Senate Majority Leader John Thune (R-S.D.) is actively working to counter Senate Republican colleagues aiming to slash Medicaid spending by hundreds of billions of dollars, with plans to bring the proposed bill to the floor next week.
Thune is feeling the urgency to accelerate the legislative process as Congress approaches the July 4 deadline for passing the bill.
A Republican senator has expressed concerns about stringent new limitations on states’ ability to utilize the healthcare provider tax to generate additional federal Medicaid funds. They are collaborating with Thune to propose measures that could prevent rural hospitals from going under.
The GOP senator is discussing provisions regarding Medicaid employment and eligibility standards with Thune and Senate Committee Chairman Mike Crapo (R-Idaho).
They are also addressing worries that the Senate bill might transfer a significant portion of Medicaid costs onto states and low-income Americans.
“We are exploring solutions, but we won’t delve into specifics just yet; we are merely discussing some potential options,” Thune remarked to reporters on Wednesday afternoon.
According to a Republican source familiar with the negotiations, there is hope that Senate GOP leaders and holdouts will come to an agreement to extend financial support directly to rural hospitals that could face closure if the Senate bill progresses in its current state.
“I have advocated for the inclusion of provider relief funds aimed at rural hospitals, nursing homes, and community health centers,” stated Sen. Susan Collins (R-Maine), who is one of the Republican holdouts.
Collins has consistently voiced concerns that restricting states’ ability to secure additional federal funds through the healthcare provider tax could severely impact rural hospitals in Maine.
GOP Senators indicate that Thune is under pressure to act swiftly to resolve the concerns of Senate Republican holdouts in time for Trump’s July 4 deadline.
White House Chief of Staff Susie Wills informed Republican senators at a lunch meeting on Wednesday that Trump hopes they will adhere to his timeline.
Sen. Kevin Cramer (R-N.D.) mentioned after the lunch that he intends to bring the bill to the floor by the end of Wednesday.
“I expect there will be every concession,” he said regarding Thune’s negotiations with Republican lawmakers who are weighing the bill’s Medicaid spending cuts.
“There’s still a possibility of reaching an agreement to gain majority support. Sometimes you can’t finalize things until you start putting proposals on the floor,” he added.
He noted that Wills urged GOP Senators to “finish up and complete it next week.”
Sen. Josh Hawley (R-Mo.), who has raised concerns about the Senate bill’s substantial cuts to funding for rural hospitals, stated he has proposed several options to senators to safeguard his local hospital for GOP leaders.
He emphasized that rural hospitals should not incur financial losses to fund the gradual elimination of renewable energy tax credits, another crucial element of the Senate legislation.
“The right action is not to leverage rural hospitals to finance pet projects,” Hawley declared. “If you need to fund a pet project in your bill, secure your own funding. Don’t undermine rural hospitals.”
Sen. Lisa Murkowski (R-Alaska) conveyed that discussions with leadership are progressing positively.
“There are still a lot of moving parts,” she remarked, adding that recent discussions have been “more encouraging.”
“We’re still affecting small and rural hospitals,” she continued.
“From Alaska’s perspective, the situation is improving slightly,” she noted.
Murkowski explained that Alaska is the only state that does not use provider taxes to secure additional federal Medicaid funds, yet altering Medicaid through changes in job and eligibility requirements could still adversely impact small and rural hospitals.
“For many of our small hospitals, Medicaid is their primary payer. What happens to the hospital if people are removed from it?” she questioned.
“We are seeing constructive discussions,” she said concerning negotiations with GOP leaders.
Murkowski indicated that she is not opposed to incentivizing work for Medicaid benefits but raised concerns about implementing large, statewide work mandates in a short time frame.
“It’s rooted in our [Medicaid system’s] architecture. It doesn’t require individuals to work—that’s how we document everything within our system. That’s a significant challenge for us,” she explained.
Thune must address Murkowski’s and other GOP senators’ worries regarding amendments to the Supplemental Nutrition Assistance Program (SNAP), another funding source for the bill aimed at balancing the costs of newly proposed tax cuts.
The Senate bill would reduce federal SNAP funding allocated to states while also providing a potential way to mitigate funding cuts by enhancing error rates when administering benefits. States with error rates of 6% or higher would need to fund 5-15% of the cost of federal food assistance.
“There are still some hurdles with implementing SNAP,” Murkowski noted.
Thune informed reporters on Wednesday that he is also collaborating with Republican colleagues who have concerns regarding the timeline for phasing out tax credits related to various renewable energy sources.
“That issue hasn’t been fully resolved yet,” he stated.
Sen. Shelley Moore Capito (R-W.Va.) expressed dissatisfaction with the current language of the bill that abruptly terminates tax credits for clean hydrogen production facilities not already in progress by the end of the year.
Capito mentioned that she spoke with Crapo, the chairman of the finance committee, regarding her concerns.
The Senate bill is favorable towards nuclear, geothermal, and hydroelectric energy tax credits extending into the 2030s. This represents a success for Sen. Tom Tillis (R-N.C.), whose home state is currently evaluating a new nuclear power plant proposed by Duke Energy in Stokes County.
Tillis noted that he inquired about the “couple” pertaining to the renewable energy tax credit.
“The couple I’m referencing,” he stated.
Source: thehill.com