Reconciliation Update: Senate Finance Committee Releases Their Version
Late on Monday, the chair of the Senate Finance Committee released their portion of the “big, beautiful” budget reconciliation bill. Since Senate Finance oversees Medicaid and Medicare, this is where our focus has been over the past few weeks, after the House passed their version of bill right before Memorial Day.
As we have shared previously, the Senate often likes to do its own thing, as we’re seeing in the release of this draft text. The good news for long term care is that Senate Republicans recognize the vulnerabilities of the population we serve and are attempting to insulate us from any Medicaid reductions.
What’s In Senate Finance’s Version
Medicaid Provider Taxes
Senate Finance is proposing some changes for states that did or did not expand Medicaid (see if your state is an expansion state):
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Non-expansion states: a freeze on current provider taxes, like the House passed.
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Expansion states: a phased reduction of the hold harmless threshold by 0.5% annually starting in 2027. This phased reduction would continue for five years through 2031 until the threshold reaches 3.5%. However, there is a carve out for nursing homes and intermediate care facilities. These provider classes are exempt from the phased reduction to 3.5%.
Retroactive Coverage
Current law affords retroactive coverage for three months prior to the approval of an entered application. Senate Finance language proposes 60 days for all categories of eligibility other than expansion new adults. Compared to House language, which reduced retroactive coverage to 30 days, this represents a step in the right direction and an invitation to ongoing dialogue.
Staffing Mandate
Senate Finance includes a permanent repeal of the staffing mandate.
What Happens Next
There are many other provisions in this draft legislation, and we are continuing to comb through the language and potential implications. But this is progress for the sector.
In terms of process, once Senate Republicans coalesce around language, they will proceed directly to the Senate floor for consideration of all pieces of the legislation. They want to achieve this by the Fourth of July. If the Senate’s version is different than the House’s, then it must go back to the House to be considered once again.
So yet again, there are a lot of changes that can happen between now and then. But the next couple of weeks are critical, and we are remaining vigilant at every step of the legislative process. This week, we are hosting our Council for Post-Acute Care meeting in Washington, D.C., so the timing is perfect to keep the pressure on lawmakers.
How You Can Help: Contact Your Senators
Just last week, a record 700 of you came to D.C. to lobby your members of Congress directly. Thank you for making AHCA/NCAL’s Congressional Briefing such a tremendous success! But we can’t let up.
Now is the perfect time to reach back out to your senators, especially if they are Republicans. Call or email, and tell them to protect Medicaid for seniors, including provider taxes. If it’s right to do so, thank them for their efforts.
Collectively, we are making an impact. And today, we’re seeing some of the results. Let’s continue to keep up the fight and win this for our residents.
Clifton J. Porter, II
President & CEO, AHCA/NCAL
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