AILSA CHANG, HOST:
President Trump's massive tax and spending bill suffered a significant setback today. Republicans are headed back to the drawing board to rewrite some key Medicaid provisions to help offset tax cuts in the bill. The president wants Congress to deliver it by the Fourth of July. And at the White House today, Trump appealed to Americans to put pressure on Congress to get it done.
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PRESIDENT DONALD TRUMP: And so if you can, call your senators, call your congressmen. We have to get the vote. I want to thank you.
CHANG: Correspondent Deirdre Walsh joins us now from the Capitol. Hi, Deirdre.
DEIRDRE WALSH, BYLINE: Hey, Ailsa.
CHANG: OK, so just how big of a setback is this for Republicans? I mean, they have to now rewrite the bill?
WALSH: Parts of it. I mean, as we just heard, the president was making the case for this bill, the tax cuts, the border security and defense money in the package. But today's hurdle in the Senate could really throw off the timeline that Senate Majority Leader John Thune set to try to get this package through the Senate by the end of this week.
The issue that's tripping them up is this provision that changes how states finance their Medicaid programs. Rural states, especially, rely on taxes that states levy on Medicaid providers. Those help boost how much money states get from the federal government to pay for their programs. But the nonpartisan Senate parliamentarian said this provision doesn't comply with the rules that allow Republicans to pass the package with a simple majority. These tax provisions raised hundreds of billions of dollars to offset the costs of the bill's tax cuts, so that's just a big hole Senate Republicans have to make up.
CHANG: A big hole - OK. Well, how are Republican leaders planning to plug up that big hole?
WALSH: They are quickly reworking the language. Republicans I talked to today said it's a technical issue and it can be adjusted in a way that they think it will still be allowed and it will still raise enough money to pay for those tax cuts. They admit they might have to adjust the timeline for some of these changes to Medicaid go into effect, but they think they can come up with a plan B and still move ahead soon.
CHANG: OK, but we have been reporting for days now that Republicans are split over Medicaid, right? So if some version of these proposals stays in the bill, are leaders worried that there could be enough opposition within their own ranks to derail this entire bill?
WALSH: I mean, Medicaid is still a big stumbling block to get to the 51 votes they need. There's a group of Republicans who warn the cuts in the bill will shift costs to the states. Some warn that this provider tax issue could cause rural hospitals and their states to close. To deal with those concerns, Republican leaders came up with this idea to propose a separate fund to help out rural hospitals. Initially, they suggested $15 million over the next five years be available to those hospitals. But some Republicans say that's just not enough, so they expect the fund could get bigger. But it's unclear right now if that approach is going to help get those votes.
CHANG: Well, as we said, President Trump held a big event today touting what he believes are the benefits of the bill. How important do you think Trump's Fourth of July deadline really is?
WALSH: It's not really a hard line. It's really a political one that the president set. At today's event, Trump was really selling the bill, promising people that the tax cuts are going to help their pocketbooks and that they'll still be able to keep their health care under Medicaid. But independent estimates on this bill show that millions could lose coverage and the tax benefits - the tax cuts in the bill benefit people more at higher incomes.
The president's highlighting things he promised during the campaign, but this comes at a time when polls show this proposal is not very popular. The real deadline comes sometime in mid-July. This bill includes 5 trillion to increase the country's borrowing authority. And then that runs out later this summer. Republican leaders expect Trump to be the closer to try to get this package through the Senate first, and then it'll go back to the House.
CHANG: That is NPR's Deirdre Walsh. Thank you so much, Deirdre.
WALSH: Thanks, Ailsa. Transcript provided by NPR, Copyright NPR.
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