Senate Finance Bill Retains Medicaid Work Mandate, Limits Provider Taxes

The Senate Finance Committee's version of the GOP tax and spending bill includes a mandate for Medicaid recipients to work 80 hours per month starting in 2026, a provision supported by Senator Chuck Grassley, who argues it incentivizes recipients to move off Medicaid and into the workforce. This bill also restricts states' use of health care provider taxes by reducing the 'safe harbor' limit, though some senators have expressed concerns about these changes. Senator Deb Fischer highlighted the inclusion of her Paid Family and Medical Leave Tax Credit in the bill, aiming to support working families by making the tax credit permanent and expanding employer eligibility. However, opposition exists among Senate Republicans like Senator Ron Johnson, who opposes the bill due to insufficient deficit reduction and concerns over raising the debt ceiling by $5 trillion. Additionally, there is pushback against the House reconciliation bill's failure to extend enhanced premium tax credits crucial for many North Carolinians, potentially doubling insurance premiums for families and threatening health coverage access. These developments reflect ongoing debate over balancing health care affordability, fiscal responsibility, and social support within the broader reconciliation legislation.