“….. the parliamentarian has taken an already very difficult process for enacting health care legislation in the Senate and made it nearly impossible….”

“The official rules keeper in the Senate Friday tossed a bucket of cold water on the Senate Republican health bill by advising that major parts of the bill cannot be passed with a simple majority, but rather would require 60 votes. Republicans hold only 52 seats in the Senate.
Senate Parliamentarian Elizabeth MacDonough said that a super-majority is needed for the temporary defunding of Planned Parenthood, abortion coverage restrictions to health plans purchased with tax credits and the requirement that people with breaks in coverage wait six months before they can purchase new plans.
The Senate is using a budget process called “reconciliation” that allows Republicans to pass a bill with only 50 votes (and the potential tie to be broken by Vice President Mike Pence). But there are strict rules about what can and cannot be included, and those rules are enforced by the parliamentarian. Those rules can be waived, but that requires 60 votes, and all the chamber’s Democrats have vowed to fight every version of the bill to “repeal and replace” the Affordable Care Act, which is set for a possible vote next week.” (A)

“In a blow to the insurance industry, the parliamentarian has advised that two key market stabilization provisions in the bill would be against the rules. First, the legislation can’t appropriate the cost-sharing reduction subsidies insurers rely on to keep premiums and deductibles low; it can only repeal them.
Additionally, a “lockout” provision requiring consumers with a break in coverage to wait six months before buying insurance also violates the rules, according to the guidance.”
“The parliamentarian has also not yet ruled on a controversial amendment from Sen. Ted Cruz (R-Texas) that would allow insurers to sell plans that do not meet ObamaCare regulations. If that provision were struck, conservative support for the bill would be in doubt.”…
“The result is that the arcane rules of the Senate could end up making the bill harder for Senate Majority Leader Mitch McConnell (R-Ky.) to pass.” (B)

“In general, the parliamentarian has taken an already very difficult process for enacting health care legislation in the Senate and made it nearly impossible—unless Mitch McConnell is willing to blow up every Senate precedent without even knowing if it would be enough to persuade 50 senators from his own party. It will be a painful weekend for those whose dreams involve the repeal or replacement of Obamacare.” (C)

(A) Senate Parliamentarian Upends GOP Hopes For Health Bill, by Julie Rovner, http://khn.org/news/ruling-by-senate-parliamentarian-upends-gop-hopes-for-health-care-bill/
(B) Parliamentarian deals setback to GOP repeal bill, by Nathaniel Weixel, http://thehill.com/policy/healthcare/343234-parliamentarian-deals-setback-to-gop-healthcare-bill
(C) Senate Parliamentarian May Have Dealt the Last, No-Kidding-Final, Blow To Trumpcare, by Ed Kilgore, http://nymag.com/daily/intelligencer/2017/07/parliamentarian-deals-potentially-terminal-blow-to-trumpcare.html

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