The only way that Republicans can pass their “families lose, billionaires win” reconciliation bill is if their proposals are not subject to a special rule that would require them to pass their bill by more than a simple majority. Put differently, any Republican proposal that the Senate Parliamentarian rejects can only pass with 60 votes–the Byrd rule–which Republicans don’t have. As drafted, the bill is a mad concoction of policies that will wreak havoc on hospitals and nursing homes, destroy jobs, leave millions uninsured and drive up the cost of health care, all to help pay for tax cuts for the ultra-rich.
As of now, the Senate Parliamentarian has said the following provisions in the Republican bill are subject to a 60-vote threshold, if they stay. But, the process is ongoing. And, the Democrats continue to challenge elements of the Republican bill.
- Eligibility and enrollment in Medicare Savings Programs, which cover the Medicare Part B premium and more for qualifying individuals with low incomes.
- Some of the rule regarding eligibility and enrollment for Medicaid and CHIP.
- Nursing home staffing regulations, which require a registered nurse to be onsite at all times and puts in place staffing standards.
- The drugs covered under the law that permits Medicare drug-price negotiation, which includes orphan drugs that treat cancer and rare diseases as drugs eligible for drug-price negotiation.
After the Parliamentarian rejected other provisions in the reconciliation bill, stating that they were subject to a 60-vote Byrd Rule Point of Order, the Republicans redrafted them and they are no longer subject to a 60-rule vote in order to pass.
- Provider taxes. The Republican bill would cut Medicaid payments to hospitals and other providers. It would devastate many rural and inner-city hospitals and their communities. It would also push millions of people off of Medicaid, destroy jobs and hurt state economies.
- Medicare eligibility for refugees, asylum seekers and people with temporary protected status. These people will lose Medicare eligibility even if they have sufficient work history, pay into the Medicare program, and meet other requirements, including age and disability status.
- Premium subsidies for more than one million non-citizen immigrants. These individuals currently get assistance paying the cost of their premiums in the state health insurance exchanges.
Defunding Planned Parenthood so that it cannot receive Medicaid funds. It’s still not clear where the Parliamentarian will come down on this provision.
[Since this post was published, the Senate has passed the bill. More to come on what the final Senate bill looks like. It still has to pass in the House.]
Here’s more from Just Care:
- Republican bill would increase medical debt significantly
- Senate Republicans propose to slash billions from Medicare
- Senate Republicans on Finance Committee pass even deadlier reconciliation bill than House bill
- Proposed Medicaid cuts imperil access to hospital care for all Americans and drive up costs
- House reconciliation bill would push millions off Medicaid
