Byrd Bath Violations Continue to Roll in on Republicans’ “One Big, Beautiful Bill”
WASHINGTON, D.C. – Today, the Senate Parliamentarian again advised that several provisions in the Republicans’ “One Big, Beautiful Bill,” would be subject to a 60-vote threshold if they remain in the bill. The below provisions are under the Finance Committee’s jurisdiction.
“We have been successful in removing parts of this bill that hurt families and workers, but the process is not over, and Democrats are continuing to make the case against every provision in this Big, Beautiful Betrayal of a bill that violates Senate rules,” said Ranking Member Jeff Merkley. “Republicans are still actively attempting to rewrite major sections of this bill to advance their families lose, and billionaires win agenda, but Democrats are scrutinizing all changes to ensure the rules of reconciliation are enforced. We cannot let Republicans succeed in betraying middle-class families across this country.”
Provisions Subject to a 60-Vote Byrd Rule Point of Order
Finance
Repealing Parts of the Rule Relating to Eligibility and Enrollment in Medicare Savings Programs. This section prohibits the Secretary of Health and Human Services from implementing, administering, or enforcing any part of the “Streamlining Medicaid; Medicare Savings Program Eligibility Determination and Enrollment” final rule until 2034. The portions of the rule which have gone into effect are subject to the Byrd Rule. (Section 71101)
Repealing Parts of the Rule Relating to Eligibility and Enrollment for Medicaid and the Children’s Health Insurance Program (CHIP). This section prohibits the Secretary of Health and Human Services from implementing, administering, or enforcing any part of the “Medicaid Program; Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes” final rule until 2034. The portions of the rule which have gone into effect are subject to the Byrd Rule. (Section 71102)
Repealing Parts of the Nursing Home Staffing Regulations and Transparency Policies. This section would prohibit the Secretary of Health and Human Services from implementing, administering or enforcing any part of the final nursing home staffing rule, which requires a registered nurse be onsite 24/7 and implements staffing standards in nursing homes until 2034. The portions of the rule which have gone into effect are subject to the Byrd Rule. (Section 71113)
Determination of FMAP for High-Poverty States. This section provides for an enhanced federal matching rate for the two states with the highest separate poverty guidelines: Alaska and Hawaii. (Section 71124)
Expanding and clarifying the exclusion for orphan drugs under the drug price negotiation program. This section would create new exemptions from Medicare drug price negotiation, which will raise prescription drug costs for seniors with cancer and rare diseases. (Section 71203)
Application of Cost-of-Living Adjustment to Non-Labor Related Portion for Hospital Outpatient Department Services Furnished in Alaska and Hawaii. This section directs the Secretary of Health and Human Services to increase payments for outpatient payments in the same manner as for inpatient hospital services for Alaska and Hawaii. (Section 71204)
Provisions Not Subject to a 60-Vote Byrd Rule Point of Order
**The below provisions have been redrafted to address the Parliamentarian’s guidance and are no longer subject to a 60-vote threshold.
Finance
Provider Taxes. Beginning in 2028, the hold harmless threshold in expansion states for provider classes other than nursing or intermediate care facilities would be reduced by 0.5 percent annually until the maximum hold harmless threshold reaches 3.5 percent in 2032. This provision also prohibits all states from increasing the rate of current provider taxes or increasing the base of the tax to a class or items of services that the tax did not previously apply. Ending states’ ability to tax health care providers would severely limit states’ ability to provide health care to millions of Americans who depend upon Medicaid for their care. (Section 71117)
Limiting Medicare coverage of certain individuals. This section revokes eligibility from certain immigrants who are not citizens. This section effectively removes the ability of refugees, asylum seekers, and people with temporary protected status from being able to enroll in the Medicare program, even if they have sufficient work history, pay into the Medicare program, and meet other requirements, including age and disability status. (Section 71201)
Permitting premium tax credits only for certain individuals. This section limits immigrants who are not citizens from qualifying for premium tax credits or cost-sharing reductions beginning in 2027. This would prohibit over 1 million currently eligible individuals from qualifying for premium assistance when purchasing insurance through the Affordable Care Act Marketplaces. (Section 71301)
Still Under Review
Finance
Defunding Planned Parenthood. This section prohibits Planned Parenthood from receiving federal Medicaid funds. (Section 71115)
The Parliamentarian’s advice is based on whether a provision is appropriate for reconciliation and conforms to the limitations of the Byrd Rule; it is not a judgement on the relative merits of a particular policy.
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