A MARTÍNEZ, HOST:
Senate Republicans have hit what could be a major roadblock in their effort to pass a massive tax and spending package, a Senate official has determined that many of the proposed changes to Medicaid cannot pass with a simple majority of Republicans. That means Republicans may have to remove hundreds of billions of dollars in planned cost savings.
NPR congressional correspondent Claudia Grisales is here now. So let's start with the policy here. What exactly won't fly with Senate rules?
CLAUDIA GRISALES, BYLINE: Good to be with you, A. Right. Medicaid has been one of the thorniest issues in this bill for Republicans. This federal program provides health coverage to low-income and disabled Americans in partnership with states. So more than 70 million people are insured through Medicaid. But it is very expensive, and Republicans wanted to cut costs in a couple of different ways, including a change that would require states to decrease the amount they can tax Medicaid providers. But the parliamentarian - this is a nonpartisan professional staffer who advises senators on the chamber's rules - said those changes do not fit the strict guidelines that allow Republicans to try to pass this entire package along party lines with this simple-majority vote.
MARTÍNEZ: And correct me if I'm wrong - Republicans have been relying on changes to Medicaid to offset a lot of spending in this bill. So how big of a blow could this be?
GRISALES: It's a pretty big blow when it comes to cost savings and their timeline. We already know Senate Majority Leader John Thune can only afford to lose three members of his conference to get this passed in the chamber, and plenty more are opposed when we add these Medicaid changes. So senators have been hung up all week on these negotiations, focused on this provision specifically, among others. And senators from rural states have warned that these provisions could have devastating impacts for hospitals that rely on this funding.
Meanwhile, Senate Republicans are under serious pressure from President Trump to get this done. He wants to sign the bill by the July 4 deadline. He's even having a big event to push for the legislation this afternoon.
MARTÍNEZ: All right, so considering all these pressures, what are their options?
GRISALES: Well, they have a couple of choices. They could go back and rewrite this measure to fit the rules and go back to the parliamentarian and argue their case for why the changes will work. They could decide to scrap the changes, scale back spending elsewhere in the bill, or they could potentially try to overrule the parliamentarian. Some House Republicans are already agitating for this on social media, but it would be unprecedented. Thune has suggested he does not want to go there.
MARTÍNEZ: So what could happen, then, if Republicans bust their deadline to get this legislation to the president's desk?
GRISALES: There's a lot at stake. This carries the bulk of the president's domestic agenda, and there's not much time left in the legislative calendar when we consider all the other bills they need to take up later this year. Add to that the debt ceiling - there's a provision to lift the debt ceiling by a so-called X date that could happen this summer. And if that's not addressed in time, it could trigger catastrophic results for the country's financial picture.
MARTÍNEZ: Wow, that is NPR's Claudia Grisales. Thanks a lot for the update.
GRISALES: Thank you.
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