Due to the Juneteenth holiday this week, it was a short legislative week for Congress. But there was still sausage-making, particularly on reconciliation.

Reconciliation

Monday evening, Senate Finance Committee Chair Crapo (R-ID) released the legislative text of the Finance Committee portion of the reconciliation bill. The Senate version of the bill will set up a major confrontation with the House. The press  statement, text, section-by-section summary, bill overview and 2025 tax reform landing page can be found here.

There are a few notable differences pertaining to Medicaid between the House-passed bill and the Senate Finance Committee bill. First, on provider caps, the Senate bill caps provider taxes at 3.5 percent by 2031, down from the current 6 percent, but only for the states that expanded Medicaid under the Affordable Care Act. The cap would be phased in by lowering it 0.5 percent annually, starting in 2027. Non-expansion states would be prohibited from imposing new taxes, but their rates would be frozen at current levels (same as the House). The lower cap would not apply to nursing homes or intermediate care facilities. The Senate bill also cuts certain existing state-directed payments to hospitals, which would be a significant hit to the hospitals’ bottom line. The House version in contrast limited future payments but grandfathered existing arrangements.

Second, the Senate bill also proposes more stringent work requirements for Medicaid eligibility. Like the House bill, the Senate’s bill would imposes work requirements on Medicaid beneficiaries beginning at 19 years old. But the Senate version says adults with dependent children older than 14 will also have to prove they work, attend school, or perform community service for 80 hours a month, while the House-passed version would exempt all adults with dependent children.

There is expected to be a vote on the reconciliation bill in the Senate next week. If the Senate passes a reconciliation bill that is different from the House, the bill would need to go back to the House for passage before it is sent to the President—which could be quite a confrontation. (Remember the House’s reconciliation bill passed by only one vote, after two members voted “present.”) And…next week is the last week that Congress is currently scheduled to be in session before their self-imposed deadline for completing reconciliation of the 4^th of July.

Allocation of Funds by the Administration

House Appropriations Committee Ranking Member Rosa DeLauro (D-CT-03) issued a statement on the two legal decisions released yesterday by the non-partisan GAO reaffirming that the President does not have the authority to unilaterally freeze enacted appropriations. DeLauro’s statement and more information on the GAO decisions can be found here.

Next week will be a very busy week for federal policy. And if you want to be kept up to date on the ins and outs of this process, and other federal policy changes, please join PriorityONE!