/>iReconciliation Byrd Rulings and Potential Floor Vote
This week will be busy as Republicans race to try to get the reconciliation package to President Trump’s desk by July 4. Last week, the Senate Finance Committee, which has jurisdiction over the most provisions of the package, including Medicaid, the Affordable Care Act, and taxes, released its version of text. The Finance Committee made substantive changes to key House-passed Medicaid and tax policies and has been met with criticism by multiple Republican Senators, such as Sen. Hawley (R-MO), along with moderate House Republicans who oppose certain tax policy changes.
Senate and House passage will be an uphill battle, but the current package is already changing as negotiations for votes and the Byrd rule process continue. Due to concerns over the Medicaid provider tax policy modified by the Senate, Senate Republicans are floating the idea of adding a rural hospital fund to help those hospitals financially and try to then win the support of concerned senators. Other policies put forth in the Senate Finance package may have been placeholders to gauge support and may continue to change as well.
The Senate parliamentarian has already ruled that certain provisions, including some related to the Supplemental Nutrition Assistance Program, do not comply with the Byrd rule and must be struck to allow for Senate passage by a simple majority. Some of the struck provisions were major savers and could cause Republicans to add or modify policies to fill those gaps. We also await a Congressional Budget Office (CBO) score of the Senate bill. The parliamentarian is expected to rule on health provisions as early as Monday. It is anticipated that the Senate will release an updated package after the Byrd process concludes and before a Senate floor vote, scheduled for later this week. That vote could get pushed back if there is continued opposition from more than three Republican senators, since that is the most they can lose on the floor vote. If the Senate vote is pushed back, the timeline of getting the bill to President Trump by July 4 could also get pushed back, as the House needs to pass the Senate-passed bill as well. As of now, both chambers are scheduled to be out of session next week.
Amid all this Senate action, the House will consider several health bills on the floor under suspension of the rules today. They include H.R. 1082, the Shandra Eisenga Human Cell and Tissue Product Safety Act, which would require HHS to increase awareness of the potential risks and benefits of human cell and tissue transplants, and H.R. 1520, the Charlotte Woodward Organ Transplant Discrimination Prevention Act, which would prohibit providers from denying an organ transplant based solely on an individual’s disability. Both bills passed out of the Energy and Commerce Committee earlier this year with bipartisan support.
There will also be action at the committee level this week, with significant House and Senate hearings. The Senate Health, Education, Labor, and Pensions Committee will consider the nomination of Susan Monarez, PhD to be Centers for Disease Control and Prevention (CDC) director. She is currently acting CDC director and was nominated to officially serve as director after the White House abruptly withdrew the nomination of former Representative Dave Weldon, MD. US Department of Health and Human Services (HHS) Secretary Kennedy will testify at the House Energy and Commerce Committee on the fiscal year (FY) 2026 budget request, where attention will likely also focus on how the agency is or is not spending FY 2025 appropriated funds and on vaccine policy.
Today’s Podcast
In this week’s Healthcare Preview, Debbie Curtis and Rodney Whitlock join Julia Grabo to discuss where the Senate is on reconciliation ahead of the quickly approaching, self-imposed July 4th deadline.
