The Senate rejected a bid by Sen. Susan Collins (R-Maine) to raise taxes on the ultra-wealthy and boost money for rural medical providers in the GOP’s megabill.
The chamber voted 78-22 against a procedural motion related to her amendment, which would have increased a rural hospital fund from $25 billion over five years to $50 billion and allowed a wider range of health providers to tap it. The amendment also would have raised the top tax rates for individuals who earn more than $25 million a year and couples earning more than $50 million starting next year.
It remains unclear whether the failure of the amendment could cost GOP leaders Collins’ vote. She had been concerned about the impact on rural hospitals from the bill, and even questioned if any amount in a rural hospital fund would help offset the losses.
“Rural providers, especially our rural hospitals and nursing homes, are under great financial strain right now, with many having recently closed and others being at risk of closing,” Collins said before the vote. “This amendment would help keep them open and caring for those who live in rural communities.”
Most Democrats joined the majority of Republicans in opposing consideration of the amendment. Sen. Ron Wyden (D-Ore.) called it a “Band-Aid on an amputation” that would barely offset the other health care cuts in the bill: “It would be much more logical to simply not cut $1 trillion from Medicaid in the first place,” he said. Georgia Sens. Jon Ossoff and Raphael Warnock and Virginia Sen. Mark Warner were the only Democrats to vote with Collins, along with independent Sen. Angus King of Maine.
Collins criticized Democrats after the vote for opposing her. “They’ve complained repeatedly about the distribution in this bill, of Medicaid cuts hurting individuals, rural hospitals, and tax cuts being extended for people who are wealthy, and yet when I tried to fix both those problems, they took a very hypocritical approach.”
She said she remained undecided on the overall bill and that the snub would not affect her decision.
Several GOP senators have aired concerns that the bill’s cuts to Medicaid in the bill would force rural hospitals to close. The bill lowers the amount a state can tax a hospital and then use the funding to qualify for more federal Medicaid dollars without having to dip into their own general funds. Hospitals don’t mind the tax because they can get higher payments from their state.
Conservatives have claimed these provider taxes amount to a “money laundering” scheme that enables states to use the extra federal dollars for other things. But the hospital industry has fought this claim, arguing that the provider taxes are needed to help rural hospitals that operate on thin margins.
