Senate Republicans’ Medicaid Cuts Threaten To Put Trump’s ‘Big, Beautiful Bill’ In Jeopardy Ahead Of Vote

Senate Parliamentarian on Thursday advised that several provisions in the Trump administration’s “One Big, Beautiful Bill” would be subject to a 60-vote threshold if they remain in the bill, including key pieces of Medicaid policy, according to Democrats on the Senate Budget Committee.

This would mean the Trump administration would not be able to rely merely on Republican votes to get the bill passed – it would need a few votes from the Democrats as well to cross the threshold of 60 ayes.

Republicans currently have a 53-47 majority in the Senate.

The provisions at risk include the plan to hold down Medicaid costs by cracking down on a state provider tax and GOP proposals to exclude undocumented residents from Medicaid, including by withholding federal funds from states that make them eligible for benefits. Another section under threat seeks to prohibit federal Medicaid and CHIP funding for gender-affirming medical care.

Politico reported that the rulings come at a critical time for Senate Majority Leader John Thune and other GOP leaders, who are already facing a revolt inside their conference from members wary of the practical and political impacts of the Medicaid changes.

However, Republicans were counting on these Medicaid provisions to offset their costly tax plans.

The report said that the Republicans will try to rework the provider tax language to get it back into the Senate bill, citing two unnamed sources. The state provider tax crackdown is expected to have a nine-figure impact on the bill.

However, the revised language will still have to be approved by the parliamentarian.

“Democrats are fighting back against Republicans’ plans to gut Medicaid, dismantle the Affordable Care Act, and kick kids, veterans, seniors, and folks with disabilities off of their health insurance – all to fund tax breaks for billionaires,” Ranking Member Jeff Merkley said.

“Republicans are scrambling to rewrite parts of this bill to continue advancing their families lose, and billionaires win agenda, but Democrats stand ready to fully scrutinize any changes,” he added.

Some Republican proposals, meanwhile, are still under review, including the section that prohibits Planned Parenthood from receiving federal Medicaid funds.

However, Republicans are hopeful for a first vote on Friday. An unnamed source told Politico that the parliamentarian’s decision is “not as fatal as Dems are portraying it to be” and that “Friday still not off the table.”

Shares of companies in the health insurance space, including UnitedHealth Group (UNH), Cigna Group (CI), Elevance Health (ELV), and CVS Health Corp (CVS), were all trading in the green on Thursday morning.

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