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Creates new Senate rules that block consideration of measures that would reduce Social Security benefits or Medicare benefits, or that rely on cuts in Medicare spending (or increases in Medicare revenues) to pay for unrelated items, unless two-thirds of Senators vote to waive the rule. It also requires that Medicare savings used as offsets be scored by the Congressional Budget Office and makes a two-thirds vote the threshold to overturn rulings on these points of order. The effect is to raise the Senate threshold for allowing benefit reductions or using Medicare savings as budget offsets, shifting how Congress can structure deficit offsets and entitlement changes and making waiver of these rules difficult without broad Senate agreement.
The Senate may not consider any bill or resolution, or any amendment, motion, or conference report on that bill or resolution, that would reduce benefits under the Medicare program (title XVIII of the Social Security Act) or reduce benefits payable under title II of the Social Security Act.
Paragraph (1) (the prohibition) may be waived or suspended only by an affirmative vote of two-thirds of the Members of the Senate, duly chosen and sworn.
Adds a new subsection (k), titled “Medicare point of order,” to Section 301 of the Congressional Budget Act of 1974 (2 U.S.C. 632).
It shall not be in order in the Senate to consider any bill or resolution (or amendment, motion, or conference report on that bill or resolution) for which the total budgetary effects, as determined by the Congressional Budget Office, use a decrease in outlays or an increase in revenue under the health insurance programs under title XVIII of the Social Security Act (Medicare) to offset the cost of a provision that is not for the purpose of carrying out those programs.
Paragraph (1) may be waived or suspended in the Senate only by the affirmative vote of two-thirds of the Members, duly chosen and sworn. An affirmative vote of two-thirds of the Members is also required to sustain an appeal of the Chair’s ruling on a point of order raised under paragraph (1).
Who is affected and how:
Medicare beneficiaries: The rule makes it harder for Congress to enact measures that would reduce Medicare benefits or rely on Medicare cuts as offsets, which increases procedural protection for current and future beneficiaries.
Social Security recipients: The rule explicitly blocks consideration of measures that would reduce Social Security benefits in the Senate unless two-thirds agree to waive, providing a high procedural barrier to benefit reductions.
The Senate and Senators: The change alters Senate floor procedure by adding enforceable points of order and raising the vote threshold to sustain appeals to two‑thirds, requiring broader consensus to consider or pass measures that cut entitlements or use Medicare savings as pay-fors.
Congressional Budget Office (CBO): CBO scoring becomes central for determining whether a measure improperly uses Medicare savings as offsets, increasing demand for timely and detailed CBO budget estimates.
Budget and legislative strategy: Lawmakers will face greater difficulty using Medicare savings to pay for unrelated priorities, likely redirecting negotiations toward other offsets (tax changes, discretionary cuts, or other entitlement adjustments). This could complicate deficit‑reduction strategies and reduce legislative flexibility.
Administrative and enforcement impact: Because these are points of order in Senate procedure, enforcement is parliamentary rather than judicial; the Chair and presiding officers will play central roles in initial rulings, and appeals will require supermajority support to overturn.
Potential side effects and tradeoffs:
The higher barrier may protect beneficiaries but also increase legislative gridlock on budget and entitlement reform, making bipartisan compromise more necessary.
Opponents seeking deficit reduction or program changes may shift tactics to avoid triggering the points of order (e.g., using non‑Medicare offsets or narrow technical changes), possibly reducing transparency around offsets.
The provision could have downstream effects on budget scoring practices, legislative drafting, and inter‑chamber negotiations because Senate floor rules constrain what can be considered in that chamber.
Expand sections to see detailed analysis
Read twice and referred to the Committee on Rules and Administration.
Introduced January 8, 2025 by Richard Lynn Scott · Last progress January 8, 2025
Read twice and referred to the Committee on Rules and Administration.
Introduced in Senate