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Senate Democrats Score a Strategic Victory Against Medicaid Cuts
In a surprising twist that could make even the most seasoned political strategist raise an eyebrow, Senate Democrats have effectively targeted the funding cuts embedded in the Republicans’ tax cuts for the wealthy bill. Thanks to the Byrd Bath process, they have secured a notable victory. One of the more controversial tactics employed by Republicans involved shifting the financial burden of Medicaid onto the states while simultaneously denying states the ability to fund the program through provider taxes.
Additionally, Republicans sought to restrict Medicaid and ACA marketplace access to immigrants, a move that raised eyebrows and sparked debate.
The Senate parliamentarian has deemed these provisions in the legislation as violations of reconciliation rules, effectively tossing them out.
Here’s a summary of what was excised from the bill, courtesy of the Senate Budget Committee Democrats:
- Prohibition of Federal Medicaid Participation for Unverified Individuals: This measure would have denied federal financial assistance under Medicaid for individuals whose citizenship or immigration status could not be verified immediately, eliminating the current 90-day grace period for verification. (Section 71109)
- Medicaid Eligibility for Immigrants: This section aimed to cut federal funding for Medicaid coverage of certain non-citizen immigrants. (Section 71110)
- FMAP Expansion Limitations: This would have reduced the federal medical assistance percentage for states that opted to cover undocumented individuals using their own funds, dropping from 90% to 80%. (Section 71111)
- Spread Pricing in Medicaid: This requirement would have mandated that Medicaid managed care contracts with pharmacy benefit managers adhere to state reimbursement methodologies for pharmacies. (Section 71116)
- Funding Restrictions on Gender Affirming Care: This provision aimed to prohibit Medicaid and CHIP funding for gender-affirming medical care. (Section 71117)
- Provider Tax Restrictions: This measure would prevent non-expansion states from increasing provider taxes, significantly limiting their capacity to fund health care for millions. (Section 71120)
- Medicare Coverage Limitations: This would have stripped eligibility for Medicare from certain immigrants, including refugees and asylum seekers. (Section 71201)
- Premium Tax Credit Restrictions: This section would limit premium tax credits to certain individuals, effectively cutting off over a million currently eligible immigrants from receiving assistance. (Section 71301)
- Prohibition of Tax Credits During Medicaid Ineligibility: This measure would deny premium tax credits to those who would otherwise qualify but are deemed ineligible due to their immigration status, undermining access to affordable insurance. (Section 71302)
As a result of this parliamentary setback, Senate Republicans are now faced with the daunting task of overhauling significant portions of the Medicaid provisions in the bill. They either have to align with reconciliation rules or devise alternative cuts.
According to Laura Weiss of Punchbowl News, who shared on X, Senate Republicans are expected to regroup:
“WHAT’S NEXT after R’s dealt a blow from parliamentarian knocking out provider tax & more Medicaid cuts? Senate R’s will keep working on provider tax crackdown. R’s expected to go back to the parl with new provider tax language & can also try other savings options with a similar goal, per multiple sources. But this will take time. Still significant Byrd Bath work with parl to go & these are critical pieces of the bill. Senate R’s still pushing for July 4 finish.”
Now, the path forward is fraught with uncertainty. Major changes will need to be made, and it remains to be seen whether these adjustments can garner approval in the House.
This ambitious effort is teetering on the brink of collapse, and the Republicans might want to temper their expectations for getting this bill signed by the 4th of July.
As the pieces of this legislative puzzle begin to fall apart, the American public watches the slow unraveling of what was once touted as Trump’s “Big Beautiful Bill.”
What are your thoughts on Senate Democrats achieving significant victories against Medicaid cuts? Share your views in the comments!
