Last night, the House Republicans passed, over unanimous Democratic opposition, their budget reconciliation resolution. This is the first step, of many, for a filibuster-proof bill that would reduce upper income individual and corporate taxes while massively cutting Medicaid and SNAP.
No change to Medicaid is happening this week.
Reconciliation is a multi-step process. Each step along the path requires more detailed trade-offs. This was the easiest step for House Republicans as it is vague as hell.
So what are the steps for a reconciliation bill of any type to pass.
- House passes a budget resolution with targeted changes in revenue and spending by Committee of Jurisdiction (more on this later)
- Senate passes its own budget resolution with targeted changes in revenue and spending by Committee of Jurisdiction
- House votes on its budget with a simple majority vote
- Senate looks at the House bill and laughs (this is only optional but frequently occurs) and writes its own draft bill
- Senate submits its draft bill to the Senate Parliamentarian for the Parliamentarian’s advice on if the proposed bill follows reconciliation rules
- This results in what is known as the “Byrd Bath” where elements that violate the following are recommended to be struck
- Can’t touch Social Security
- Can only do things that touch revenue and expenditures
- Can’t do policy only provisions
- Scoring restrictions on deficits out of the time window
- This is a likely spot of shenanigans as the Congressional Budget Office (CBO) is the traditional but not required scorekeeper
- Committee of Jurisdiction scorekeeping
- The Parliamentarian’s rulings are only advisory.
- 51 Senators can make the rule say whatever they want it to say.
- This results in what is known as the “Byrd Bath” where elements that violate the following are recommended to be struck
- The Senate votes on their bill with a simple majority (51) threshold.
- This is where Repeal and Replace failed in 2017
- House and Senate have to agree on a bill
- Either a conference committee
- Or House accepts the Senate bill without amendment (this is how the ACA passed in 2010 and Inflation Reduction Act passed in 2022)
- President signs
- 5 on the Supreme Court agree
This is the pathway to 218-51-1-5.
We’re at Step 1. And this is the easiest step.
The House resolution that passed last night contained instructions for a number of committees. The instructions for the committees are for changes in spending and revenue for programs under its jurisdiction.
For instance this is the instruction to the Homeland Security Committee:
(6) COMMITTEE ON HOMELAND SECURITY.— The Committee on Homeland Security shall submit changes in laws within its jurisdiction that increase the deficit by not more than $90,000,000,000 for the period of fiscal years 2025 through 2034.
This translates in policy terms that this committee can spend $90 billion dollars more than previously allowed on actions within its jurisdiction. Actions within its jurisdiction are highly likely detention and deportation of immigrants. But notice, nothing in this paragraph says anything about anything specific.
Now let’s take a look at the fig leaf marginal Republicans are hiding behind. I just Control-F the entire document. Medicaid is not mentioned. But anyone who knows anything about the federal budget and Medicaid knows that the House Energy and Commerce committee has substantial jurisdiction on the program. And what is the budget resolution instruction for this committee?
(4) COMMITTEE ON ENERGY AND COMMERCE.— The Committee on Energy and Commerce shall submit changes in laws within its jurisdiction to reduce the deficit by not less than $880,000,000,000 for the period of fiscal years 2025 through 2034.
Step #3 (The House passes its budget) is where the details are filled in. The trade-offs become explicit instead of implicit. This is where changes to Medicaid Federal Medical Assistance Percentage (FMAP) gets changed for just rich Blue states or for all Medicaid Expansion states. This is where work requirements or lifetime length restrictions are imposed. This is where states are given a lot less money and scorekeepers make reasonable projections that X million fewer people will have coverage in Year 1 and Year 5. This is where the figleafs disappear beyond the figleaf of Calvinistic deservingness that permeates our culture.
Last night was the easiest vote for any marginal Republican in this process.
West of the Rockies
Excellent post, David! Super informative.
Josie
Thanks, David. This is the first time I have seen the process spelled out so that I can actually understand it.
Another Scott
Thanks for this.
There was a twoot going around last night (which I can’t find, of course) that cumulative additional deficits will be estimated at $19T with $4+T coming from tax cuts. Back in olden days, Reconciliation was over 10 years because of the “typical” business cycle so that everything would kinda balance out over that time time. It seems that that “thinking” was thrown out around 1981 or so and now Reconciliation mostly a way for the GQP to force cuts and tax reductions for their donors. Especially now.
Grr…
Thanks.
Best wishes,
Scott.
Ohio Mom
Thanks for this tutorial.
My personality is, I hate suspense. I hate sports and races and contests where you are holding your breath until the end. I hate suspenseful movies (a rom com where you know it ends happily ever after is okay), I hate spy thriller novels. I am an anxious enough person without looking for extra reasons to be anxious.
So of course watching my kid’s/family’s future well-being hang in the balance like this is excruciating.
I can call my Democratic Rep and thank him for standing firm. I can call my two Republican Senators and scream into the void. I can send The Arc (national disability advocacy organization) another donation. But mostly this is like watching a car run a red light and seeing exactly where it’s going to crash into that other car and not be able to do anything but gawk (which happened to Ohio Family last fall, waiting at a red light, watching that pick-up truck ramming into that little blue car. It unfolded both slowly and in a flash).
David Anderson
@Ohio Mom: The leverage point is Step 3
Ohio Mom
@David Anderson: Got it. I can skip paying attention until then. But what is going to be different about that vote? Will the Democrat who was absent, getting chemo, be back, will aliens abduct a couple of Republicans?
catclub
No LEGISLATIVE change to Medicaid is happening this week.
FTFY
laura
The richest nation in the history of the world and one party is engaged in emiserating the majority of it’s citizenry to gift even more unearned wealth on its minority wealthy cohort.
catclub
@laura:
It worked well for France for hundreds of years. Then 1789 came.
David Anderson
@Ohio Mom: We tell our stories, we lobby with hospitals and doctors who tell their stories. We make it obvious that there is no magical bucket of WASTE FRAUD ABUSE money — and we make it obvious that if a Congress critter says they care about maternal mortality or opioid overdoses or mental health or community based supports for individuals with IDD and SMI or anything else, Medicaid plays a huge role in this and cutting 10% of federal funding over a decade and an evergrowing percentage after that leads to VERY BAD THINGS.
The goal is to make the marginal Republican terrified of losing in November 2026 — more terrified than losing a primary in Spring 2026 because they did not vote for more tax cuts
Ohio Mom
@David Anderson: As I’m sure you already know, Medicaid is full of financial controls. Ohio Family never sees Ohio Son’s Medicaid dollars.
We meet with his caseworker from the county and plan the next year of OS’s activities: say he’s going to this day program on these days? The caseworker writes up the plan, fills out who knows how much paperwork which goes through who knows how many reviews. Eventually all the boxes are checked and a starting date at the day program is identified.
The money (which started as a state-federal match), goes through some set of pipes and arrives in the day program’s account. And when OS wants to leave the day program, it’s the same steps in reverse.
To be a provider of Medicaid-funded services is its own set of hoops. OS participates in a social group led by a psychologist and the last thing she wants to do with her time is everything involved in becoming a Medicaid provider. So it is private pay.
I have long joked that only the likes of Rick Scott are in a position to steal from Medicaid (i know he stole from Medicare, for the purposes of the joke I conflate the two). There aren’t any openings for us little people to get at the money.
Katrina
This was an incredibly helpful snd illuminating post.
Aaron
@David Anderson: Thanks for highlighting that. I know you’ve said it before and will said it again, but I hope it’s not spamming to clearly state each and every time that the House is the key point this time. (Also, #3 is going to be a lot more specific than this was, so that should help.)
RevRick
@David Anderson: Which committee handles the climate change portion of the IRA? Because that would be the target of GOP preference.
azlib
@David Anderson:
This is exactly right. It is all about pressure on marginal Republicans. I am still contacting my marginal Republican rep about his lockstep vote. He is a big deficit hawk and right now his hypocrisy slip is showing.
MazeDancer
Excellent summary. Feel like it should be distributed as a textbook.
ChrisSherbak
Thank you. Seems like “increase deficit by 900tn and decrease deficit by 800tn” altho vague (generally), should be highlit. Aren’t these the “fiscal conservative” guys? Maybe poke the GOP bear(s) that hate deficit increases? Esp. Planned ones? I think overall it was 4tn INCREASE ya?
Also, point of information: wouldn’t raising the debt ceiling be technically NOT financial, i.e. raising/lowering the deficit/debt? So it should NOT be doable via reconciliation?
John Cole
The Dems need to delay and slow roll this as long as they can for popular opposition to take root and grow. We need to make sure that the people doing this, if they get away with it, receive the electoral equivalent of the death penalty.
Satanley (aka weasel)
@West of the Rockies:
Am very late to reading this and am sure the comments are dead, but in the spirit of appreciating the front pagers I wanted to second this! Will be sharing it around
Terraformer
You never see this kind of clear, concise explanation of Congressional machinations in big press and media. I wonder why that is
kudos, David!
Grin and Bare
Thank you so much for this post, David. Very informative.
Ramona
I read and appreciate ALL your posts David. I just don’t comment because I have nothing to add given your expertise. So many thanks for this particular outline of the procedure.
chemiclord
@catclub: I like to say, “If you could promise me that we could get 1789 France, and not follow it up with 1793 France, then sign me up for the Great Revolution.”
Yet, history suggests that the sort of people who successfully use violence to overthrow a government wind up being the exact sort of people that can’t be trusted with the peace afterward.