Parliamentarian’s wrench into ‘big, beautiful’ bill might spare Minnesota some Medicaid cuts

WASHINGTON The Senate Parliamentarian dealt a serious blow to the U S Senate s big beautiful bill on Thursday a move that threatens President Trump s economic agenda and spares Minnesota from particular of the steep Medicaid cuts that would have cost the state hundreds of millions of dollars The bill is being considered under the reconciliation process which bars the use of a filibuster but must be subject to the Byrd Rule which prevents the inclusion of extraneous provisions including those that don t directly affect spending or revenue and those that make major increases to the deficit John Connolly deputy commissioner of the Minnesota Department of Human Services and state Medicaid director was cautious about the rulings made by Senate Parliamentarian Elizabeth MacDonough who specific angry GOP lawmakers demand to be fired At this point we aren t sure about those provisions Connolly noted of MacDonough s rulings during a virtual press conference on Thursday A major impact of the parliamentarian s ruling on Minnesota is the tossing of a provision that would cap the Medicaid provider tax for states that have expanded Medicaid under the Affordable Care Act Majority of states including Minnesota charge extra taxes to anatomical providers and in return give them higher Medicaid payments Since the cost of the Medicaid operation known as Diagnostic Assistance in Minnesota is shared between the state and federal leadership those enhanced payments bring more federal matching funds to Minnesota Minnesota s provider tax is low at But to shore up finances in rural hospitals and other Medicaid-dependent hospitals in the state the newly adopted state budget would raise that tax to on participating hospitals The state hoped to extract an additional billion a year from the federal executive for their plan which must be approved by the Centers for Medicare Medicaid Services CMS but the Senate bill would cap provider taxes at The parliamentarian ruled that the cap violated the Byrd Rule But the provision has already run into political trouble as several Senate Republicans have voiced deep concern about the provider tax cap s impact on their rural hospitals House Majority Leader John Thune stated reporters on Thursday that Republicans might not get everything we want on the provider tax but will hopefully salvage majority of of the Medicaid reforms in the bill Those reforms center on new work requirements increased out-of-pocket payments for various Medicaid recipients and other changes in the administration wellbeing campaign for the poor that is expected to decrease enrollment In this file photo demonstrators protest outside the office of Sen Bill Cassidy R-La regarding the proposed cuts to Medicaid on Capitol Hill in Washington Wednesday June Credit AP file Photo Jose Luis Magana Connolly announced his department will rush the proposed increase in the provider tax to CMS so it would be considered under current Medicaid rules It will be considered in alignment with federal rules at the time he stated Republican leaders in the House and Senate were relying on the provider tax change and other wellbeing care restrictions to save billions of dollars to offset the cost of trillions of dollars in tax cuts in the mega bill Those tax cuts would make permanent a package of tax breaks Trump pushed through Congress in his first term that are expiring at the end of the year Another boost to the state was parliamentarian s rejection of the Senate bill s proposal which was also included in the House reconciliation bill aimed at punishing states that offered undocumented immigrants medical care services That provision would cut the federal Medicaid reimbursement rate Minnesota receives from the federal administration from to for those covered under the ACA s Medicaid expansion Since undocumented immigrants are barred from the Medicaid operation unless they have temporary protected status or another form of permission to live in the United States states like Minnesota pay for their wellness care out of state funds So the provision was considered more of a punishment not a improvement Minnesota has just now eliminated the eligibility of undocumented adults from MinnesotaCare but the state continues to provide state-funded fitness care to undocumented children Connolly predicted that the change in the reimbursement rate would cost the state million a year in lost Medicaid revenue But MacDonough s decision the provision did not pass the Byrd rule means that may no longer happen Democrats rejoiced at MacDonough s decision saying her ruling has blown a billion hole in the budget reconciliation bill s savings I think their best option at this point is to just scrap the whole thing mentioned Sen Tina Smith D-Minn in a post on X MacDonough has not yet ruled on all parts of the bill Still undecided is whether the bill s defunding of Planned Parenthood will pass the Byrd Rule and the tax breaks that are at the heart of Trump s agenda are still under review Obliterated or not A big debate in Washington D C this week concerned how much damage last weekend s air strikes on Iran s nuclear facilities have incurred At a Thursday press conference Secretary of Defense Pete Hegseth continued to parrot President Donald Trump s assertion that the massive air strikes have ended Iran s nuclear ambitions Hegseth a Minnesota native and former Fox News show host also derided media outlets that cited initial intelligence reports that the strikes failed to destroy key enrichment facilities and that those facilities could resume operation within months Hegseth and Chairman of the Joint Chiefs of Staff Gen Dan Caine based their assessment on AI modeling of test videos of the bunker bombs used in the strikes Hegseth also reported the intelligence reports were leaked because someone had an agenda to try to muddy the waters and make it look like this historic strike wasn t prosperous Hegseth declined to answer questions about reports that Iran had removed its store of uranium from one of those sites Trump at a news conference during a NATO meeting in the Hague on Wednesday revealed it would have been too arduous for Iran to do so In other news Reporter Matthew Blake wrote about the state Legislature s failure to approve new University of Minnesota regents which caused a bit of a dustup because several regent decisions have created disagreement Responsibility now falls to Gov Tim Walz who will select four interim regents Reporter Brian Arola has a story about an million boon to the state s rural drinking and wastewater projects And we wrote about how Minnesota s inability to keep records of gun sales meant that state personnel were likely unaware of Vance Boelter s arsenal This and that A reader questioned reports that the wife of alleged shooter Vance Boelter says she knew nothing of any plans to go on a murderous rampage targeting Democratic lawmakers It has been shared that his wife was stopped leaving the area in a motorcycle with guns and in cash the reader wrote Was his large cache of guns something she was unaware of Did she purchase any of the family s weapons and ammunition She disclosed a announcement denying knowledge and responsibility and has revealed she will have no further report I hope the administration are considering her involvement Please keep your comments and any questions coming I ll try my best to respond Please contact me at aradelat minnpost com The post Parliamentarian s wrench into big beautiful bill might spare Minnesota chosen Medicaid cuts appeared first on MinnPost