On Friday, Senate Democrats released a list of provisions in the Republican health-care bill that the Senate parliamentarian holds can pass via a simple, filibuster-proof majority vote. Among those provisions that didn’t meet her scrutiny are the bill’s plans to defund Planned Parenthood, restrict tax-credit funding for insurance plans that provide abortions, and a six-month “lockout” period from purchasing insurance for people who don’t maintain continuous coverage.
If this preliminary guidance holds, the Better Care Reconciliation Act—which is already in dire straits—seems likely to fail.
The final assessment of the parliamentarian, Elizabeth MacDonough, is a critical step in the GOP’s strategy for passing their bill to repeal and replace Obamacare. Republicans have opted to pass their health-care legislation via the special reconciliation process, under which they can cut debate short in the Senate and thus eliminate indefinite filibusters, which Democrats would certainly use in order to block any attempt to repeal Obamacare. But bills have to follow a certain procedure—called the Byrd Rule—in order to pass by reconciliation.
Broadly, the Byrd rule states that reconciliation legislation can only include changes to laws that directly affect the federal budget, and can be scored by the Congressional Budget Office. So for example, Republicans could “repeal” Obamacare premium tax credits via reconciliation by making the credit $0 for everyone, but couldn’t in theory use the same bill to eliminate the requirement for insurers that take premium tax credits to also take people with pre-existing conditions.