Skip to content
News and updates

Category: Health/Medical

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

Posted on

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

Posted on

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.

House Passes AHCA, the ACA Repeal

Posted on

By a vote of 217-213, the House passed a bill that would repeal parts of the 2010 health care law and change Medicaid from an open-ended entitlement system to one that limits states’ federal funding.

Passage fulfills a core Republican campaign promise of the past seven years. The measure, HR 1628, moves to the Senate, where supporters will face major challenges in passing it.

The legislation would replace the income- and cost-based subsidies for insurance in the health care law with an age-based tax credit beginning in 2020. It would effectively end the law’s expansion of Medicaid in 2020. It would block federal funding for Planned Parenthood for one year.

The bill would result in the loss of medical coverage for 24 million people by 2026, under a March Congressional Budget Office projection that did not take into consideration recent amendments. That analysis has not been updated. The Senate will not take up the measure until a new projection is released.

The bill would repeal taxes in the 2010 law for wealthier people with investment income, medical device manufacturers, health insurers and others. The CBO estimated the bill would reduce deficits by almost $337 billion over 10 years, under the earlier projection in March.

The House modified the original version by adding three amendments. One, by Rep. Tom MacArthur (R-NJ) would let states get waivers so they could exempt insurers from Obamacare minimum benefit rules and a ban on charging sick people higher prices. Another, by Rep. Fred Upton (R-MI) would provide $8 billion over five years to help people with medical conditions whose insurance premiums rose after a state got a waiver. The third, by Reps. Gary Palmer (R-AL) and David Schweikert (R-AZ)  would create a $15 billion federal program to help cover the costs of high medical claims.

House to Vote on ACA Repeal Today

Posted on

Following an amendment that won the support of two Republican hold-outs on the American Health Care Act (AHCA), House GOP leaders move to consider the AHCA today. This vote will be a defining moment for President Donald Trump and House Speaker Paul Ryan, to say nothing of the rank-and-file Republicans.

The GOP also is planning to vote on a separate bill that would eliminate AHCA’s exemptions for members of Congress and their staff to avoid Budget Reconciliation issues with the MacArthur Amendment, which was unveiled last week. The latest amendment, from Rep. Fred Upton (R-MI), would add $8 billion to $9 billion in funding over five years for high-risk pools aimed at subsidizing more expensive premiums for people with pre-existing conditions. The amendment has persuaded reluctant House Members – including House Freedom Caucus member Billy Long (R-MO) – to switch their votes to support this new version of the bill..

Republicans have a members-only meeting planned for 9 a.m. to talk strategy, and the vote could be as et 1 p.m. Some members want a quick vote and to promptly leave for recess, but the need for arm-twisting and the potential for delays could push the vote itself late into the day.