More Provisions in Republican Bill Violate Senate Rules, According to Parliamentarian

WASHINGTON, July 25 – The Senate parliamentarian determined Tuesday that additional provisions of the Republican “Better Care Reconciliation Act” released on June 26, 2017, violate the Byrd Rule. Should the Senate proceed to the bill, these provisions may be struck from the legislation absent 60 votes.

"Not only is the legislation being proposed by Republican leadership a disaster for the American people, the process has been a travesty. This is legislation which impacts every American and one-sixth of our economy, yet this bill has been written behind closed doors, without a single hearing," Sen. Bernie Sanders, the ranking member on the Senate Budget Committee, said. "One of the results of this absurd process is that many of the provisions in the latest Republican bill have been found to be in violation of Senate rules. Today, we have learned of two more violations – the 'age tax' and 'small business health plans' sections."

Background From the Senate Budget Committee Minority Staff on the Parliamentarian's Latest Byrd Bath Decisions

Provisions Subject to a 60-vote Byrd Rule Point of Order

  • Change in Permissible Age Variation in Health Insurance Premium Rates (“Age Tax”): This section allows insurers to charge older Americans at least five times more than what they charge younger individuals. (Sec. 204).
  • Small Business Health Plans: This section would allow small businesses to establish “association health plans” that could be sold across state lines. For regulatory purposes, these plans would be treated as part of the large group market and thus would be exempt from many ACA requirements such as covering essential health benefits. (Sec. 139). 

Provisions Not Subject to a 60-vote Byrd Rule Point of Order 

  • Flexible Block Grant Option for States: This section allows states the option to receive a lump sum Medicaid “block grant” instead of the per capita cap payments. (Sec. 134).

Still Under Review

  • Waivers for State Innovation (Essential Health Benefits): This section amends Sec. 1332 of the ACA to allow states to waive age rating, essential health benefits, and pre-existing condition requirements so long as their proposal does not increase the federal deficit. (Sec. 207).