Chief Senate Parliamentarian Will Play Crucial Role in Health Care Legislation

Generally speaking, Ms. MacDonough, the Senate parliamentarian since early 2012, will allow measures to benefit from the budget’s special, procedural shortcut if they are related to the budget. If not, the provision can be challenged under the “Byrd rule,”

.. That means Republicans likely won’t be able to address many health-insurance market regulations in their first legislative attempt to dismantle the law—Ms. MacDonough would likely rule those to be too unrelated to the budget to merit inclusion in the privileged legislation.

.. Republicans are using as their blueprint a measure repealing the Affordable Care Act that passed Congress in early 2016 under reconciliation, before being vetoed by President Barack Obama.

.. After conferring with Ms. MacDonough, Senate leaders altered the bill. For example, instead of simply repealing the individual mandate—the requirement that many individuals buy coverage or pay a penalty—the Senate simply set the penalty at zero dollars.

.. Parliamentarians are considered nonpartisan and are hired by the Secretary of the Senate, though they can lose their jobs if their decisions displease powerful lawmakers. Then-Majority Leader Trent Lott fired parliamentarian Robert Dove in 2001 over decisions he made

.. Ms. MacDonough, who has worked in the parliamentarian’s office since 1999, is popular with GOP leaders.

“She’s a brilliant lawyer, a thorough and fair referee and a walking encyclopedia of Senate precedent and procedure,” said Don Stewart, deputy chief of staff for Senate Majority Leader Mitch McConnell (R., Ky.).

How Democrats could bring down Obamacare repeal

Senate Democrats want House conservatives to think twice before supporting Speaker Paul Ryan’s Obamacare repeal bill — because Democrats believe they can strip out key provisions used to woo the right when the bill comes over to the Senate.

.. They plan to argue to the Senate parliamentarian that language that allows states to impose work requirements for Medicaid coverage and prohibits tax credits from being used on insurance coverage of abortion is not allowed.

.. the so-called “Byrd Rule” that restricts reconciliation bills from “extraneous” matters and provisions that don’t affect the budget.

.. The Family Research Council has already warned Republican lawmakers that the abortion prohibition is likely to get eliminated by Byrd rules because it does not have a pure budgetary impact.

.. Key House Republicans say it will be much more difficult to support the legislation without the work requirements and the abortion restriction.

.. Ted Cruz of Texas and Freedom Caucus Chairman Mark Meadows (R-N.C.), argue that the Senate should ignore any ruling from the parliamentarian that limits red meat additions to the repeal bill. But Senate leaders appear unwilling to consider such an explosive move, which could essentially eliminate the filibuster.

.. Anti-abortion groups raised concerns that there was no way to restrict the HSA money from covering abortion and comply with Byrd rules.