
Senate Republicans are nearing a vote to slash more than $1.6 trillion in government spending over a decade within President Donald Trumpās ābig, beautifulā bill ā and the conference could enact more cuts in the final hours before a vote on final passage.
Trump and Senate Republicans are touting the largest cut to mandatory spending in American history within the upper chamberās budget bill. The Senate proposal notably exceeds the initial House draftās estimated savings by $200 billion over a ten-year period, surpassing Senate Republicansā goal of slashing spending by $1.5 trillion over a ten-year period.
Senate Majority Leader John Thune has also backed an effort to secure more cuts within the presidentās sweeping tax relief and immigration legislation.
The deficit-reducing measure is sponsored by Republican Florida Sen. Rick Scott and would lower the 90% federal match rate for new Medicaid enrollees in states that expanded coverage under the Affordable Care Act. A group of deficit-concerned senators, including Scott, helped secureĀ a vote on the amendment, which will occur during an anticipated marathon session of voting, known as a āvote-a-rama,ā before senators will vote on final passage of the bill.
āWe think itās really good policy,ā Thune told reporters Sunday. āWeāre going to do what we can to support that effort.ā
āThereās a high level of interest in our conference of making it part of the final bill,ā Thune added. āI donāt know how Republicans couldnāt be in favor.ā
The amendment, however, could die on the Senate floor due to moderate GOP senatorsā opposition to reducing the federal governmentās contributions to state Medicaid programs, known as the federal medical assistance percentage (FMAP). Scottās proposal notably exempts the existing expansion population on Medicaid rolls.
Trump notably thanked Scott and the cohort of fiscal hawks for ultimately supporting the opening debate on the bill Saturday night. The presidentĀ saidĀ he would work with the group to āREDUCE WASTEFUL SPENDINGā and āENSURE OUR MEDICAID SYSTEM HELPS THOSE WHO TRULY NEED ITā among other priorities, in a statement on the Social Media platform Truth Social.
A majority of the $1.6 trillion in cuts over a decade within the Senateās budget bill come from reducing federal spending on Medicaid and Medicare with the vast majority of savings coming from the former.
āWe are making some commonsense reforms toĀ Medicaid to eliminate waste, fraud, and abuse and protect the program for the people who need it the most,ā Senate Majority Leader John Thune said during a speech on the Senate floor on June 17 that previewed his conferenceās ambitious reforms to the entitlement program.
Senate Republicans areĀ proposing to implement nationwide work requirements for some able-bodied adults on Medicaid and crack down on certain statesā use of provider taxes to collect additional federal Medicaid funding.
Thune has touted these reforms as ācommonsenseā measures to rein in federal Medicaid spending, which is projected to balloon to more than $650 billion in 2025, amounting to a 60% increase between 2019 and 2025. The majority leader has also argued that Medicaid needs to be āstrengthenedā to serve pregnant women, children, seniors and the disabled rather than continuing toĀ expandĀ coverage to able-bodied adults or illegal immigrants ā as some blue states have done.
The majority leader has also repeatedlyĀ madeĀ the case for lowering the ceiling on provider taxes in Medicaid expansion states, arguing the tax maneuver allows states to unfairly leverage more federal dollars to pad state budgets and lets the federal government contribute more dollars for the coverage of able-bodied adults rather than the vulnerable groups Medicaid is intended to serve.
Under Senate Republicansā current proposal, provider taxes would be gradually reduced to 3.5% in Medicaid expansion states starting in 2028 ā a provision that is expected to result in hundreds of billions in savings. A number of moderate GOP senators, including Thom Tillis of North Carolina have voiced deep objections to this proposal, citing billions of dollars in Medicaid funding their states could lose.
Other Medicaid reforms that would yield savings could also be incorporated in the upper chamberās final budget bill, but remain in flux as Senate Parliamentarian Elizabeth MacDonough, an unelected official with outsize influence over the budget reconciliation process, continues to review provisions to ensure compliance with budget rules.
Though MacDonough has signed off on the vast majority of provisions that Democrats have challenged as violating budget rules, several Medicaid-related provisions have been flagged as noncompliant and must be revised to be included in the final package.
These provisions include reducing federal Medicaid contributions to states that offer healthcare to illegal immigrants through state funds and prohibiting illegal immigrantsā access to Medicaid dollars. MacDonough has yet to rule if Republicans can move forward with banning abortion providers, such as Planned Parenthood, from receiving Medicaid funds.
Though Trump has criticized the MacDonoughās influence over the final shape of his bill, he has not explicitly called for her ouster unlike several House and Senate Republicans.
Senate GOP leadership has also gone on the offensive against Democratsā messaging accusing the presidentās landmark bill of āgutting Medicaidā with the imposition of work requirements among other reforms. That proposal would require able-bodied adults including those with children 14 years-old and older to be working, seek work, volunteer or be in school for at least 20 hours a week.
āAn American Enterprise Institute study recently found able-bodied adults on Medicaid who donāt work spend 4.2 hours every day watching TV and playing video games,ā Senate Majority Whip John Barrasso, the number-two ranking Republican, wrote in an op-ed for the Daily Caller News Foundation. āThat is 125 hours per month. They ought to be working ā or at least looking for a job.ā
āSenate Republicans are proposing a responsible path to self-reliance for able-bodied, working-aged people,ā Barrasso added. āNo more taxpayer-funded coddling.ā
The Senateās budget bill also slashes spending on green energy subsidies by accelerating the termination of solar and wind tax credits, which could save hundreds of billions of taxpayer dollars.
The Senateās proposal will have to clear the House before Trump signs the budget bill into law. A number of moderate Republicans in the lower chamber are voicing concern about aggressive spending cuts while members of the conservative House Freedom Caucus are pushing for more deficit reduction.
āFor all cost cutting Republicans, of which I am one, REMEMBER, you still have to get reelected,ā Trump wrote on the social media platform Truth Social Sunday evening. āDonāt go too crazy!ā
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