Provisions violate rules, says Senate parliamentarian

It could give Dems chance to challenge GOP’s health bill.

WASHINGTON — The Senate Republican bill to dismantle the Affordable Care Act encountered huge new problems late Friday night after the Senate parliamentarian challenged key provisions that are needed to win conservative votes and to make the health bill workable.

The provisions appear to violate Senate rules, the parliamentarian said, giving Democrats grounds to challenge them as the Senate prepares for a battle next week over the future of the Affordable Care Act.

One provision questioned by the parliamentarian and cherished by conservatives would cut off federal funds for Planned Parenthood for one year. Another would prohibit use of federal subsidies to buy insurance that includes coverage for abortions.

A third provision would penalize people who go without health insurance by requiring them to wait six months before their coverage could begin. Insurers would generally be required to impose the waiting period on people who lacked coverage for more than about two months in the prior year.

If formally challenged, the provisions could survive only with 60 votes, a near-impossibility in the partisan, narrowly divided Senate where Republican leaders are trying to find a way to placate both moderates and conservatives. The abortion-related provisions are important to many conservatives, not just in the Senate but also in the House.

And Democrats made clear they would seize on the ruling. “The parliamentarian’s decision today proves once again that the process Republicans have undertaken to repeal the Affordable Care Act and throw 22 million Americans off of health insurance is a disaster,” said Sen. Bernie Sanders, I-Vt.

Sanders, the ranking member of the Senate Budget Committee, disclosed the preliminary decisions by the parliamentarian, Elizabeth MacDonough.

The waiting period provision, which could also be in trouble, is more fundamental to the working of the bill. Because the legislation would end the Affordable Care Act’s mandate that almost all Americans have health insurance, the waiting period was designed to ensure that people could not simply wait to get sick before they purchased a policy.

Senate Republican leaders plan to begin debate next week on their bill to repeal major provisions of the Affordable Care Act, President Barack Obama’s signature domestic achievement, which has provided health insurance to roughly 20 million Americans.

At the moment, Republican leaders lack the votes to ensure passage of the bill, and they are still modifying it in hopes of gaining support from uncommitted Republican senators. All Democrats are expected to oppose the repeal bill.

Under the procedure that Republicans are using to speed passage of the health care bill, senators can object to a provision if it does not change federal spending or revenue or if the budgetary effects are “merely incidental” to some policy objective. The parliamentarian serves as a sort of referee, determining whether specific provisions of the bill comply with Senate rules.