WASHINGTON – President Donald Trump’s major tax, spending and policy legislative package suffered a blow on June 26 when the Senate’s parliamentarian ruled that several key Medicaid provisions designed to help cajole nervous Republicans into voting yes can’t be included in the bill.
The decision from the chamber’s leading rules expert strikes a blow against proposed Republican changes to Medicaid, the federal health insurance for lower-income families, which has been one of the main battlegrounds in debate over the legislation.
Trump and fellow Republicans, who aim to pass the bill without counting on any Democratic support, aim to reduce Medicaid spending by requiring work by able-bodied adults and denying access to non-citizens.
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But under Senate rules allowing a simple majority approve the bill, all the provisions must directly impact the federal budget.
Parliamentarian Elizabeth MacDonough ruled several Medicaid provisions are subject to filibuster, which would require 60 votes to overcome. The decision is a potential death-knell in a chamber where Republicans outnumber the Democratic caucus 53 to 47.
“Democrats are fighting back against Republicans’ plans to gut Medicaid, dismantle the Affordable Care Act, and kick kids, veterans, seniors, and folks with disabilities off of their health insurance – all to fund tax breaks for billionaires,” Sen. Jeff Merkley of Oregon, the top Democrat on the Budget Committee, said in a statement. “Republicans are scrambling to rewrite parts of this bill to continue advancing their families-lose, and billionaires-win agenda, but Democrats stand ready to fully scrutinize any changes.”
The provisions at stake aimed to:
Prohibit Medicaid participation to adults and children whose citizenship or immigration status could not be immediately verified.
Deny Medicaid eligibility to immigrants who are not citizens.
Reduce federal Medicaid matching funds to 80% from 90% for states that provide coverage to undocumented immigrants.
Prohibit Medicaid and the related Children’s Health Insurance Program from funding gender-affirming care.
Block states from increasing provider taxes on nursing homes or intermediate care facilities, which Democrats said could cut health care to millions of people.
Republicans criticized the parliamentarian’s decision.
“The Senate Parliamentarian is not elected,” Rep. Greg Steube, R-Florida, wrote on social media. “She is not accountable to the American people. Yet she holds veto power over legislation supported by millions of voters.”
This article originally appeared on USA TODAY: Trump, Senate GOP face tax bill setback on Medicaid overhaul
