Senate Conservatives Push for Amendment to Affordable Care Act in Budget Bill
Fiscal conservatives in the Senate are aiming for a significant change through the One Big Beautiful Bill Act—specifically, a partial repeal of President Barack Obama’s Affordable Care Act.
These fiscal hawks successfully introduced their amendment after pausing their votes on a motion to advance the extensive 10-year budget plan.
Now, nearly ten years after a group of Republicans blocked the repeal of Obamacare, the party finds itself revisiting this pivotal legislation, which received heavy criticism from President Donald Trump during his initial presidential campaign.
“We cannot let Democratic-controlled states misuse YOUR tax dollars to provide Medicaid benefits for illegal immigrants, taking advantage of this safety net and risking support for those truly in need,” tweeted Senator Rick Scott, R-Fla., after securing the concession.
Late Saturday night, the advancement of the 10-year fiscal proposal was at risk as Senators Scott, Mike Lee from Utah, and Cynthia Lummis from Wyoming withheld their votes.
Initially, Senator Ron Johnson, R-Wis., voted “no” on furthering the bill. However, Senate Republican leaders, together with Vice President JD Vance, were able to persuade the four senators by promising a vote on an amendment to reduce the federal government’s contribution to state Medicaid spending.
This deal allowed the bill to move forward with a narrow 51-49 vote, despite Senators Rand Paul, R-Ky., and Thom Tillis, R-N.C., remaining firm against it.
So, what could the proposed amendment achieve if it passes?
According to the Affordable Care Act of 2010, also known as Obamacare, Medicaid eligibility expanded to cover a wider group of individuals, including those above the poverty line and working-age adults without dependents. In states that adopted this expansion, the federal government shoulders 90% of the costs for these new enrollees, compared to an average of 60% for those eligible before the law was enacted.
These funding rates are referred to as federal matching assistance percentages.
The proposed amendment seeks to eliminate the higher funding rate for expansion enrollees starting in 2031. This means that future expansion enrollees would receive the same level of benefits as existing participants in the program.
Meanwhile, those already enrolled in the expansion would continue receiving benefits at the 90% rate.
Scott expressed on social media that his plan to adjust these matching percentages aligns with President Trump’s vision of balancing the budget and prioritizing the needs of Americans. He also extended his gratitude to Senate Finance Committee Chairman Mike Crapo and the other senators for their support in bringing the amendment to the floor.
Despite Scott’s confidence in the amendment’s success, it remains uncertain how pivotal the matching assistance issue will be for Republicans in both the House and Senate.
Some, like Representative Chip Roy, R-Texas, have called for similar reforms, but others, including Representative David Valadao, R-Calif., have warned they will oppose the One Big Beautiful Bill if it alters the House’s handling of Medicaid.
Republicans already faced a setback on Saturday night regarding the Medicaid issue when Tillis cast a “no” vote in response to the bill’s proposed reduction of the state provider tax, a method states use to access more federal funding for healthcare programs.
