AP
Senate Majority Leader Mitch McConnell (right) with Sens. John Thune (middle) and Tom Cotton
The Senate parliamentarian on Thursday said a key section of the Republican healthcare plan that would allow states to waive essential health benefits and preexisting condition requirements would require 60 votes to advance.
It joins a growing list of provisions the parliamentarian has released that need the 60 votes, which puts those provisions in jeopardy due to certain Democratic opposition.
That's because of something called the Byrd rule. The Byrd rule was passed in 1985 and says that any bill going through the budget reconciliation process - what Republicans in the Senate hope to do with their healthcare bill - can be blocked on the grounds that it contains an "extraneous matter" or something "merely incidental" to the federal budget.
The budget-reconciliation maneuver through which the GOP hopes to move the Better Care Reconciliation Act allows a bill that adjusts the federal budget to pass through the Senate with a simple 50-vote majority to avoid a filibuster. Any other legislation needs 60 votes to avoid a filibuster, which would be likely from Democrats.
On Thursday, the Senate has continued to debate on a healthcare plan after both a vote on a version of the BCRA and a vote on a repeal-only bill failed. Right now, the conversation has shifted toward a "skinny repeal" bill, which would repeal both the individual and employer mandates and defund Planned Parenthood for a year. Axios reported that the essential health benefits waivers - which is now subject to the Byrd rule - would also be included in the plan. If included, it could put that plan in jeopardy as well.
"The parliamentarian's latest decision reveals once again that Republicans have abused the reconciliation process in an attempt to radically change one-sixth of the American economy by repealing the Affordable Care Act," Sen. Bernie Sanders wrote in a news release.
Here are all the other parts of the BCRA subject to the Byrd Rule
- The BCRA's age tax, which would allow insurers to charge older adults up to five times more than young, healthy adults.
- The small-business provision that would allow businesses to establish plans that could be sold across state lines.
- The plan to defund Planned Parenthood
- A provision that would restrict the use of tax credits for abortions.
- Getting rid of the essential health benefits for Medicaid in 2020.
- How the bill deals with cost-sharing subsidies
- The section that locks individuals out of the insurance marketplace for six months if they don't have continuous coverage.
- The medical loss ratio.
- The provision that allows states that haven't used all of their block grants for health coverage for non-health purposes.
- Changes to the Medicaid waiver system by prioritizing HCBS waivers.
- A provision that requires a report regarding CMS-64 and Transformed Medicaid Statistical Information System data.