The Senate parliamentarian blocks Medicaid changes in Trump’s bill, a blow to the Republican party

The Senate rule executor gave a great blow to the Senate Republicans on Thursday morning by ruling out a key provision of Medicaid in the Megabill that advances the legislative agenda of President Donald Trump is out of service.

The Senate parliamentarian, Elizabeth MacDonough, discovered that a provision that is into account in the use of the states of the medical care provider by the states to help raise additional funds from Medicaid does not agree with the rules that govern a package such as the “Big Big Beaut bill law”, that senators are making changes as republicans work to comply with the bottom of the quarter Julio Trump’s passage deadline.

Macdonough’s failure means that Senate Republicans will need to reorganize the provision or discard it completely if they want to advance when trying to approve the bill using only republican votes.

The ruling is a great setback for republican leadership, which is under pressure to quickly move to the Senate floor to meet the deadline of July. This ruling will require potentially important reworkings of the bill with relatively little time to achieve them. And it does not matter how they change it, the leaders will like some faction of the Republican Conference, which could promote the approval of the bill.

The provider’s fiscal credit provisions had been emerging as a thorn on the leadership side even before the MacDonough ruling.

For days, a small but critical faction of the Conference of the Republican Party of the Senate has been increasing the main flags about the way in which this cut to the income of the medicality of the states could beat the rural hospitals in their states. Several Republicans in the Senate threatened to retain their votes for the package due to these changes in the supplier tax, so for that group, Macdonough’s failure is probably welcome.

But the changes in the provider’s tax rate were one of the main ways in which the Republicans planned to reform Medicaid and reduce costs. Getting off this provision will increase the cost of the package and risk bothering several conservative Republicans, or will force the Senate Republicans to return to the drawing board to find another way to reduce costs.

If changes are made, all eyes will be in a handful of Senate Republicans. Some changes could be the business factors for those whose vote is critical to move the bill on the finish line.

Last weekend, Macdonough carefully examined the bill of the house for possible violations of the Senate rules. She has already issued a series of decisions that Democrats are promoting as important victories.

This review, called Byrd Bath, who is named after the late Senator Robert Byrd, who helped institute the rules governing the budget reconciliation packages, is still underway in the Senate.

Any willingness that Macdonough returns out of order with the rules of the Senate must be stripped or otherwise the legislation will be subject to the threshold of 60 votes in the Senate. Republicans should avoid this, or may not approve the bill.

There are already shouts of some Republicans so that the leader of the majority John Thune leads the Senate in a vote to annul the parliamentarian. The Senate can technically cancel MacDonough with a simple majority of the votes. But Thune has long said he will not annul it because he has promised not to touch the rules of the Senate’s filibuster.

It is not yet clear if this ruling will force a greater delay in the efforts by the leadership to obtain a great law of Big Beauty bill to the Senate at the end of this week or during the weekend.