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Category: Health/Medical

Trump to Address Congress Tonight, Senate Approves Ross, and Zinke Up

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Last night, the Senate confirmed another Cabinet nominee for Trump as it voted 72-27 to confirm billionaire investor Wilbur Ross as Commerce Secretary.

Ross is a 79-year-old businessman who made his fortune by turning around companies in distressed industries like textiles and steel and is expected to play a leading role in trade policy.

The Senate now turns to Interior Secretary nominee, Rep. Ryan Zinke (R-MT). Out of the 15 primary federal department chiefs, Zinke looks like he will soon become the 11th Cabinet member confirmed. The Zinke nomination is expected to take the maximum amount of time possible similar to nearly every other Trump nominee.

Trump Address Congress, 

Meanwhile, it’s a little over a month into his new Administration and President Donald Trump will address a joint session of Congress for the first time tonight at 9 pm Eastern/6 pm Pacific. While not an official State of the Union address, the new president’s first address to Congress traditionally has been a tone setting speech. Expect a speech from Trump that will offer his vision for the country, including his policy priorities, but will not likely be heavy on details.

The While House has previewed the speech and expect Trump to hit on such topics as: the coming Presidential Budget Request (PBR); recent antisemitic attacks; the White House and the media, including CNN and false reporting; Obamacare repeal and replacement; and an extreme vetting Executive Order (expected Wednesday).

See the White House preview here. 

Meanwhile, the White House has said that the PBR will be previewed March 16th with something akin to a skinny budget, but the complete PBR will not be released until mid-May. The OMB, with newly approved OMB Director Mulvaney, began circulating top line numbers to agencies yesterday in preparation for a full budget preview and request.  As those documents were circulating, the Trump PBR will call for $603 billion in military spending, which is a 2% boost from current levels. That sum would also represent a $54 billion, or 10%, increase over budget caps set in law. Additionally, the plans has no cuts coming from entitlement programs such as Medicare and Social Security. The increase would come from the non discretionary defense portions of the budget.

Before the FY2018 PRB is released, the Trump Administration is expected to ask Congress for a $30 billion in supplemental defense spending via the Overseas Contingency Operations account that is not subject to the spending caps. It’s a move that’s been used by Congress previously. 

Administration Regulatory Reform Update

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Last week, White House Chief of Staff, Reince Preibus, issued a memorandum to all executive departments and agencies to freeze new or pending regulations — giving the new Administration time to review them, which is a common practice for any incoming administration.

For any regulations that have yet to be sent for publishing in the Federal Register, the memo asks the agency to not send any regulation to the Federal Register until reviewed by someone selected by the President.

The memo makes an exception for “critical health, safety, financial, or national security matters,” and asks agencies to identify any regulations that can’t be delayed for other reasons.

Recently issued research-centered regulations that could be impacted include:

  • federal policy for the protection of human subjects (Common Rule),
  • Department of Education’s final Rule on open licensing requirements for competitive grant programs, and
  • updates to the Uniform Guidance (including updates to the procurement rule and the micro-purchase threshold).

The Office of Federal Relations will continue to monitor actions coming from the Administration.

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.

 

Trump’s First Executive Actions

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True to his word, President Trump has issued an Executive Order (EO) impacting the ACA. First, Trump signed a broad EO giving all federal agencies wide latitude to change, delay or waive provisions of the law that they deemed overly costly for insurers, drug makers, doctors, patients or states. The order also directs agencies to give greater flexibility to states in implementing the health care law.  

Additionally, Trump’s Chief of Staff, Reince Preibus, issued a Presidential Memorandum freezing  agencies from issuing pending federal regulations until the Trump Administration has time to review the pending regs. 

Trump Transition Previews Budget

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Staffers for the Trump transition team have been meeting with career staff at the White House ahead of Friday’s presidential inauguration to outline their plans for shrinking the federal bureaucracy. The proposal takes directly from the Heritage Foundation’s FY 2017 budget blueprint and the Republican Study Committee’s (RSC) FY 2017 Budget Proposal.

While the annual President’s Budget Request is important to set the Administration’s policies and agenda. Congress is ultimately responsible for approving a federal budget and appropriating funds.

The Trump budget, which will not likely be officially unveiled until mid-April, would reduce federal spending by $10.5 trillion over 10 years. The preliminary proposals from the White House budget office will be shared with federal departments and agencies soon after Trump takes the oath of office Friday. Also, Trump’s Cabinet picks have yet to be apprised of the reforms, which would reduce resources within their agencies.

The Commerce and Energy departments would see major reductions in funding, with programs under their jurisdiction either being eliminated or transferred to other agencies. The departments of Transportation, Justice and State would see significant cuts and program eliminations.

The Heritage FY 2017 blueprint, which is reportedly being used as a basis for Trump’s proposed cuts, calls for eliminating several “corporate welfare” programs including:

  • the Minority Business Development Agency,
  • the Economic Development Administration,
  • the International Trade Administration, and
  • the Manufacturing Extension Partnership.

The total savings from cutting these four programs would amount to nearly $900 million in 2017.

The Corporation for Public Broadcasting would be privatized, while the National Endowment for the Arts and National Endowment for the Humanities would be eliminated entirely.

At the Department of Justice, the blueprint calls for reducing funding for its Civil Rights and its Environment and Natural Resources divisions and eliminating:

  • the Office of Community Oriented Policing Services,
  • Violence Against Women Grants and the Legal Services Corporation.

At the Department of Energy, it would roll back funding for nuclear physics and advanced scientific computing research to 2008 levels, and would eliminate

  • the Office of Electricity,
  • the Office of Energy Efficiency and Renewable Energy and
  • the Office of Fossil Energy, which focuses on technologies to reduce carbon dioxide emissions.

At the State Department’s , funding for the Overseas Private Investment Corporation, the Paris Climate Change Agreement and the United Nations’ Intergovernmental Panel on Climate Change are candidates for elimination.

Many of the specific cuts were included in the 2017 budget adopted by the conservative RSC, a caucus that represents a majority of House Republicans. It is notable, that the RSC budget plan would reduce federal spending by $8.6 trillion over the next decade.

 

Trump vowed during the campaign not to cut Medicare and Social Security, a pledge that Rep. Tom Price (R-GA), Trump’s nominee to head the Department of Health and Human Services, told lawmakers in testimony Wednesday has not changed.

That said, it could be very difficult to reduce U.S. debt without tackling the entitlement programs. Conservative House budgets have repeatedly included reforms to Medicare and Social Security, arguing they are necessary to save the programs.

 

This proposal is expected to be met with strong opposition by Democrats.
The Office of Federal Relations will continue to update on this issue.