Medicaid changes don’t meet Senate rules in ‘big, beautiful bill’ says parliamentarian

Senate Republicans hit a major setback in their race to pass a massive tax and spending package on Thursday, as a chamber official ruled against a key provision to get the conference on board to vote for the plan by week’s end.

The nonpartisan Senate parliamentarian, who plays a key role in determining what provisions can stay in the fast-tracked bill, said the GOP change to how states can tax Medicaid providers does not adhere to rules for passing the bill with a simple majority. This was a key provision to help offset the costs of the bill’s tax cuts.

Senate Republicans a day earlier had proposed a $15 billion rural health stabilization fund to address the slashing of a provider tax that is a critical source of funding for many states. The parliamentarian said that provision won’t fly.

Democrats, who are making arguments before the parliamentarian to slash key sections of the bill, called the ruling a win.

“With more decisions to come, this guidance results in more than $250 billion in health care cuts removed from the Republicans’ big bad bill,” said Sen. Ron Wyden, D-Ore., and the top Democrat on the Senate Finance Committee. “Democrats fought and won, striking health care cuts from this bill that would hurt Americans’ walking on an economic tightrope.

“This bill is rotten to its core, and I’ll keep fighting the cuts in this morally bankrupt bill until the end,” Wyden added.

But a senior Republican official familiar with the discussions told NPR that Republicans will “continue our work to find a solution to achieve the desired results/savings” and maintained it was not as big of a issue as Democrats were arguing.