Budget Reconciliation Process Continues with Senate Consideration of Revised House Resolution

On April 5, the Senate voted 51-48 to pass a modified version of the House-passed budget resolution with reduced deficit reduction targets for Senate committees as compared to the House. Specific to health care, the revised Senate resolution instructs the Senate Finance Committee (SFC), which has jurisdiction over Medicaid, to propose changes that will increase the deficit by no more than $1.5 trillion, but does not provide a target number for potential cuts.

The revised resolution maintains the cuts for House committees, including instructions to the Energy and Commerce Committee (E&C), which also has jurisdiction over Medicaid, to find at least $880 billion in savings over the next 10 years. In effect, if this version of the resolution passes both chambers, this gives Senate committees much more flexibility to roll back potential cuts that may be considered by the House, including potential Medicaid cuts. House Speaker Mike Johnson (R-LA) has stated large Medicaid program cuts, such as per capita caps and changes to the Federal Medical Assistance Percentage (FMAP), are no longer under consideration.

While there is no clarity into proposals being considered for cuts, a partial or full repeal of regulations promulgated by the Biden Administration including the nursing home staffing rule, the Medicaid/CHIP ACCESS rule, and the Medicaid Eligibility rule, could be on the table. The next step in the process is for the House to pass the revised resolution, which may be difficult given conservatives’ skepticism of the lack of certainty around budget cuts.