‘Deeply harmful’ Medicaid cuts still in ‘big beautiful’ bill after parliamentarian ruling, expert says

Some Medicaid cuts posed in Republicans' "big beautiful" bill have been rejected by the Senate parliamentarian for inclusion in the legislation

Yet other parts of the posed Medicaid cuts — including new work requirements of 80 hours per month and more frequent redetermination evaluations every six months — were not questioned by the Senate referee

The Senate bill is "deeply harmful" to the gram, regardless of whether the visions identified by the parliamentarian stay in or out, said Allison Orris, senior fellow and director of Medicaid policy at the Center on Budget and Policy Priorities

An inflated pig with the message "Medicaid Is Not A Piggy Bank For Billionaires" is stationed at a rally opposing House Republicans Tax posal prior to the final House Vote on Capitol Hill on May 21, 2025 in Washington, D

Jemal Countess | Getty Images Entertainment | Getty ImagesWhile some Medicaid cuts posed in Republicans' One Big Beautiful Bill Act were rejected by the Senate parliamentarian on Thursday, other reforms to the gram that could affect individuals' access to coverage were left untouched

The Senate parliamentarian rejected posed changes aimed at capping states' vider taxes, which are used to help fund states' Medicaid expenditures

The Senate vision reduces the safe harbor limit in expansion states and puts a moratorium on any new vider taxes in all states

Yet other parts of the posed Medicaid cuts — including new work requirements of 80 hours per month and more frequent redetermination evaluations every six months — made it past the Senate referee. "The Senate bill, the House bill, includes deep cuts to Medicaid and other health grams, and is deeply harmful, whether or not these visions stay in or out," said Allison Orris, senior fellow and director of Medicaid policy at the Center on Budget and Policy Priorities

More from Personal Finance:'Big beautiful' bill poses new federal Medicaid work requirementsHealth-care cuts in GOP budget bill mpt medical debt: ReportSenate version of 'big beautiful' bill includes $6,000 senior bonusThe House version of the One Big Beautiful Bill Act would reduce federal Medicaid spending by almost $800 billion, according to estimates from the Congressional Budget Office

Republican lawmakers are pushing to pass the bill through budget reconciliation, an expedited legislative cess that requires a simple majority vote

This week, the Senate parliamentarian evaluated whether the posal complies with the Byrd rule, which hibits the inclusion of changes that are extraneous to the budget

While the Senate parliamentarian's decisions mean certain visions cannot stay in as written, that leaves room for lawmakers to change the language of the posal or make other adjustments

How Medicaid vider taxes may affect coverageMedicaid vider taxes offer a way for states to raise money for the non-federal of funding toward the gram, Orris said

If states are limited on how they can do that, the federal government will spend less on Medicaid, she said

The CBO scores a reduction in vider taxes as a Medicaid cut, Orris said, because it is assumed states will not be able to replace that revenue

Oz: Major goal in Medicaid is to align the federal government with the statesSquawk BoxIn response to restrictions on vider taxes, states could make decisions that would result in people losing Medicaid coverage, Orris said

Based on the House version of the bill, the CBO has estimated around 400,000 people could lose Medicaid coverage based on the posed changes to vider taxes, she said

Some Republican lawmakers have expressed concerns that the changes to the vider taxes would hurt rural hospitals financially and mpt them to reduce services or close

In addition to Medicaid vider taxes, the Senate parliamentarian also rejected posals to make certain immigrants who are not citizens ineligible for Medicaid coverage. 8 million people may lose Medicaid coverage based on both the House version of the "big beautiful" bill and Affordable Care Act changes including expiring subsidies and rule changes posed by the Trump administration, according to Washington, D. -based think tank Third Way