S 1903119th CongressIntroduced

A bill to prohibit changes to Medicare and Medicaid in reconciliation.

Introduced: May 22, 2025

HealthcareSocial Services

Standard Summary

Comprehensive overview in 1-2 paragraphs

This bill would block any changes to Medicare and Medicaid in the budget reconciliation process. It amends the Congressional Budget Act of 1974 to explicitly include Medicare and Medicaid in the category of programs whose reforms or policy changes cannot be enacted through reconciliation. In practical terms, it would prevent Congress from using the fast-track reconciliation vehicle (which often requires only a simple majority in the Senate) to alter Medicare or Medicaid, and would require any changes to these programs to go through ordinary legislation, which typically involves more rigorous debate and potential for a broader coalition. The measure redefines the scope of what reconciliation can address by expanding the reference from the Social Security Act to cover Social Security, Medicare, and Medicaid, and it adds Medicare (Title XVIII) and Medicaid (Title XIX) to the list of program areas that cannot be changed via reconciliation.

Key Points

1What it does: Amends Section 310(g) of the Congressional Budget Act of 1974 to prohibit changes to Medicare and Medicaid in budget reconciliation.
2Scope change: Replaces the section heading to read “Social Security, Medicare, and Medicaid,” expanding the scope beyond Social Security old-age programs.
3Specific additions: Explicitly includes the Medicare program under Title XVIII and the Medicaid program under Title XIX as programs that cannot be altered through reconciliation.
4Mechanism: Reframes “recommendations with respect to” to include three areas—old-age Social Security, Medicare, and Medicaid—thereby shielding Medicare and Medicaid from reconciliation-based policy changes.
5Practical effect: Any reforms or cost-containment measures for Medicare or Medicaid would need to pass through regular legislation, requiring broader support (e.g., 60 votes in the Senate, depending on other legislative dynamics).

Impact Areas

Primary group/area affected: Medicare beneficiaries (seniors and certain disabled individuals) and Medicaid recipients, along with providers and health plans that participate in these programs.Secondary group/area affected: Policymakers and the budget process, since reconciliation is a fast-track budget tool that often shapes spending and tax policy; this bill would constrain how entitlement reforms can be pursued.Additional impacts:- Reduces maneuverability for reform efforts targeting Medicare/Medicaid within reconciliation bills, potentially increasing the difficulty of enacting changes to these programs.- Might shift the political and legislative burden for any Medicare/Medicaid policy changes to regular-order legislation, where bipartisan support and veto considerations play larger roles.- Could influence fiscal planning and stakeholder expectations around entitlement policy by creating a more durable shield for Medicare and Medicaid in budgetary enactments.

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