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The Senate narrowly adopted a massive bill for taxation and internal policy on Tuesday which would likely lead to millions of beneficiaries of the Medicaid security insurance program.
The adoption of legislation – a major priority by President Donald Trump – is a success for the Republicans, who have dodged a certain number of policies and political obstacles to bring the bill to the finish line.
However, it was a battle to happen. The Senate has gone through a “Voting-a-rama“, Where Democrats have introduced a number of amendments urging legislators to reconsider Medicaid cups or stimulate support for rural hospitals, which began on Monday and were spent on Tuesday noon.
The bill finally adopted 51-50, after three Republicans, meaning. Rand Paul de Kentucky, Thom Tillis de Caroline du Nord and Susan Collins du Maine, joined the Democrats to vote against the package. Vice-president JD Vance expressed shooting vote. A similar rise battle can be in advance when the bill returns home.
Legislation includes several health care plans. Many of them focus on Medicaid and have become some of the most debated provisions.
In particular, many beneficiaries of adults in security security insurance should record a minimum of 80 hours of work, volunteering or hours of training per month to stay covered. States would also be required to check the eligibility of beneficiaries in Medicaid more frequently and to implement costs sharing for certain services provided to high income registrants.
In addition, the bill would freeze taxes on providers – arrangements that states use to finance their share of funding from Medicaid – in states that have not extended Medicaid, and gradually lower the authorized rates in the expansion states. It is a more aggressive policy than that offered in the House and was a point of collision for certain senators until Monday evening, which feared that the rural hospitals of their district could not survive the financial ramifications.
In an effort to wake people on the closure, legislators added a 25 billion dollars fund to help rural package hospitals. Late Monday evening, Collins proposed to double this amount in vain.
“I am happy that the bill contains a special fund that I proposed to provide some help to our rural hospitals, but it is not enough to compensate for other changes in the Medicaid system,” said Collins on X after the vote.
In total, reconciliation legislation would increase the number of people not insured by 11.8 million people in 2034, according to an estimate published on Saturday by the Congressional Budget Office. This would also increase the country’s budget deficit by $ 3.3 billions of dollars over the next decade.
The Senate bill reduces Medicaid more strongly than the proposal of the lower chamber – 100 billion dollars more due to the restrictions on the taxes on providers and the payments led by the State which allow the States to strengthen the financing of MEDICAID suppliers, according to an analysis of Manatt Health. Some House Republicans have raised concerns about the text of the Senate, arguing that Medicaid cuts are too steep.
The legislation also reduces the funding of Medicaid for one year for major abortion suppliers, limits the way Medicaid funds can be used to treat legal migrants and ceilings how much federal money states can receive if they use their own funds to provide health care to undocumented persons.
The Senate has also made changes to health insurance, in particular to prohibit most immigrants from receiving services and deleting a provision which would equalize the reimbursement rates of doctors to a measure of inflation.
The bill has also faced many challenges in the upper room. GOP senators worked throughout the weekend in order to obtain the legislation on reconciliation towards Trump’s office by July 4, reworking parts of their proposal aimed at appeasing the Senate parliamentarian and convincing the skeptical legislators about the deep cups of Medicaid.
Democratic legislators firmly oppose the bill, arguing that it preserves the tax reductions that benefit the richest Americans while reducing funds for Medicaid and food assistance.
“It is the largest Medicaid cup in history and represents the greatest transfer of wealth in history,” said Senator Ron Wyden, D-ear on Monday. “It is caviar on children, hedge funds on health care, Mar-A-Lago on the middle class.”
The health sector was frank on the possible impacts of legislation. Hospitals argue that Medicaid cuts will increase their unpaid care burden as a number of uninsured climbs, hitting their results and forcing them to reduce services.
“We are deeply disappointed by today’s vote in the American Senate,” the CEO of the American Hospital Rick Pollack said on Tuesday. “The actual consequences of these nearly 1 dollars billion in Medicaid reductions – the greatest ever proposed by the congress – will lead to irreparable damage to our health system, which reduces access to care to all Americans and seriously undergo the capacity of hospitals and health systems to take care of our most vulnerable patients.”
The CEO warned that hospitals could see longer waiting times and may have to reduce staff or close completely, especially in rural areas.
Now the bill will return to the House to obtain approval. The version of the Senate is likely to deal with the challenges of certain conservative members who believe that the bill did not go far enough to reduce costs.
“The version of the Senate adds $ 651 billion to the deficit – and it is before the costs of interest, which doubles the total,” the Caucus said in a statement on Monday, “this is not the tax responsibility. This is not what we agreed.”
