Tax and Healthcare Bill in Congress

By Bo Erickson, David Morgan, and Andy Sullivan
WASHINGTON (Reuters) – Republicans in the U.S. Congress scrambled on Thursday to resolve complicated tax and health care provisions in their comprehensive tax-cut and spending bill as President Donald Trump urged them to pass it by a July 4 deadline.

Trump aims to promote the package—which nonpartisan analysts estimate will add approximately $3 trillion to the federal government’s $36.2 trillion debt—at a midday White House event featuring truck drivers, firefighters, ranchers, and other workers who the administration claims would benefit from the bill.

Senate Republicans have yet to produce their version of the legislation before a possible weekend vote, and the overall shape of the bill appeared more uncertain after a nonpartisan referee ruled that several healthcare provisions violated the complex process Republicans are invoking to bypass Democratic opposition.

Democratic Senator Ron Wyden from Oregon stated that these elements collectively represented over $250 billion in health care cuts. Democrats oppose the bill, criticizing it as a wasteful giveaway to the wealthiest Americans.

Senate Republicans have spent recent weeks revising a bill that narrowly passed the House of Representatives last month. The nonpartisan Congressional Budget Office reported that the House version could add $2.8 trillion to the debt over the next decade and rise to $3.4 trillion when factoring in interest expenses.

Uncertainty prevailed on Thursday regarding whether Republicans could amend the bill to comply with the complex budget rules or attempt to override the decision made by the Senate parliamentarian. Senator Rick Scott, a Florida Republican, remarked, “It’s pretty frustrating. But what we need to do is work through this process.”

A source familiar with the matter suggested that Senate Republicans still had a way forward, describing the July 4 deadline as attainable. The bill encapsulates much of Trump’s domestic agenda, extending his 2017 tax cuts, enhancing immigration enforcement, and cutting green-energy incentives while tightening food and health safety-net programs. Analysts say the bill would effectively transfer wealth from younger Americans to the elderly.

DEBT DEADLINE AHEAD
Trump has urged Republicans to pass the bill by the July 4 Independence Day holiday, yet lawmakers face a more pressing deadline later this summer when they need to raise their self-imposed debt ceiling or risk a catastrophic default.

Republicans controlling both chambers of Congress generally support the package but can afford to lose no more than three votes in either chamber. Disagreements over various provisions linger—especially concerning a proposed tax break for state and local tax payments and a tax instigated by health care providers that some states utilize to enhance the federal government’s Medicaid funding.

The bill intends to restrict those “provider taxes,” which nonpartisan watchdogs highlight as an accounting trick that escalates Medicaid costs. Rural hospitals and health providers warn that these cuts could compel them to reduce operations or face closure, with some Senate Republicans seeking to mitigate this provision.

The provider tax is among several health and education provisions disregarded by the Senate parliamentarian, adding to the uncertainty surrounding its status. Senator Josh Hawley of Missouri remarked, “This would be a chance to get it right and to protect rural hospitals.”

The parliamentarian also flagged provisions that would deny student aid and Medicaid health coverage to certain immigrants and prohibit Medicaid funding for transgender medical care.

Lawmakers established decades ago that the Senate parliamentarian, currently Elizabeth MacDonough, would possess the authority to determine which policies can be enacted through “budget reconciliation,” the process Republicans now employ to bypass the 60-vote filibuster rule.

Republican Senator Tommy Tuberville of Alabama suggested that she should be dismissed, tweeting, “Her job is not to push a woke agenda.” However, others, including Senate Republican Leader John Thune, have stated they will not overturn her decisions.