.”
Democrats took a victory lap after the ruling, noting the rulings blew a $250 billion hole in the megabill’s savings.
“Democrats fought and won, striking healthcare cuts from this bill that would hurt Americans walking on an economic tightrope,” said Senate Finance Committee Ranking Member Ron Wyden (R-Ore.) in a statement.
The parliamentarian also ruled early Thursday against a Republican proposal to prohibit plans from not getting certain Obamacare payments if they cover abortion. There are 12 states that currently require such coverage and insurers have worried they don’t have enough time to implement the payment change before the start of open enrollment.
There remain some outstanding policies, such as Republicans’ effort to defund Planned Parenthood and removal of a nursing home staffing rule.
Republicans still aren’t closing the door to taking a first vote on Friday. One person granted anonymity to discuss the schedule insisted that the parliamentarian’s decision is “not as fatal as Dems are portraying it to be” and that “Friday still not off the table.”
