Dem
47
GOP
53
Speaker Mike Johnson said he was going to pass Donald Trump's One Big Beautiful Bill by July 4th. That now seems increasingly unlikely. What's the next holiday that could be the deadline? Labor Day celebrates workers and the law making it a federal holiday was signed by a Democrat, Grover Cleveland, so that's no good (although, in Cleveland's favor, he was the only other president to serve two nonconsecutive terms). Given all the scary things the administration is doing, how about Halloween? Plan B could be Veterans Day, although the evangelicals might prefer Christmas.
The latest hangup is an obscure, but crucial, provision in the bill that deals with Medicaid reimbursement rates. It limits what health insurance companies pay states who contract with them to provide Medicaid coverage. The CBO says the bill will take $1 trillion out of government payments for health care. Some of the cuts are to Medicaid while others are to the Affordable Care Act. In all, $1 trillion less money coming into hospitals is serious money. The projection is that the bill will cause 11 million people to lose health care coverage. It will also raise out-of-pocket costs for millions of others. If these people discover this before Nov. 2026, they might make their feelings known at the polls.
Rural hospitals get much of their revenue from Medicaid. These cuts will force some of them to shut down nonemergency services, like pregnancy care. Other rural hospitals may simply no longer be able to make a go of it and will close altogether. This also affects rich people: If you have a heart attack and the nearest hospital is 100 miles away, and it is snowing, well, good luck. Estimates show that as many Republicans as Democrats will be hurt by the cuts. Donald Trump's pollster told him that the bill will hurt his supporters and he has opposed the cuts, but the bill seems to have a life of its own, and the cuts are needed to make the tax cuts for millionaires and billionaires possible.
An additional problem is that Senate Parliamentarian Elizabeth MacDonough has ruled that multiple provisions in the bill drowned in the Byrd bath and have to be buried. In particular, the proposals for killing the CFPB, slashing Fed employees' salaries, eliminating the Treasury Department's Office of Financial Research, and killing off the Public Company Accounting Oversight Board are not primarily budget related and can't be put in a reconciliation bill. They need to be put in a normal bill, which can be filibustered. This will require Sen. Tim Scott (R-SC), who is chairman of the Senate Banking Committee, to go back to the drawing board. Unless he can find $1 billion to cut quick like a bunny, this could delay passage.
Oh, MacDonough has also ruled that a provision that limits the way judges deal with people who thumb their noses at court orders has nothing to do with the budget and must go.
Another thing MacDonough ruled ineligible to be in a reconciliation bill is the Republicans' plan to shift some of the cost of SNAP (food stamps) to the states. She said that is a policy decision, not a budget decision, and has to be done via the regular order.
Another problem for the bill is Sen. Josh Hawley (R-MO). He is a strong opponent of the massive cuts to Medicaid, probably because someone has told him that it threatens constituents in his largely rural state. He wants to reduce the cuts, but then the math doesn't work. In short, the bill is still in limbo. (V)