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Politico
7 hours ago
- Business
- Politico
Senate megabill will strengthen Obamacare, says red state hospital CEO
A provision in a key Senate committee's version of the GOP megabill will backfire against Republicans by forcing red states to consider doing exactly what Republicans don't want them to: expand Medicaid, the CEO of the South Carolina Hospital Association told POLITICO. Republicans have sought to shelter the 10 conservative states that have declined to expand Medicaid to cover more low-income people, as Obamacare encourages with generous federal subsidies. But the Senate bill, in an effort to find the savings needed to extend President Donald Trump's 2017 tax cuts, would still blow a hole in the budgets of Palmetto state hospitals by reducing what insurers who contract with the state to provide Medicaid services can pay them. States and Washington share the insurance program's costs. 'It affects the viability of the whole system,' said Thornton Kirby, chief executive of the South Carolina Hospital Association, which estimates the Senate proposal will cost the state over $2.3 billion annually. 'If you take away this alternative way to balance the budget, you leave us with only one path…Medicaid expansion,' Kirby said. The Senate is rushing to complete its version of a bill that would enact Trump's agenda using a procedure that requires only a simple majority vote. Trump wants it done by July 4, but with the slim margins in both houses of Congress, the industries affected by the bill are hoping to peel off votes to save themselves from cuts. Republicans can lose no more than three votes in either chamber as long as Democrats remain united in opposition. To make the case that the restrictions on so-called state-directed payments need to go, the hospital association is leaning on three home state Republicans with clout: Sen. Tim Scott, who has a seat on the Finance Committee that has proposed the restrictions; Rep. Russell Fry, who's on the Energy and Commerce Committee that drafted the Medicaid provisions of the megabill the House passed last month; and Henry McMaster, the governor of South Carolina and, Kirby said, a personal friend. 'I don't want to put him in the hot seat,' Kirby said of McMaster. 'He doesn't want to see [Medicaid] upended.' Of Scott, Kirby said he's in touch at least every other day and that the senator and Trump ally 'has been a champion.' 'He understands…he doesn't want to go down that path' of Medicaid expansion, Kirby added. The three Republicans did not immediately respond to requests for comment. Expanding Medicaid could help replace the revenue the Senate provision would take away because it would make many more people — South Carolina now has one of the nation's higher uninsured rates at 9 percent — eligible for the program. Under Obamacare, the federal government picks up 90 percent of the cost for the new enrollees. Under the Finance Committee proposal, state-directed payments to hospitals serving Medicaid patients would fall by 10 percent each year until the total payment rate is only 100-110 percent of the Medicare payment rate. In South Carolina, the current payment rate is more than twice the rate paid by Medicare, the federal health insurance program for elderly people. Hospitals in states that have expanded Medicaid would take an additional hit under the Senate proposal. The Finance Committee would lower the provider tax rate that the 40 states that have expanded Medicaid can levy on hospitals from 6 percent to 3.5 percent. States have used the taxes to boost their federal matching funds, which they have then sent back to hospitals in higher reimbursements. The Senate would freeze the tax rates in states like South Carolina that haven't expanded Medicaid, but would not require them to lower them. The version of the megabill the House passed would freeze the rates for all states, a plan Kirby was willing to accept. On Friday, Sen. Josh Hawley (R-Mo.) urged GOP leaders to strike the Finance Committee language on Medicaid, warning the crackdown won't clear the House. Republican senators hope to pass their version of the bill next week after which the House would need to pass it before Trump could sign it into law.
Yahoo
3 days ago
- Business
- Yahoo
Senate GOP leader faces pushback after members blindsided by Trump bill
Senate Majority Leader John Thune (R-S.D.) is facing strong pushback from members of the GOP conference over the Finance Committee's piece of President Trump's tax and spending bill, which largely ignores GOP senators' concerns about Medicaid cuts and the quick phaseout of clean-energy tax credits. Senate Republicans who raised red flags over Medicaid spending cuts the House passed say they were blindsided by the Senate's version of the bill, which would cut Medicaid by several hundred billion dollars beyond what the House proposed. They are warning that the Finance Committee's language will cause dozens of rural hospitals to close in their home states, require lower-income Americans to pay more for medical procedures and shift costs onto the states. 'I had no idea that they were going to completely scrap the House framework like this. This totally caught me by surprise. And I've talked to other senators, and that's what I've heard consistently from everybody I've talked to,' said Sen. Josh Hawley (R-Mo.), who has repeatedly warned about the impact of Medicaid cuts on his constituents and rural hospitals. 'No one was expecting this entirely new framework,' he said. Hawley and other Republicans have complained for weeks that the House cuts to Medicaid went too far and called for changes, but those warnings appeared to have little impact on Thune or Senate Finance Committee Chair Mike Crapo (R-Idaho). Instead, Thune and Crapo sided with conservatives, such as Sens. Rick Scott (R-Fla.) and Roger Marshall (R-Kan.), who called for deeper spending cuts than what the House passed. GOP lawmakers and aides ascribed Thune's decision to add even bigger spending cuts in the bill to his sensitivity to the broad desire within the Senate Republican conference for more deficit reduction. Some Senate GOP sources note that Thune won his contested race to become Senate majority leader in November by picking up more support from conservatives than his chief rival, Sen. John Cornyn (R-Texas). But perhaps a more important factor in Thune's decision to move in the direction of deeper Medicaid spending cuts is that one of his top priorities is to make several corporate tax cuts in the bill permanent. Making those tax breaks permanent requires finding hundreds of billions of dollars in spending cuts to offset the cost and comply with the Senate's Byrd rule, which does not allow provisions passed under the special budget reconciliation process to add to the deficit outside the 10-year budget window. The Senate bill would permanently restore immediate deductions for research and development expenses, the 100 percent bonus depreciation for investments, and the EBITDA-based limitation on business net interest deductions. But now Thune has to find a way to get Republicans who are balking over the Medicaid cuts to support the bill. Sen. Lisa Murkowski (R-Alaska) told reporters Tuesday she has major problems with the Medicaid language Crapo unveiled. 'I'm still not satisfied with where we are on Medicaid,' Murkowski said, calling it a 'priority' she wants to address. Murkowski has also voiced concern over language in the Senate bill to impose stricter work requirements for Medicaid beneficiaries, according to colleagues familiar with her objections to the bill. She has questioned whether states like Alaska will have enough time to implement sweeping changes, such as a requirement that adults with dependent children older than 14 show that they work, attend school or perform community service for 80 hours a month. Sen. Susan Collins (R-Maine) on Tuesday flagged changes to states' use of health care provider taxes as a major concern for her home state. Collins said she wants to see 'many changes' made to the bill before it comes to the floor. 'This is still a work in progress,' she said. 'I'm still asking for many, many changes.' The Center for Healthcare Quality and Payment Reform reported last month that 10 of Maine's 24 rural hospitals are in danger of closing. Hawley on Tuesday warned that nearly half of Missouri's rural hospitals would face closure if the Senate bill passes without major changes. 'It's very bad policy, and it hurts poor people,' he said. 'It's not just the right thing to do to shut down a bunch of rural hospitals to pay for tax cuts, or in this case, it's tax subsidies in the form of Green New Deal subsidies that go to private equity and hedge funds.' The objections of these senators to the bill's Medicaid provisions poses a serious challenge to Thune, who already has two 'no' votes in his conference against the bill from Sens. Rand Paul (R-Ky.) and Ron Johnson (R-Wis.). Paul says he won't vote for the package as long as it includes language to raise the debt ceiling by $5 trillion — a core component of the legislation. Johnson says the legislation doesn't do nearly enough to cut the federal deficit and slammed language drafted by the Finance Committee to limit the deduction for pass-through businesses to 20 percent instead of the House bill's more generous 23 percent deduction. Thune on Tuesday said he's willing to work with Collins, Murkowski, Hawley and other Republican colleagues who are asking for changes to the Medicaid spending cuts. 'We are in conversations with all of our members,' he told reporters. He said that the proposed restrictions on health care provider taxes are 'important reforms.' But he said 'we continue to hear from our members specifically on components or pieces of the bill that they would like to see modified or changed or have concerns about, and we're working through that.' He said the 'math that I'm working with' is to get 51 votes in the Senate. If Paul and Johnson vote 'no' as they're threatening, Thune could afford only one other Republican defection and still pass the bill. He controls 53 seats in the chamber. Thune also faces challenges from other Republicans who aren't happy about the quick phaseout of clean energy tax breaks, which could threaten tens of billions of dollars in investments in Republican-represented states. Sen. Shelley Moore Capito ( said she's not happy about language in the bill that would terminate the clean hydrogen production tax credit for projects that are not under construction by Dec. 31. That threatens significant federal support for the Appalachian Regional Clean Hydrogen Hub in West Virginia. 'I'm concerned, I'm just going to grab Crapo in there right now,' Capitol said while heading into a Republican lunch meeting Tuesday. 'I think I'm concerned about it.' Capito is the chair of the Senate Republican Study Committee and a member of the GOP-elected leadership. She said she wanted to hear more from constituents in West Virginia about how the Medicaid cuts would affect them. 'We're talking to the governor and others in office to see what kind of impacts this will have,' she said. Sen. Jim Justice ( told reporters Tuesday he also has concerns about the bill's changes to health care provider taxes and would not be a 'rubber stamp' for the legislation. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Politico
3 days ago
- Business
- Politico
‘Fight of our lives': Lobbying intense on climate law credits
The morning after the Senate Finance Committee released a new megabill text that would roll back tax credits for renewable energy development, the solar industry's top lobby group hosted a rally in the shadow of the Capitol. 'Time to storm the Hill!' Abigail Ross Hopper, CEO of the Solar Energy Industries Association, said Tuesday. Lobbyists and industry leaders have been in a mad dash to rescue some of the energy tax incentives in the Democrats' 2022 Inflation Reduction Act. The House's 'One Big Beautiful Bill Act,' passed last month, would roll back many of the credits dramatically. And a Senate draft is not much better for sources like wind and solar. SEIA's rally included workers and leaders for dozens of companies before marching to meet with lawmakers and aides. It was the group's eighth lobbying day this year. 'We are in a fight for our lives,' Hopper told the crowd, saying that 330,000 jobs are at stake. Trade groups and other advocates have been releasing studies warning about the legislation's potential harms to projects and employment, particularly in red states. The legislation's real effects remain a moving target because Republican leaders have promised to keep tweaking their tax, energy and border spending package. 'We are not at the end. We had that language come out of the Senate Finance [Committee] last night, but we are not finished,' she said. 'I would not ask you to travel here, take time away from your families, take time away from your businesses, if I thought that this was done. This is not done. You have the opportunity today … to tell these legislators what this means to you.' Hopper told reporters that the Finance Committee draft represented 'some steps toward progress, but it is far from acceptable.' Companies and groups thought Republicans and President Donald Trump would ease from targeting climate law credits because of their economic impact. The House bill was a wake-up call, said Mike Carr, a lobbyist at Boundary Stone Partners who represents companies in solar, batteries and related fields. 'I think there was a general assumption that … they weren't going to pull the rug out from it,' Carr said. 'And the House bill really did pull the rug out from a lot of this.' Since the House passed its bill, it's been all hands on deck, Carr said. 'There's been a real frenzy since then, trying to help people understand how much is on the line, how many jobs could potentially be lost in various sectors.' Other major organizations fighting for the energy incentives include the American Clean Power Association and the American Council on Renewable Energy. 'While the Senate Finance Committee proposal eliminates poison pills from the House legislation, abrupt changes to the clean energy tax credits unnecessarily penalize companies that are making good faith investments under current law,' ACP CEO Jason Grumet said in a statement. The Edison Electric Institute thanked the Finance Committee for its work but made it clear that it sees room for improvements. 'Financial certainty and access to cost-effective financing are critical tools for electric companies as they continue to make needed investments to meet rising customer demand and to expand generation capacity,' said Pat Vincent-Collawn, the group's interim CEO. The group had taken a dimmer view of the House version, particularly around sourcing requirements, the short timeline for ending credits and tax credit transferability. Big business groups like the American Petroleum Institute and the U.S. Chamber of Commerce have been mostly supportive of the congressional Republicans' efforts, but have also been pushing for longer timeframes for some tax credits, including for hydrogen and carbon capture. Before the Senate bill was released, the Chamber wrote in a post that the group would 'continue to urge policymakers to preserve pro-growth tax policies that enhance U.S. energy competitiveness and security, including credits for clean hydrogen production and carbon oxide sequestration, as well as technology-neutral credits to help meet the country's rapidly growing demand for electricity generation.' Republicans launched a new group called Built for America this month to advocate for the energy incentives from a conservative viewpoint. The $2 million campaign, led by former West Virginia Lt. Gov. Mitch Carmichael and former Trump campaign adviser Bryan Lanza, is putting advertisements in conservative platforms like Fox News and Truth Social, which is owned by the president. 'Trump country is booming. We're building, hiring and winning in America, because energy tax credits put America first,' one of the ads says. Another group called Advanced Energy United launched a six-figure campaign of its own targeting a handful of Senate Republicans with digital ads. That group is backed by major technology firms like Microsoft, automakers like Ford and other firms like NRG. 'Repealing these tax credits would devastate local economies, raise energy costs, and hand the keys of energy leadership to China — and the Senate now has a choice to make,' Harry Godfrey, the group's managing director for federal priorities, said in a statement. A number of companies and associations have retained new lobbyists in recent months to fight for the credits they support, according to disclosures filed with Congress. They include battery maker Energizer Holdings, chemical manufacturer Johnson Matthey, the Hydrogen Jobs Now Coalition, battery recycler Ecobat and the Clean Energy Buyers Association. The far-right House Freedom Caucus pointed to news that Energizer had retained a slate of Democratic lobbyists from Washington Council Ernst & Young. 'This should tell Republicans everything you need to know: The Swamp isn't even hiring Republicans to lobby on preserving the #GreenNewScam IRA tax subsidies,' the caucus wrote on X. Those pushing to terminate the tax credits have their advocates too. Pro-fossil fuel activist Alex Epstein has been involved, and Rep. Chip Roy (R-Texas) called him an 'enormous help' in rolling back the credits in the House bill. Epstein was disappointed in the Senate Finance Committee draft. 'Sad update' he wrote on X, outlining his view of the changes. 'Nothing is set in stone yet, there's still time for Congress to do the right thing. Tell your Senator,' he added.
The Hill
3 days ago
- Business
- The Hill
Senate GOP leader faces pushback after members blindsided by Trump bill
Senate Majority Leader John Thune (R-S.D.) is facing strong pushback from members of the GOP conference over the Finance Committee's piece of President Trump's tax and spending bill, which largely ignores GOP senators' concerns about Medicaid cuts and the quick phaseout of clean-energy tax credits. Senate Republicans who raised red flags over Medicaid spending cuts the House passed say they were blindsided by the Senate's version of the bill, which would cut Medicaid by several hundred billion dollars beyond what the House proposed. They are warning that the Finance Committee's language will cause dozens of rural hospitals to close in their home states, require lower-income Americans to pay more for medical procedures and shift costs onto the states. 'I had no idea that they were going to completely scrap the House framework like this. This totally caught me by surprise. And I've talked to other senators, and that's what I've heard consistently from everybody I've talked to,' said Sen. Josh Hawley (R-Mo.), who has repeatedly warned about the impact of Medicaid cuts on his constituents and rural hospitals. 'No one was expecting this entirely new framework,' he said. Hawley and other Republicans have complained for weeks that the House cuts to Medicaid went too far and called for changes, but those warnings appeared to have little impact on Thune or Senate Finance Committee Chair Mike Crapo (R-Idaho). Instead, Thune and Crapo sided with conservatives, such as Sens. Rick Scott (R-Fla.) and Roger Marshall (R-Kan.), who called for deeper spending cuts than what the House passed. GOP lawmakers and aides ascribed Thune's decision to add even bigger spending cuts in the bill to his sensitivity to the broad desire within the Senate Republican conference for more deficit reduction. Some Senate GOP sources note that Thune won his contested race to become Senate majority leader in November by picking up more support from conservatives than his chief rival, Sen. John Cornyn (R-Texas). But perhaps a more important factor in Thune's decision to move in the direction of deeper Medicaid spending cuts is that one of his top priorities is to make several corporate tax cuts in the bill permanent. Making those tax breaks permanent requires finding hundreds of billions of dollars in spending cuts to offset the cost and comply with the Senate's Byrd rule, which does not allow provisions passed under the special budget reconciliation process to add to the deficit outside the 10-year budget window. The Senate bill would permanently restore immediate deductions for research and development expenses, the 100 percent bonus depreciation for investments, and the EBITDA-based limitation on business net interest deductions. But now Thune has to find a way to get Republicans who are balking over the Medicaid cuts to support the bill. Sen. Lisa Murkowski (R-Alaska) told reporters Tuesday she has major problems with the Medicaid language Crapo unveiled. 'I'm still not satisfied with where we are on Medicaid,' Murkowski said, calling it a 'priority' she wants to address. Murkowski has also voiced concern over language in the Senate bill to impose stricter work requirements for Medicaid beneficiaries, according to colleagues familiar with her objections to the bill. She has questioned whether states like Alaska will have enough time to implement sweeping changes, such as a requirement that adults with dependent children older than 14 show that they work, attend school or perform community service for 80 hours a month. Sen. Susan Collins (R-Maine) on Tuesday flagged changes to states' use of health care provider taxes as a major concern for her home state. Collins said she wants to see 'many changes' made to the bill before it comes to the floor. 'This is still a work in progress,' she said. 'I'm still asking for many, many changes.' The Center for Healthcare Quality and Payment Reform reported last month that 10 of Maine's 24 rural hospitals are in danger of closing. Hawley on Tuesday warned that nearly half of Missouri's rural hospitals would face closure if the Senate bill passes without major changes. 'It's very bad policy, and it hurts poor people,' he said. 'It's not just the right thing to do to shut down a bunch of rural hospitals to pay for tax cuts, or in this case, it's tax subsidies in the form of Green New Deal subsidies that go to private equity and hedge funds.' The objections of these senators to the bill's Medicaid provisions poses a serious challenge to Thune, who already has two 'no' votes in his conference against the bill from Sens. Rand Paul (R-Ky.) and Ron Johnson (R-Wis.). Paul says he won't vote for the package as long as it includes language to raise the debt ceiling by $5 trillion — a core component of the legislation. Johnson says the legislation doesn't do nearly enough to cut the federal deficit and slammed language drafted by the Finance Committee to limit the deduction for pass-through businesses to 20 percent instead of the House bill's more generous 23 percent deduction. Thune on Tuesday said he's willing to work with Collins, Murkowski, Hawley and other Republican colleagues who are asking for changes to the Medicaid spending cuts. 'We are in conversations with all of our members,' he told reporters. He said that the proposed restrictions on health care provider taxes are 'important reforms.' But he said 'we continue to hear from our members specifically on components or pieces of the bill that they would like to see modified or changed or have concerns about, and we're working through that.' He said the 'math that I'm working with' is to get 51 votes in the Senate. If Paul and Johnson vote 'no' as they're threatening, Thune could afford only one other Republican defection and still pass the bill. He controls 53 seats in the chamber. Thune also faces challenges from other Republicans who aren't happy about the quick phaseout of clean energy tax breaks, which could threaten tens of billions of dollars in investments in Republican-represented states. Sen. Shelley Moore Capito ( said she's not happy about language in the bill that would terminate the clean hydrogen production tax credit for projects that are not under construction by Dec. 31. That threatens significant federal support for the Appalachian Regional Clean Hydrogen Hub in West Virginia. 'I'm concerned, I'm just going to grab Crapo in there right now,' Capitol said while heading into a Republican lunch meeting Tuesday. 'I think I'm concerned about it.' Capito is the chair of the Senate Republican Study Committee and a member of the GOP-elected leadership. She said she wanted to hear more from constituents in West Virginia about how the Medicaid cuts would affect them. 'We're talking to the governor and others in office to see what kind of impacts this will have,' she said. Sen. Jim Justice ( told reporters Tuesday he also has concerns about the bill's changes to health care provider taxes and would not be a 'rubber stamp' for the legislation.
Yahoo
3 days ago
- Health
- Yahoo
Hospitals stunned by Senate GOP's Medicaid plan
One of the most powerful lobbies in Washington is redoubling its efforts to avoid a cut to Medicaid payments in the GOP's megabill. Hospital executives weren't happy last month when the House included a provision in its version of the bill freezing a loophole states have used to boost payments to hospitals serving the low-income patients enrolled in Medicaid. Hospitals have long enjoyed deference from lawmakers — since they both care for and employ their constituents. But they were infuriated when Senate Republicans on the Finance Committee released their version of the bill on Monday. Their proposal went even further than the House measure in curtailing the ability of states to impose taxes on providers. States have used those taxes to gain a larger federal Medicaid contribution, which they have then directed back to hospitals with higher reimbursements. The Senate's proposal would lower the amount the 40 states that have expanded Medicaid under Obamacare can levy in provider taxes from 6 percent to 3.5 percent. It has hospital lobbyists painting a bleak picture of their financial prospects in a last-ditch effort to change senators' minds. 'No senator wants to be the reason their local hospital shutters its doors, and now is their opportunity to stop that from happening,' said a source familiar with hospital industry thinking granted anonymity to speak freely on strategy. More than 250 hospital leaders flew into Washington on Tuesday to urge senators to preserve Medicaid as part of an American Hospital Association lobbying campaign. The association spent almost $8.5 million on lobbying in the first quarter of the year, a high water mark dating back almost two decades. 'There are aggressive conversations ongoing…to make sure that all senators recognize the vulnerability that it is going to potentially put all of our hospitals in,' said one stakeholder granted anonymity to speak on strategy, adding that the lobbying push will continue in the states later this week after senators depart Washington for the Juneteenth holiday. Hospitals have long gotten their way on Capitol Hill, as they don't just offer health care to a community but are sometimes its biggest employer. There are signs of encouragement this time around, too, as several influential GOP senators lodged objections to their colleagues' proposal after its release Monday. 'We've got all kinds of concerns,' Sen. Jim Justice ( who had accepted the House's language, said on Tuesday. But for now, at least, anxiety is running high. The industry was able to get House Republicans to steer away from cuts to provider taxes. Instead, Republicans there installed a moratorium on any new taxes but allowed current ones to continue. Thirteen state hospital groups said they were okay with that. But the Senate went in another direction, and it has sent hospitals and their allies scrambling. 'The further the cuts that are made, the more devastating it is,' said Shantel Krebs, president and CEO of Avera St. Mary's, a hospital in South Dakota, in a call with reporters Tuesday. The Senate Finance Committee's version of the megabill keeps the moratorium in place, but only if the state is one of 10 that hasn't taken advantage of an Obamacare provision offering federal funds to expand Medicaid to cover lower-middle income people. States that have expanded Medicaid must lower their taxes to 3.5 percent. This would imperil more than 30 states and the District of Columbia that have taxes above 3.5 percent, according to data from the health care think tank KFF. The House version was palatable partly because red-state governors intervened to mitigate the impact, one hospital lobbyist said. 'I would assume there will be just a massive amount of pushback from states, and we'll see whether it moves the needle,' the person said. Hospitals are not used to losing on Capitol Hill. In recent years they have successfully fought off efforts to lower Medicare payments for their outpatient clinics so they're in line with doctors' offices. Lawmakers on both sides of the aisle have criticized hospitals for getting paid more for performing the same service. Hospital groups have also successfully fought off a payment cut to safety net hospitals, which serve low-income patients, that lawmakers included in Obamacare. The cut aimed to help pay for the bill. And the Democrats who passed Obamacare in 2010 expected the Medicaid expansion would make the hospitals whole. But Congress has repeatedly passed legislation to block the cuts from taking effect at hospitals' request. Now, the industry is working against a Senate hungry for savings to pay for the megabill, the primary purpose of which is to extend the tax cuts President Donald Trump and a Republican Congress enacted in 2017. It's also up against conservatives' philosophical opposition to the state taxes. Some conservatives close to Trump have argued that states and hospitals are essentially engaged in 'money laundering' when they use provider taxes to boost federal Medicaid contributions and then send the money back to the hospitals. Brian Blase of the conservative Paragon Health Institute posted on X Monday that even Joe Biden wanted to tackle provider taxes. 'The [Senate Finance] proposal is just a commonsense good government step to restore accountability in Medicaid and focus states on getting value from their programs,' he said. Senate Republicans can lose only three members and still pass the megabill if Democrats remain united in opposition. GOP leaders want to meet Trump's demand that they pass it by July 4. Hospitals listening to the tepid reaction from some in the GOP caucus to the provider tax restrictions see reason for hope. 'From the standpoint of West Virginia, I think the president outlined where he stood, and what's coming out right now could be much different and so we've got concerns,' Justice said, referencing Trump's repeated pledge to protect Medicaid. Sen. Susan Collins (R-Maine) has largely declined to delve into specifics since the Finance Committee released its plan, but she reiterated her concerns about the provider tax language and said she's still 'asking for many changes.' The most outspoken pushback has come from Sen. Josh Hawley (R-Mo.), who spoke with Trump on Tuesday. Hawley told reporters that the Senate language is 'alarming' and 'surprising' and that Trump had told him he was also surprised by the language in the bill. Finance Committee Chair Mike Crapo's decision to go further in curtailing the taxes than the House bill caught GOP senators off guard, after several indicated last week that they expected the Senate's plan would largely match the House's. The two chambers will have to agree on the bill text before Trump can sign it into law. The language Crapo settled on nets the Idaho Republican and Senate Majority Leader John Thune something they are desperately hunting: More savings. Crapo predicted that making changes to the Medicaid language would help give Republicans several hundred billion dollars to work with. Republicans can pass the bill with a simple majority if they adhere to special budget rules that require the bill not increase the deficit within a 10-year window. 'Every spending reduction that we were able to achieve was helpful in achieving the permanence,' Crapo said, referencing GOP plans to make the 2017 tax cuts permanent. The 2017 law, in order to reduce the cost of the measure, set the tax cuts to expire at the end of this year. Crapo added that he was 'not surprised' that there was pushback from his colleagues and that the Medicaid language might not be fully locked in: 'Right now, we're vetting it,' he said. One lobbyist pointed out hospitals would be happy to make a deal. 'Right now, the Senate bill is so bad for hospitals,' the person argued, 'that if it's softened a little bit, you could … almost neutralize them.'
