Several provisions in the bill to repeal and replace Obamacare, including anti-abortion provisions, may not make it into the final draft next week because they do not meet the requirements of budget reconciliation.
The Senate is advancing the healthcare bill through reconciliation, which requires only a simple majority of votes for passage but also has strict rules attached to it, including that changes to law can apply only to budget items, revenue, and spending. Senate Parliamentarian Elizabeth MacDonough is tasked with advising the chamber as to which provisions follow the rules, and her assessment is likely to affect the bill’s final text.
The bill, the Better Care Reconciliation Act, prohibits tax credits that help people buy private health coverage from going to plans that cover abortions. It also cuts off family planning funding for one year for facilities that also provide abortions, often known as a provision that would “defund Planned Parenthood.”
According to the Senate parliamentarian, the anti-abortion provisions violate reconciliation’s Byrd rule, as does the “six-month lockout” that Republicans planned to use as an alternative to Obamacare’s individual mandate, which requires people to buy health insurance or pay a fine. The provision would require people who do not stay enrolled in coverage to wait six months before enrolling again.
Paying cost-sharing reduction subsidies, which help insurers reduce out-of-pocket costs for customers and would help stabilize the Obamacare exchanges for next year, were also declared against the rules.
A bill would need 60 votes to include the provisions.
Provisions that passed the Byrd rule include work requirements on people who are in Medicaid and a provision to fund healthcare for states that did not expand the Medicaid program to low-income people under Obamacare.
Excluding the anti-abortion provisions could complicate the bill’s passage. Conservatives have long sought to cut off federal funds from Planned Parenthood. Other senators were wary about the provisions, including centrist GOP Sens. Lisa Murkowski of Alaska and Susan Collins of Maine, who have said they are against stripping federal funding from Planned Parenthood. They have not signed on to bills to repeal Obamacare.
“No amount of legislative sleight of hand will change the fact that the primary motivation here is to pursue a social agenda by targeting Planned Parenthood because we provide the full range of reproductive healthcare, including abortion,” Dana Singiser, vice president of Public Policy and Government Affairs for the Planned Parenthood Federation of America, said in a statement. “The bottom line is that it is absurd for anyone to assert that the purpose of this provision is budgetary, when it is plainly clear that this dangerous policy is rooted in a political agenda.”
