Senate Republican leaders considerably elevated the scale of a rural hospital aid fund and rewrote controversial language freezing well being care supplier taxes in a late-night bid to maintain President Trump’s “big, beautiful bill” on observe for a vote Saturday afternoon.
Republican leaders elevated the scale of the proposed rural hospital aid fund from $15 billion to $25 billion, with the cash to be distributed over 5 years.
However the proposal falls far wanting the $100 billion that Sen. Susan Collins (R-Maine), a key swing vote, requested to be allotted to a well being care supplier aid fund to assist rural hospitals, nursing properties and neighborhood well being facilities.
The $25 billion rural hospital fund would allocate $10 billion in funding in 2028, one other $10 billion in 2029, then $2 billion in 2030, one other $2 billion in 2031 and at last $1 billion in 2032.
Altogether, it could present solely a fraction of the federal Medicaid funding that states are projected to lose over the subsequent decade due to caps on using well being care supplier funds.
For instance, Sen. Thom Tillis (R-N.C.) has projected that North Carolina would forfeit $38.9 billion in Medicaid funding from 2026 to 2035 on account of capping the supplier tax price.
Senate Republican leaders reduce language establishing a moratorium on new or elevated well being care supplier taxes in states that didn’t develop Medicaid beneath the Reasonably priced Care Act, which the parliamentarian discovered violated the Byrd Rule as a result of it didn’t produce a considerable budgetary impact, based on a Republican senator briefed on the parliamentarian’s ruling.
And so they delayed the phase-in of a 0.5 share level annual discount of the cap on well being care supplier taxes in states that expanded Medicaid beneath the ACA by one yr.
As an alternative of states’ well being care supplier taxes being diminished from 6 p.c to five.5 p.c in 2027, the half-point discount within the cap in supplier taxes would go into impact in 2028.
Republicans hope the modifications in language associated to well being care supplier taxes will move muster with Senate parliamentarian Elizabeth MacDonough.
MacDonough dominated on Thursday that the part of the invoice capping states’ use of well being care supplier taxes violated the Byrd Rule wouldn’t be eligible to move with a simple-majority vote beneath the price range reconciliation quick observe.
Republican senators briefed on the discussions with the parliamentarian stated she additionally objected to the timeline for reducing the cap on well being care supplier taxes in Medicaid growth states.
GOP lawmakers stated they hope the parliamentarian will settle for the cap language whether it is delayed by a yr.
Senate Price range Committee Chairman Lindsey Graham (R-S.C.) launched the revised textual content of the Senate modification to the One Huge Lovely Invoice Act, which handed the Home on Could 22.
The Senate modification is 940 pages lengthy and cuts federal Medicaid spending considerably greater than the Home bundle.
Senate Majority Chief John Thune (R-S.D.) informed Republican colleagues at lunch Friday that he plans to carry a vote on continuing to the bundle noon Saturday.
If the movement to proceed to the invoice passes, that will arrange 20 hours of debate, equally divided between Republicans and Democrats, on the laws earlier than a protracted collection of modification votes referred to as a vote-a-rama.
Senators would vote on closing passage of the invoice on the finish of the vote-a-rama.
Trump has set a deadline of July 4 for passing the invoice.
