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Senate Republicans dealt a blow on Medicaid modifications in funds invoice : NPR
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Senate Republicans dealt a blow on Medicaid modifications in funds invoice : NPR

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Last updated: June 26, 2025 3:32 pm
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Published: June 26, 2025
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Senate Majority Chief John Thune, R-S.D., speaks with reporters following the weekly Senate Republican luncheon on the Capitol in Washington, DC, on June 24. Senate Republicans are working to shortly move the ‘One Large, Stunning Invoice,” President Trump’s signature laws.

Saul Loeb/AFP by way of Getty Pictures


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Saul Loeb/AFP by way of Getty Pictures

Senate Republicans hit a significant setback of their race to move a large tax and spending bundle on Thursday, as a chamber official dominated towards a key provision to get the convention on board to vote for the plan by week’s finish.

The nonpartisan Senate parliamentarian, who performs a key function in figuring out what provisions can keep within the fast-tracked invoice, stated the GOP change to how states can tax Medicaid suppliers doesn’t adhere to guidelines for passing the invoice with a easy majority. This was a key provision to assist offset the prices of the invoice’s tax cuts.

Senate Republicans a day earlier had proposed a $15 billion rural well being stabilization fund to deal with the slashing of a supplier tax that may be a important supply of funding for a lot of states. The parliamentarian stated that provision will not fly.

Democrats, who’re making arguments earlier than the parliamentarian to slash key sections of the invoice, referred to as the ruling a win.

“With extra selections to come back, this steerage ends in greater than $250 billion in well being care cuts faraway from the Republicans’ large dangerous invoice,” stated Sen. Ron Wyden, D-Ore., and the highest Democrat on the Senate Finance Committee. “Democrats fought and gained, putting well being care cuts from this invoice that will damage People’ strolling on an financial tightrope.

“This invoice is rotten to its core, and I am going to preserve preventing the cuts on this morally bankrupt invoice till the tip,” Wyden added.

A senior Republican official acquainted with the discussions informed NPR that Republicans will “proceed our work to discover a answer to attain the specified outcomes/financial savings” and maintained it was not as large of a problem as Democrats had been arguing.

Medicaid provisions have been among the many most tough provisions within the invoice. At problem is a directive that states reduce the tax they impose on Medicaid suppliers from 6% down to three%. Critics say the change will end in main challenges for rural hospitals that depend on that cash. It’s a part of a posh system that determines how a lot federal funding is obtained as a part of the joint program run with states.

Different provisions had been flagged by the parliamentarian, together with one barring Medicaid from masking gender affirming care and denying protection to some Medicaid recipients who are usually not U.S. residents.

Senate Republicans had hoped to start voting on the laws this week, nevertheless it’s unclear if they will meet their deadline to ship it to President Trump’s desk by the July 4th deadline. They’re additionally going through intense strain from Trump to move the invoice this week, and several other members of the convention are due for a White Home assembly in the present day.

The laws carries the majority of Trump’s home agenda, however the GOP convention has struggled to resolve main sticking factors. Whereas Senate committee leaders have made a number of vital modifications to the invoice in latest days, the problem of funding for rural hospitals emerged as a significant roadblock.

The brand new Medicaid language was added to the Home-passed invoice within the Senate, drawing objections from Sen. Susan Collins, R-Maine, Sen. Josh Hawley, R-Mo. and Sen. Thom Tillis, R-N.C. On Wednesday, the Senate Finance Committee on Wednesday put out the compromise stabilization fund that will direct $15 billion over a 5-year interval to states in want. Nonetheless, that fell in need of what different senators say was wanted.

Collins has stated the fund wanted to be nearer to $100 billion, and warned colleagues from racing to a vote this week with out fastidiously resolving the problem. Hawley has argued the Senate modifications would pressure drawn-out negotiations with the Home, delaying ultimate passage of the laws. Tillis, who’s operating for reelection in 2026, served within the state home in his residence state earlier than coming to Congress and warned states would not be capable of make up the hole in funding because of the new cuts within the invoice.

Senate GOP leaders are additionally ready for a willpower of whether or not main tax provisions within the invoice meet the strict guidelines for what might be included. The parliamentarian remains to be reviewing these parts to ensure every has a direct influence on the funds, amongst different rules. A number of different provisions within the Home model, equivalent to one barring nationwide judicial injunctions, have already been reduce in that evaluate.

There may be additionally lingering debate over the destiny of vitality tax credit within the invoice, modifications to the security internet program for low-income households often called the Supplemental Vitamin Help Program or snap and a provision on public lands.

Senate Republicans are additionally navigating variations with Home GOP lawmakers who characterize districts in New York and California who insist they should protect a state and native tax break, often called SALT. That part of the invoice was negotiated with Home Speaker Mike Johnson for his or her constituents who pay excessive state and native taxes.

Senate Majority Chief Thune can solely afford to lose three GOP votes so as to move the invoice.

Fiscal hawks within the Senate, equivalent to Sen. Ron Johnson, R-Wisc., and Sen. Rand Paul, R-Ky., have raised considerations about new deficit spending and will each probably vote towards the plan because of this.

Nonetheless, even when Thune is ready to resolve all the points in his chamber, a number of completely different factions of Home Republicans are warning they’ll oppose the most recent invoice that is rising from the Senate. Thune has repeatedly referred to as Trump the “nearer” for the large laws, and he is betting political strain will pressure Republicans to again the bundle.

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