Senate Republicans clash over Medicaid changes in Trump’s tax package

Senate Republicans are making progress in advancing President Donald Trump’s “big, beautiful bill,” but there are some concerns over key provisions in the package. The Senate Finance Committee recently unveiled its portion of the budget reconciliation package, which includes making the president’s first-term tax cuts permanent and proposed changes to Medicaid, niche tax issues, and Biden-era green energy subsidies.

During a closed-door meeting, Senate Republicans received a briefing on the bill, with some expressing dissatisfaction over certain provisions. Senate Majority Leader John Thune is facing pressure as he can only afford to lose three votes in the Senate, and Democrats are unlikely to support the package without significant changes.

One of the most contentious issues is the changes to the Medicaid provider tax rate, which some Republicans fear could negatively impact rural hospitals and Medicaid beneficiaries. Senator Lisa Murkowski expressed her concerns, stating that she is not satisfied with the current Medicaid provisions in the bill.

The Senate Finance Committee’s version of the bill includes a provision that lowers the Medicaid provider tax rate in expansion states annually until it reaches 3.5 percent. This move is intended to help pay for the overall bill and discourage states from opting into Medicaid expansion. However, Senator Josh Hawley argued that this could harm rural hospitals in states like Missouri.

Additionally, the Senate’s tax package provides more flexibility for green energy tax credits compared to the House version. Some Senate Republicans pushed for a slower phase-out of these credits, which was included in the final bill.

Senate Republicans met with Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz to discuss the Medicaid changes in the bill. Dr. Oz defended the changes, stating that they would not affect hospitals’ viability. However, some lawmakers remain skeptical and are seeking further clarification on the impact of these changes.

Despite the disagreements within the Senate Republican caucus, Senate Finance Committee Chair Mike Crapo assured that they are working to address concerns and reach a consensus. Fiscal hawks like Senator Ron Johnson are advocating for significant spending cuts, while others believe that the current package falls short of addressing the current economic challenges.

As discussions continue, Senate leaders are aiming to resolve these issues before the self-imposed July 4 deadline. It remains to be seen how the final version of the bill will address the concerns raised by Senate Republicans and whether it will garner enough support to pass both chambers of Congress.