Even more key provisions of Senate Republicans’ Better Care Reconciliation Act could be subjected to an obscure rule that puts the bill in peril.
The Senate parliamentarian said Tuesday that two other parts of the Republican legislation would require 60 votes to advance. That was in addition to the list the parliamentarian put out on Friday of parts of the bill that need the 60 votes.
That’s because of something called the Byrd rule. The Byrd rule was passed in 1985 and says that any bill going through the budget reconciliation process — what Republicans in the Senate hope to do with their healthcare bill — can be blocked on the grounds that it contains an “extraneous matter” or something “merely incidental” to the federal budget.
The budget-reconciliation manoeuvre through which the GOP hopes to move the BCRA allows a bill that adjusts the federal budget to pass through the Senate with a simple 50-vote majority to avoid a filibuster. Any other legislation needs 60 votes to avoid a filibuster.
The Senate parliamentarian said Tuesday that the BCRA’s age tax (which would allow insurers to charge older adults up to five times more than young, healthy adults) and the small-business provision that would allow businesses to establish plans that could be sold across state lines would both be subject to 60 votes. Republicans currently hold 52 seats in the Senate, making it nearly impossible to get to 60 votes.
That’s in addition to other key parts of the bill — including a plan to defund Planned Parenthood, restricting federal tax credits from being used for abortions, and a provision that would make people wait six months for health insurance if they have a lapse in coverage — all require 60 votes, according to the Senate parliamentarian.
“Should the Senate proceed to the bill, these provisions may be struck from the legislation absent 60 votes,” the Senate budget office said.
On Tuesday, the Senate voted to open debate on legislation to overhaul the healthcare system, clearing the first major hurdle in the process.
Here are all the other parts of the BCRA that could put the bill in jeopardy
- The plan to defund Planned Parenthood
- A provision that would restrict the use of tax credits for abortions.
- Getting rid of the essential health benefits for Medicaid in 2020.
- How the bill deals with cost-sharing subsidies
- The section that locks individuals out of the insurance marketplace for six months if they don’t have continuous coverage.
- The medical loss ratio.
- The provision that allows states that haven’t used all of their block grants for health coverage for non-health purposes.
- Changes to the Medicaid waiver system by prioritising HCBS waivers.
- A provision that requires a report regarding CMS-64 and Transformed Medicaid Statistical Information System data.
Here’s the list of the BCRA provisions that pass and don’t pass the Byrd rule, as well as a few that are still under review.
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