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Category: 2018 UW Federal Agenda

House Budget Markup of AHCA Delayed

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Happy Pi Day! DC is under snow, and the House Budget Committee has delayed its markup of the ACA replacement bill, the American Health Care Act (AHCA), until Thursday morning. It was originally scheduled for Wednesday. The Congressional Budget Office released its long-awaited score of the AHCA yesterday, which said that 14 million would lose coverage immediately. By 2026, more people would be uninsured than before the ACA was enacted – 52 million.

The measure would reduce the federal deficit by $337 billion over the next decade by cutting federal Medicaid spending by nearly $900 billion over the same time, which would lead insurance premiums to increase at first, then shrink.

The full House is still expected to consider and pass the measure next week. It will proceed onto the Senate from there.

Mark Up Still Going

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The House Ways and Means (W&M) Committee finished their portion of the Republican ACA repeal measure around 4:30 am this morning. The Committee approved their marked up draft by a vote of  23-16. The panel worked through the night, with Republicans overcoming Democratic protests that the process was rushed and the bill would force Americans to lose insurance coverage. 

The House Energy and Commerce  (E&C) Committee continues to mark up their section of the measure — 23 and a half hours as of this posting. Watch the hearing live here. For both committees, it has been an exercise in procedural maneuvering , particularly for E&C. To wit, it took E&C 12 hours to debate and then vote on the first amendment offered to the bill, which came from Ranking Member Frank Pallone (D-NY), to rename the bill “Republican Pay More for Less Care Act”. It failed along party lines. They are still working, and Democrats have asserted the they have “hundreds” of amendments.

During the week of March 13, the House Budget Committee is expected to package the W&M language with provisions from the E&C. The House will vote on the combined measure later in the week.

House Passes FY2017 DOD Approps Bill

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Today, the House voted 371 to 48 to pass HR 1301, the FY2017 Defense Department spending measure.

The legislation replaces the continuing resolution  for the Pentagon and falls well within the budget control law’s caps on overall defense spending with a total of $577.9 billion. That is is below the sequester levels may allow it to move through both chambers without too much opposition. The measure includes $61.8 billion for overseas operations, an account that is not limited by law.

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.

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.