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Text of Senate Healthcare Bill Released

As promised, the Senate Republican leadership released earlier today the text of the healthcare legislation that was being worked on by a small group of Republican Senators. The 142-page bill has a number of provisions of importance to the University of Washington and other institutions of higher education, including those related to possible changes to Medicaid.

This bill is an attempt by Senate Republicans to craft its own legislation in response to the House’s version of a bill to “repeal-and-replace” Obamacare.  At this point in time, the future of the measure remains uncertain as a number of Republican Senators have expressed their opposition to it in its current form.

The text of the measure is available here.

Collins to Stay On as NIH Director

Yesterday, the White House announced that Dr. Francis Collins will continue to serve as Director of the National Institutes of Health (NIH). Collins has led the NIH since 2009 and previously led the NIH Human Genome Research Institute.

Earlier this year, a bipartisan group of Congressional leaders wrote a letter to the President asking him to keep Collins.

Memorial Day Recess, Health Care & Tax Reform Slowly Move, Omnibus Already?

The House and Senate are in recess to observe Memorial Day this week. Members returned to their home districts to work as efforts continue behind the scenes in DC on health care and tax reform.

Health care continues to be a big unknown in the Senate. According to the most recent impact analysis released by the Congressional Budget Office (CBO), the amendments to the AHCA do little to improve the bill. The AHCA would lead to 14 million people without insurance in 2018 and 23 million uninsured in 2025. The bill also hurts the Medicaid program, cutting $834 billion over 10 years.

The bill is now with the Senate where various Senate Republicans have indicated that any health care measure will undergo a dramatic overhaul in the coming weeks. Senate Republicans ca not ignore CBO completely — they have to pay attention to the cost estimates to make sure they comply with budget rules.

A specific timeline for the bill has not yet been set or made public. Currently, Senate staffers are drafting legislation intended to jump-start conversation when the Senate reconvenes next week.

House and Senate leaders and the White House going to try to put their heads together and cook up a single tax plan – instead of allowing each chamber to craft its own bills, like Republicans are doing now on health care and as happened with the 1986 tax revamp. However, the timeline to accomplish reform is slipping due to several factors (including the need to raise the debt ceiling much earlier than previously anticipated) and a failure to reach consensus about what provisions should actually change. All politicians hate the tax code, but there is not agreement on which provisions exactly what they hate. Voters gripe about complexity but are opposed to losing any breaks that benefit them.

Looming over tax reform is federal government’s need to raise the debt ceiling now, several months before Congress was prepared to act. At the beginning of 2017, Treasury estimated that the Department could use extraordinary measures until the Fall so that the federal government could continue to operate.

Now, senior White House officials are requesting Congress address and raise the debt ceiling prior to the August Recess. The request sets up a potentially monumental political fight. It is something that will not just be a fight between Republicans and Democrats but within each of the parties. The GOP is torn over whether to combine spending cuts with the debt ceiling lift, and Senate Democrats are already signaling they may push for their own concessions since their votes are going to be needed to avoid a devastating government default.

Rumor of the Week! House Appropriators are floating the idea of passing a 12- bill omnibus before the August Recess. Such a move would certainly accelerate the FY 2018 process, which is significantly behind this cycle due to the late completion of the FY 2017 appropriations in May. To complete such a package would put tremendous pressure on the House Appropriations committee to craft, mark up and combine all 12 bills (none of which are currently in public draft form) and would be a significant accomplishment if any of the bills were already available. FY 2018 begins October 1 and right now, lawmakers have just 12 legislative days planned when both chambers will be in session in September. Stay tuned!!

House Out, Senate Still Working

The House is out for a pre-scheduled recess this week — and likely to do a victory lap about passing the AHCA last week — while the Senate continues to move through nominations, Russian investigations, and maybe health care reform.

Also last week, FY 2017 funding is finally secured, and Congress is beginning to take stock of how far behind schedule they are for FY 2018.  There are now only four-and-a-half months left before the new fiscal year begins on Oct. 1 – and that includes the month-long August recess. Typically, at this point in the Congressional calendar, at least one of the 12 standing appropriations bills has been marked up by committee and the House and Senate Appropriations Committees are well on their way to drafting the other standing bills.

However, there is no guidance for appropriators on the annual spending limits, which is something set up by the annual budget measurers, which has yet to be passed by the House and Senate. The House took a first step with the AHCA last week, but within hours of the passage of the House legislation, Republican Senators made clear they didn’t support the measure and would begin drafting their own version…and that might take a while…like August. 

President Donald Trump has yet to submit a full FY 2018 budget request, which is typically due in early February. While the President offered an outline of discretionary spending plans in March, his full budget is not likely to come before May 22, and even then, it is unclear how in depth the budget released might be.

Stay tuned.