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Senate Republicans’ plan to force states to share the cost of the country’s largest nutrition program to pay for their policy megabill has been halted by the chamber’s rules. The Senate parliamentarian determined that the cost-sharing plan would violate the so-called Byrd Rule, which limits what can be included in the reconciliation process, and would be subject to a 60-vote filibuster threshold, according to an advisory sent out Friday night by Senate Budget Committee Democrats. (Yarrow, 6/21)

The Senate’s rules referee late Saturday allowed Republicans to include in their megabill a 10-year moratorium on enforcing state and local artificial intelligence laws — a surprising result for the provision that’s split the GOP. Senate Commerce Chair Ted Cruz (R-Texas) rewrote a House-passed AI moratorium to try to comply with the chamber’s budgetary rules. His version made upholding the moratorium a condition for receiving billions in federal broadband expansion funds. (Adragna, 6/22)

A Senate official rejected on Sunday a measure in Republicans’ sweeping domestic policy bill that could limit lawsuits seeking to block President Trump’s executive actions. ... Republicans are pushing their bill to carry out President Trump’s agenda through Congress using special rules that shield legislation from a filibuster, depriving Democrats of the ability to block it. (Edmondson and Gold, 6/22)

Tax legislation recently unveiled by Senate Republicans only costs $441 billion when tallied using a novel accounting method requested by the GOP. The new estimate by the Joint Committee on Taxation, which was released late Saturday night, shows how Senate Republicans were able to slash the costs of sweeping tax legislation set to be included in the GOP’s sweeping megabill by using a “current policy baseline” — a never-before-used technique that wipes out the cost of extending existing tax cuts that are set to expire at year’s end. (Guggenheim, 6/22)

Two of the largest tobacco firms in the United States are waging a lobbying battle over a key provision in the GOP’s massive tax and spending bill. The version of the legislation that the House passed last month included language to claw back a $12 billion tax break that tobacco producers — most of them in North Carolina — use to make their products cheaper to export. The version of the legislation the Senate is considering would leave the tax break untouched. (Bogage, 6/20)

Senate Republicans say they are looking for ways to safeguard rural hospitals from proposed cuts to a key Medicaid funding method, amid concerns from the powerful hospital lobby and others that the budget reconciliation bill could force many facilities to close. (Raman and Hellmann, 6/20)

Hampshire Memorial Hospital is nestled deep in the Appalachian Mountains, past more than 20 miles of winding mountain roads dotted with lush trees and ridges. It is the only hospital for a county that spans 645 square miles and, for many of its 24,000 residents, is the sole option for health care ranging from routine ailments to life-threatening emergencies. Like every rural hospital in West Virginia, Hampshire Memorial relies deeply on Medicaid, the government health insurance program for the poor that covers about one-third of residents in this deep-red state. But its ability to continue treating Hampshire County — among the poorer and sicker counties in the country — has been thrown into doubt by President Donald Trump’s sprawling tax and spending package that he has said he wants on his desk by July 4. (Abutaleb, 6/23)

In southern Colorado's San Luis Valley, clouds billow above the towering mountains of the Sangre de Cristo range. A chorus of blackbirds whistle, as they flit among the reeds of a wildlife refuge. Big circular fields of crops, interspersed with native shrubs, give it a feel of bucolic quiet. Despite the stark beauty in one of the state's most productive agricultural regions, there's a sense of unease among the community's leaders as Congress debates a budget bill that could radically reshape Medicaid, the government health program for low-income people. (Daley, 6/22)

�鶹Ů�� Health News: Federal Proposals Threaten Provider Taxes, Key Source Of Medicaid Funding For States 

Republican efforts to restrict taxes on hospitals, health plans, and other providers that states use to help fund their Medicaid programs could strip them of tens of billions of dollars. The move could shrink access to health care for some of the nation’s poorest and most vulnerable people, warn analysts, patient advocates, and Democratic political leaders. No state has more to lose than California, whose Medicaid program, called Medi-Cal, covers nearly 15 million residents with low incomes and disabilities. That’s twice as many as New York and three times as many as Texas. (Wolfson, 6/23)

�鶹Ů�� Health News: �鶹Ů�� Health News' 'What The Health?': Supreme Court Upholds Bans On Gender-Affirming Care 

Meanwhile, the Senate is still hoping to complete work on its version of President Donald Trump’s huge budget reconciliation bill before the July Fourth break. But deeper cuts to the Medicaid program than those included in the House-passed bill could prove difficult to swallow for moderate senators. (6/20)