Sunday, June 29, 2025

Question: 🙋‍♂️

Two provisions added to the bill just days ago — and tailored specifically to boost Medicaid payments to Alaska and Hawaii — have been ruled to violate the Senate’s Byrd rule. That limits what can pass through the reconciliation process with a simple majority.

GOP leaders had hoped the Medicaid provisions focused on non-contiguous states, along with other Alaska-friendly changes, would be enough to win the vote of Sen. Lisa Murkowski (R-Alaska). She had voiced concerns over deep cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP).

Murkowski voted to move forward with the bill Saturday night after making committee chairs and leadership sweat.

Elsewhere, Senate Republicans attempted to expand a Medicare drug-price negotiation exemption for “orphan” drugs to include medicines that treat multiple rare diseases. But the parliamentarian ruled it is not in compliance with rules and could threaten the ability to pass the megabill with a simple majority. The orphan drug provision was in the House-passed bill, but was not included in the first Senate Finance Committee’s proposal earlier this month.

The parliamentarian also ruled against provisions that sought to block implementation of two Biden-era regulations that seek to make it easier for older adults and individuals with disabilities to enroll in Medicaid and maintain coverage.

Also flagged by the parliamentarian was a provision that would prohibit implementation of a Biden Administration rule on nursing facility staffing, which was estimated to reduce federal Medicaid spending by $23 billion over 10 years.
You know: “fraud, waste, and abuse” committed by “able bodied persons.” 🙄 And one more thing:
The Senate Republican proposal to delay planned cuts to provider taxes that fund state obligations to Medicaid survived the so-called “Byrd bath” and will not be subject to a supermajority vote. The changes would still incrementally lower the allowable provider tax in Medicaid expansion states from 6 percent down to 3.5 percent. But the drawdown would begin in 2028, one year later than planned.
Or why a lot of this (it’s more likely to pass, in one form or another, than not), is time settings like that. This BBB sets the GOP up for failure in the midterms, and the long run. At least if we can get veto proof majorities. Is this the “art” of the deal? Is this making friends and influencing people and cutting deals left and right? Is this how Trump guarantees his majority in 2027? Art of the deal? Shit, I’ve negotiated better than that.
George Clooney sanctioned, ‘s all I’m sayin’.
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