Senate parliamentarian rejects multiple Medicaid cuts in GOP budget reconciliation bill

The Senate parliamentarian has rejected multiple Medicaid cuts in the GOP budget reconciliation bill.

Senate parliamentarian Elizabeth MacDonough rejected Republicans' plan to cap the states' use of healthcare provider taxes to collect more federal Medicaid funding, per a Democratic summary of the parliamentarian's ruling, The Hill news outlet reported on Wednesday. The provision would have generated hundreds of billions of dollars in savings to offset the cost of making President Trump's 2017 tax cuts permanent.

MacDonough decided that the provision violates the Byrd Rule, which determines what legislation is eligible to pass the Senate through the budget reconciliation process that only requires a simple-majority vote to pass.

Senate Republicans could bypass the parliamentarian's rulings by having a simple-majority floor vote to establish a new precedent, expanding the scope of what is eligible under reconciliation. They could also attempt to rewrite the cap in a way that meets the parliamentarian's approval.

Sen. Jeff Merkley, D-Ore., the ranking Democrat on the Senate Budget Committee, said in a statement regarding the parliamentarian's cuts, “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.”

MacDonough also ruled against a provision in the bill that would have revoked Medicare eligibility for many non-citizens; another section that would have lowered the Federal Medical Assistance Percentage grant from 90% to 80% for states that use their own funds to provide Medicaid coverage to illegal immigrants; a separate provision that would have prohibited Medicaid and the Children’s Health Insurance Program federal funding for adults and kids with unverified citizenship or immigration status; and a section that would have prevented federal Medicaid and CHIP funding for gender-affirming medical care.