(June 26, 2025) - The Senate continues to hurdle toward a vote on the One Big Beautiful Bill even though its final text is currently unsettled. In order to meet President Trump’s deadline of sending a bill to his desk by July 4, Senate GOP leadership intends to bring the bill directly to the floor without going through a committee process. Their hope is to schedule floor time for the bill’s consideration while negotiations continue so that there is a sense of urgency. Once final deals have been made, they will insert the final text as part of a “wrap around” amendment before voting on final passage.
Complicating matters is the fact that the Senate Parliamentarian, Elizabeth MacDonough, has been deeming many provisions of the Senate’s nascent bill as not adhering to rules for reconciliation bills under the Budget Act of 1974. In order for a provision to meet the Budget Act’s standards, it must not make changes to the federal budget that are incidental to the purpose of the provision. In other words, if the Parliamentarian discerns that your goal is to change the Medicaid program rather than save or spend federal dollars as part of such changes, she will deem it ineligible. All provisions deemed ineligible are subject to a budget point of order which can only be waived by a 3/5 majority vote, a sizable majority currently beyond Senate Republicans’ grasp
Earlier today, the Parliamentarian deemed the Senate bill’s provider tax language to be ineligible, or technically speaking, subject to a budget point of order. This means that Senate GOP leadership has three options: 1) strip the language from the bill; 2) change the language to try and make it reconciliation compliant; 3) challenge the Parliamentarian’s ruling, which can be overridden with a majority vote. Option 1 is currently unacceptable to Senate Republicans. Option 3 is fraught with danger because this would set a precedent that all such future points of order can be overridden by a majority vote; this is commonly referred to as the “nuclear option” because it essentially changes the rules permanently.
So, Senate GOP leadership is angling for option 2. The Kansas Hospital Association has been clear that, while not perfect, we prefer the House’s position on provider assessments and state directed payments to the Senate position because it would allow both Kansas’ full provider tax at 6% as approved by the state legislature and our state directed payment program to go forward. The House position has not yet, as far as we know, been tested by the Parliamentarian. All of this could change rapidly, but we have been and continue to work with Senator Jerry Moran’s office on this issue to ensure that the technical language in the bill is favorable to Kansas hospitals. KHA has appreciated Sen. Moran and his staff reaching out to us on the numerous policy issues being considered that may impact Kansas hospitals. We will keep you posted as more information becomes available – stay tuned.