The Senate parliamentarian ruled on Wednesday to reject Republican language in the Senate megabill that would prohibit federal subsidies under the Affordable Care Act (ACA) from going to qualified health plans that cover abortion services.
The Republican language in the bill would restrict the ACA’s cost-sharing subsidies from lowering the costs of plans that cover abortion services in about a dozen states, according to the Commonwealth Fund, an independent health research and policy group.
The provision would have had an “outsized impact” on states such as Connecticut, Michigan and New Mexico, where insurers now cover abortion services voluntarily but would have incentive to drop abortion coverage to become eligible for federal cost-sharing payment under the Republican proposal, according to a Commonwealth Fund analysis.
The Senate Parliamentarian, Elizabeth MacDonough, rejected another provision to end “silver loading” under the Affordable Care Act, which would change the longstanding practice of allowing insurers to increase premiums to cover the cost of subsidies that resulted in larger premium tax credits and made marketplace premiums more affordable for millions of consumers.
The Brookings Institution estimated that eliminating silver loading could cause large price increases for people with ACA-subsidized health insurance.
The Congressional Budget Office estimated that several hundred thousand people could lose health coverage as a result of ending silver loading.
MacDonough also ruled against a section of the bill that removes federal student aid eligibility from certain immigrants who are not citizens.
The Department of Education classifies non-citizens who are refugees, granted asylum or paroled as eligible for federal student aid.
She also rejected a section of the bill that would have expanded federal Pell Grants to programs at unaccredited and for-profit institutions of higher education.
Sen. Jeff Merkley (D-Ore.), the ranking member of the Senate Budget Committee, touted the rulings.
“The Byrd Rule must be enforced, and Republicans shouldn’t get away with circumventing the rules of reconciliation,” he said in a statement.
“Democrats will continue to make the case against every provision in this Big, Beautiful Betrayal of a bill that violates Senate rules and hurts families, students and workers,” he said.
Senate Republicans are still drafting final changes to the massive budget reconciliation package, which Senate Majority Leader John Thune (R-S.D.) hopes to bring to the floor on Friday.
The parliamentarian still needs to render rulings on the tax and Medicaid provisions that make up the core of the bill.
