Senate Majority Leader John Thune (R-S.D.) is vigorously working to counter his Republican colleagues who are looking to drastically reduce Medicaid funding by hundreds of billions of dollars. He aims to push the bill for a vote in the coming week.
Thune faces pressure to expedite legislative processes as Congress approaches the July 4 deadline to pass the bill.
One Republican senator has expressed concerns over new constraints that would limit states’ abilities to utilize healthcare provider taxes to generate additional federal Medicaid funding. This senator is collaborating with Thune on a potential proposal meant to assist rural hospitals that could be at risk of closure.
The senator, along with Thune and Senate Committee Chairman Mike Crapo (R-Idaho), is discussing various provisions related to Medicaid jobs and eligibility criteria.
They are also addressing worries that the Senate’s legislation might shift a significant amount of Medicaid costs to states and low-income citizens.
Thune told reporters, “We’re exploring solutions, though I can’t go into specifics just yet. We’re just discussing some possible options.”
A source familiar with the discussions indicated that Senate GOP leaders and those reluctant to support the bill are looking to strike a deal that would allocate financial backing directly to rural hospitals, particularly if the current iteration of the bill moves forward.
Senator Susan Collins (R-Maine) expressed her support for including relief funds for rural hospitals, nursing homes, and community health centers. She has frequently voiced her concerns about the potential devastating effects on rural hospitals in Maine if states are restricted in raising additional federal funds through healthcare provider taxes.
GOP senators maintain that Thune is under significant pressure to swiftly close the gap with Senate Republicans before Trump’s July 4 deadline.
White House Chief of Staff Susie Wills urged Republican senators during lunch on Wednesday to adhere to Trump’s timeline.
Senator Kevin Cramer (R-N.D.) mentioned his aim to bring the bill to the floor by the end of Wednesday, suggesting that he expects every concession during negotiations concerning Medicaid spending cuts.
He remarked, “There’s still a chance to find a workable solution. Sometimes things fall into place once you start putting them on the floor.”
Cramer added that Wills encouraged GOP senators to finalize the discussions promptly.
Senator Josh Hawley (R-Mo.) criticized the Senate bill for its significant cuts to rural hospitals. He has provided several suggestions to Senate leaders to safeguard funding for his hometown hospital.
“Rural hospitals shouldn’t lose funding just to subsidize other initiatives,” Hawley argued. “If you want to fund your project, find the money elsewhere rather than diverting funds from rural hospitals.”
Senator Lisa Murkowski (R-Alaska) believes talks are progressing positively. She noted, “There are still numerous variables at play,” but recent discussions seem more promising.
Murkowski pointed out that, from an Alaskan perspective, things seem to be improving slightly. Alaska is unique in that it does not utilize provider taxes to acquire additional federal Medicaid funding, but any changes to Medicaid eligibility could still adversely affect small and rural hospitals.
“For many small hospitals, Medicaid serves as a primary payer. Losing coverage for certain individuals would undoubtedly have consequences for them,” Murkowski stated.
“We’ve made positive strides,” she added regarding her discussions with GOP leaders.
While Murkowski doesn’t oppose work requirements for Medicaid benefits, she is apprehensive about implementing extensive statewide work requirements swiftly.
She said, “It’s a structural issue in our Medicaid system that doesn’t necessitate work – our documentation hinges on that. It’s a significant challenge for us.”
Thune must address concerns from Murkowski and other GOP senators about modifications to the Supplemental Nutrition Assistance Program (SNAP), another financial component related to the bill meant to mitigate new tax cuts.
The Senate bill proposes cuts to federal SNAP funding for states but also offers a chance to offset those cuts by improving error rates in benefit distribution. States with high error rates would be required to cover a portion of federal food aid costs.
Thune also touched upon ongoing discussions with Republican colleagues worried about a timeline for phasing out tax credits for various renewable energy sources.
“That issue remains unresolved,” he indicated.
Senator Shelley Moore Capito (R-W.Va.) expressed dissatisfaction with bill language that abruptly eliminates tax credits for clean hydrogen production facilities not under construction by year’s end.
Capito has raised her concerns with Crapo, the finance committee chair.
The Senate bill is seen as beneficial for nuclear, geothermal, and hydroelectric energy tax credits extending through the 2030s, which is particularly favorable for Senator Tom Tillis (R-N.C.), whose home state is considering a new nuclear power plant.
Tillis remarked, “I have inquiries regarding the renewable energy tax credits.”
