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Category: Legislation

House Committees Mark Up ACA Repeal

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Mark up for both the House Energy and Commerce (E&C) and House Ways and Means (W&M) committees will happen this morning beginning at 10:30 am. Both committees will consider the bills until they’re done and each committee is expecting around 100 amendments per committee. Highlights of the bill are below . 

Watch the W&M hearing here. 

Watch the E&C hearing here. 

Big Items:

  • It would convert federal Medicaid financing to a per capita cap beginning in FY 2020 based on FY2016 enrollment.
  • It would reduce eligibility from 138% to 100% of FPL. 
  • It repeals all ACA taxes except for the Cadillac tax, which is delayed until 2025.
  • It repeals Medicaid DSH cuts for non-expansion states beginning in 2018 and for
    expansion states in 2020. Expansion states will not absorb cuts for DSH across all states. Rather,
    the cuts will be divided across states, and expansion states will absorb only their share in 2018
    and 2019.
  • It would retain coverage requirements like preexisting conditions, dependents up to age 26, preventative coverage, and prohibition on lifetime and annual limits.
  • Tax credits to purchase coverage are reduced. 
  • It would repeal of the individual mandate (but insurers may charge a 30 percent higher premium for one year for individuals returning to the health care market after having been uninsured.

House and Senate Consideration

The House E&C and W&M mark up is today. After that, both parts will have to go to the House Budget Committee to be “married together” and more changes can be made. House Budget consideration could be as soon as Friday depending on when E&C and W&M finish. House Leadership will likely try to put the bill up for full consideration by next week. 

From there, it will go to the Senate.  The Senate will attempt to pass this via the Senate Budget Reconciliation process, which means that the Senate will consider this via a straight up or down vote — 60 votes are not needed. However, whatever the House passes, the Senate will change to conform to Reconciliation rules, so presumably McConnell can change the legislation enough to pacify some of these Senators and/or pick up Democrats like Senator Joe Manchin (D-WV), who represents a state where Trump is very popular. 

There are restrictions in what the Senate can considered via Budget Reconciliation. Namely, there is a restriction called the Byrd Rule, which means, in overly simplistic terms, provisions considered in a budget bill have to be related to cost or spend money; they cannot legislate. Why is this important? There are items in the House draft, such as Section 103 in the E&C draft (the provision defunds Planned Parenthood) that will be struck from the Senate’s version by virtue of the fact that these provisions legislate. 

While officially, the Senate should do as the House and send the bill to the companion Senate committees (HELP, Senate Finance, and Senate Budget), there is a push to have McConnell move this straight to the Senate Budget Committee or Senate Floor. Regardless, this legislation will move quickly in each legislative body. 

The goal is to have the whole bill passed and signed before Congress leaves for a two-week Easter Recess on April 7th. 

In the mean time, the Congressional Joint Committee on Tax has estimated this will cost $500 B over the next 10 years due to all of the ACA taxes repealed — all ACA taxes are repealed but for the the Cadillac Tax, which is delayed until 2025. There still is no CBO score, which would include an accounting of all revenue lost as well as the number of people losing coverage. A CBO score isn’t expected until after the measure is considered by the House. 

Politically

Conservative political groups are blasting the measure already. The Club for Growth, Heritage Action, FreedomWorks, and Americans for Prosperity have all been very critical of the measure and have the ear of conservative Members. Other groups, such as AARP, have also come out against the bill. 

The Office of Federal Relations will continue to track the legislation and continue to provide updates.

More Cabinet Posts, FY 2018 Budget Update

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It will continue to be a busy week for the House and Senate. Today, the Senate will continue to work on confirmations as four Cabinet positions – Betsy DeVos for Secretary of Education, Senator Jeff Sessions for Attorney General, Rep. Tom Price for Secretary of HHS, and Steven Mnuchin for Secretary of Treasury  – are up for full Senate consideration this week. Rep. Mike Mulvany (R-SC), Trump’s nominee to lead the Office of Management and Budget (OMB), is still working his way through the Senate, which could cause some budget complications for FY 2018 (see below). 

Senators are expected to move on a House-passed Congressional Review Act resolution nullifying a regulation curbing methane emissions from oil and gas wells on federal lands. Once passed, it will mark the third energy-related rule nullified by the Republican Congress. 

Today, the House continues efforts to stop regulations finalized by former President Barack Obama now focusing on the Department of Education. So far, lawmakers have introduced Congressional Review Act resolutions targeting the Obama Administration’s regulations governing teacher preparation programs as well as its accountability rule under the Every Student Succeeds Act.

It is the first Monday in February, which is technically Presidential Budget day. On the first Monday in February, the Administration is statutorily required to submit their budget request for the upcoming fiscal year (in this case FY 2018) to Congress. All recent Presidents (including Obama…multiple times) have missed the statutory deadline for budget submissions in their first year in office. There is no penalty for missing the date and a full budget proposal may not emerge from the White House until April or May.

While a delay in the budget submission is expected for a new Administration, virtually guarantees a delay in the entire FY 2018 appropriations process. Regardless of who controls Congress, lawmakers typically fail to get regular spending bills passed before the start of the new fiscal year, which begins on October 1. This year enjoys the particular complication of not having closed out FY 2017 with the current CR running until April 28th. Congress will have to address FY 2017 and immediately (or concurrently) FY 2018. 

 

More Confirmation Hearings, Republican Retreat

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It’s a busy short week for Congress. House and Senate Republicans head to Philadelphia this week to begin sorting out fiscal priorities for the coming year in the party’s annual retreat. 

The retreat should lay out the first 100 days game plan for the Administration and Congressional Republicans and could lay the groundwork for setting fiscal priorities in the first year of the Trump Administration.

The Government Accountability Office (GAO) warned Congress in a report last week that the country is headed toward a fiscal train wreck. That’s even before any new spending programs or tax cuts are considered. Soaring costs for entitlement programs, from an aging population and rising health care costs, will combine with increasing interest payments to push the federal debt to record levels, the GAO said.

Federal debt as a share of the economy reached 77 percent last year, compared to the historical average since World War II of 44 percent. Without a change in policy, the ratio will exceed its historic high of 106 percent within 15 to 25 years.

Also, welcome to the first week of Congress with President Trump in the White House. Congressional leaders from both parties will meet with the new president at the White House today for a 5 p.m. reception. 

The House will have a light week of mostly suspension bills. The only non-suspension bill the House will vote on next week is HR 7, the No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2017.  The measure, sponsored by Rep. Chris Smith (R-NJ), would prohibit federal funds, including those provided to the District of Columbia, from being used for abortions or for health benefits that cover abortions. The House has voted on a version of the bill in prior years as part of Republicans’ sustained targeting of Planned Parenthood.

The Senate continues to work on the confirmation process. Senate Democrats are demanding paperwork and additional time to question the remaining nominees, but truly all they can do is slow down the process. Up this week are Rep. Mike Pompeo (R-KS),who is up for CIA director, Rep. Tom Price (R-GA), who is up for Secretary of HHS and will appear before Senate Finance for another chance to defend ACA repeal, and Rep. Mick Mulvany (R-SC), who is Trump’s pick for White House budget director. Rep. Mulvaney gets a full day on Tuesday at two confirmation hearings: a morning hearing by the Senate Budget Committee and an afternoon examination by the Senate Homeland Security and Governmental Affairs Committee.

 

House Takes Up Bill to Change Rule-Making Process

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Earlier this week, the House took and passed H.R. 5, a bill intended to change the federal rule-making process. Among other things, the bill would codify agency requirements on considering the costs and benefits of a proposed rule as well as alternatives. It would also add more steps for federal agencies to follow when considering new rules or changes to existing rules that would increase costs in excess of at least $100 million.

Senate Passes Budget with ACA Repeal Instructions

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Early Thursday morning, Senators voted 51-48 to adopt the FY2017 budget resolution, with Senator Rand Paul (R-KY) casting the only Republican vote against it. With just 51 votes, the Senate moves forward with plans to repeal the ACA while avoiding a filibuster from Senate Democrats. Ultimately, the Senate considered 19 amendments before the final vote — and stymied each one, mostly through procedural votes.

The key amendment of the vote-a-rama was an amendment offered by Senator Bob Corker (R-TN), who was joined by other moderate GOP Senators, would delay an initial deadline to write legislation to repeal the 2010 health care law,. The amendment was ultimately withdrawn without a vote.

The Corker Amendment would have pushed back the Jan. 27 deadline for four House and Senate committees to write legislation to repeal the health care law, the sole purpose of the budget resolution under consideration. A vote on the amendment would have been a key indicator of where Senators stood on a growing debate among Republicans about how quickly Congress should repeal the law, especially without a clear replacement ready to go.

The FY 2017 budget resolution includes reconciliation instructions with the purpose of repealing the health care law, which would occur through separate legislation.