Note: The Senate today (July 1) passed the Reconciliation bill. None of the accepted amendments during the vote-a-rama impact the long term care profession, and the bill now returns to the House for consideration. AHCA/NCAL will provide important updates as they are available.
The Senate this weekend released its updated version of the “big, beautiful” budget reconciliation bill. Several important updates are outlined below.
As background, all provisions must meet what’s known as the Byrd Rule to ensure they remain focused on fiscal matters for the legislation to pass with a simple majority rather than the traditional 60 votes in the Senate. Certain provisions in the first draft of the Senate bill did not pass the Byrd Rule, and this new version attempts to fix that while also build consensus among Republican lawmakers.
What’s Included
Medicaid Provider Taxes
The revised language continues to exclude nursing homes and intermediate care facilities from provider tax reductions.
For expansion states, provider taxes are still being reduced from the 6% ceiling to 3.5% by a half percentage point each year. But the implementation of this reduction now starts in FY 2028 instead of FY 2027.
For non-expansion states, existing provider tax arrangements may continue under current thresholds. However, no new taxes may be added after enactment.
Retroactive Coverage
Like the first draft of the Senate bill, retroactive coverage for Medicaid beneficiaries other than expansion new adults is revised to 60 days.
Staffing Mandate
The updated bill now offers a 10-year delay of the federal staffing mandate for nursing homes to pass the Byrd Rule.
What Happens Next
President Trump is pushing for swift action on this bill, and Republicans continue to strive to get the bill to the President’s desk by this Friday, July 4. The Senate worked through the weekend to get through some procedural hurdles, including the vote-a-rama where amendments can be proposed, but are unlikely to change the bill.
Since the Senate’s version is different than the House’s, if it passes, it must go back to the House to be considered once again. With a slim majority in both the House and Senate, it remains to be seen if this new version will ultimately pass.
We will continue to keep you informed as this bill progresses.