Written by Joseph Macbeth, President/CEO; Gary Blumenthal, Senior Policy Advisor; and Nicole Jorwic, Senior Policy Advisor

The House Reconciliation Act, also called the “One Big Beautiful Bill” by the White House and majority party in the House and Senate, is encountering resistance from a mixture of Senate Democrats and some Senate Republicans whose citizens could lose billions of dollars of health care, human service opportunities and other critical funding that contribute to state budgets.  Meanwhile, many state Governors are concerned that their states would either cut services and supports for people with disabilities, elders and children or significantly raise state taxes.  Obviously, neither option is good.

What’s going on with the Reconciliation Act in the U.S. Senate?

Senate Republicans are pushing a major bill backed by the Trump administration that would create sweeping changes to health care and taxes. As of today, it seems that the bill is running into serious trouble in the Senate.

Why is the bill stuck?

A nonpartisan official in the Senate chamber, known as the parliamentarian, has ruled that several parts of the bill break long-established Senate rules. When that happens, those parts of the bill will need 60 votes to remain in the bill – instead of the simple majority (51 votes) that the rest of the bill requires.

That’s a huge problem for Republicans, who don’t have 60 votes in the Senate. Some major sections of the bill are likely to be removed or rewritten. If not, the bill could fail.

The White House and Congressional Republicans are pulling out every possible option to make their tax cut happen.  While Democrats are throwing in every possible objection to defend Medicaid, Medicare and human services.

The parliamentarian ruled that the following parts of the bill would need 60 votes to pass, and the Democrats could mount a filibuster – meaning they could prevent the bill from being acted on as they threaten to give endless speeches that might result in the bill never getting to a final vote. Below are the parts of the bill that are in most in trouble and ruled out of order by the non-partisan Parliamentarian:

• Provider Tax Limits: This provision would take away the power of states to raise local taxes on hospitals and health care providers to fund Medicaid. This provision was ruled out of order and will now need to be rewritten or abandoned.  The hospital lobby is strongly opposing this provision.
• Gender-Affirming Care Ban: This provision would prevent Medicaid and CHIP from covering gender-affirming health care. This is also out of order per the Parliamentarian and could be rewritten or dropped.  This provision is a priority for many Republican Members of Congress and is frequently discussed on cable news. The reality is that this is a rare medical procedure for people born with gender dysphoria.
• Immigrant Health Coverage Limits: Denying Medicaid and CHIP to certain immigrants contradicting that we all were once immigrants.
• More Provisions Are Still Being Debated before the Parliamentarian, where the outcome remains unclear including:
  • Repealing nursing home staffing rules.
  • Cutting Medicaid coverage for people with disabilities, kids and seniors.
  • Defunding Planned Parenthood.
  • Undoing ACA premium financial help for over 1 million people.

• Republicans are trying to rewrite the parts of the bill that were ruled out.
• Democrats will keep challenging anything they believe violates the rules or hurts ordinary people.
• We believe that the bill is far from being finalized, and anything can happen.  It’s a longshot but the Reconciliation Act could be further weakened to the point that it is impossible to enact.

• Opposition to the bill appears to be growing.

Here’s What You Can Do?

• Do not Give Up.
• Call, visit and write your US Senators.
• When communicating with legislative staff:
  • Speak calmy and do not yell
  • Be polite and respectfully tell them how much danger people with disabilities are in, how their families will be impacted, how millions of jobs will be lost, how state budgets will be overwhelmed, and how people’s lives are at stake.
• Every conversation matters. Alert your friends, family, newspapers, TV stations, social media connections and anyone you can reach to call their Senator NOW, tomorrow and every day until the bill is hopefully defeated.

We have a real chance to defeat the bill if everyone pitches in.