White House and Leaders in Congress Start Budget Talks
This week, the White House and leaders in Congress will start direct budget negotiations in order to reach an agreement before the September 30 deadline. Under the Budget Control Act of 2011, a spending deal must be reached to avoid $126 billion in automatic cuts to both defense and non-defense programs. While Congress has always reached a deal to avoid the automatic cuts and increase federal investment, both the President’s Budget and the Senate Republican budget called for stiff cuts to non-defense programs.
Key White House aides will be sitting down tomorrow with Speaker Nancy Pelosi (D-CA), Senate Majority Leader Mitch McConnell (R-KY), Senate Minority Leader Chuck Schumer (D-NY), and House Minority Leader Kevin McCarthy (R-CA). Although House Democrats have moved swiftly to pass appropriations bills this spring, both parties remain deeply divided over spending limits. The White House has recently proposed a one-year continuing resolution to delay any deal until after the 2020 presidential election.
House Democrats Advance Ban on Census Citizenship Question
In the House, appropriators have been swiftly unveiling and approving spending measures. Although the Agriculture Appropriations bill has yet to be released, legislators have started reviewing funding for the decennial Census. In the Commerce, Justice, and Science bill, House Democrats put forth a bar on the contested citizenship question.
The inclusion of a citizenship question on the Census is likely to result in a significant undercount of persons living in the United States, which skews data sets, interferes with funding formulas, and undermines local efforts to improve public health and other initiatives. The Supreme Court recently heard arguments in a challenge from New York and other states, many of which stand to lose federal funding if there is an undercount. A decision is expected in mid- to late-June.
Washington State Introduces the Country’s First Public Option
Last week, Washington State was the first state to roll out the public option for health insurance. A public option was a key element of the debate around the Affordable Care Act (ACA) that was ultimately left out of the final legislation. Healthcare advocates are closely watching implementation of the landmark legislation, which is expected to take effect for the 2021 plan year.
This option will be sold through the state’s exchange starting next fall 2020, targeting individuals who currently aren’t covered by their employer or government plans through Medicaid or the ACA exchange. The legislation would direct state officials to subsidize individuals who earn up to 500% of the federal poverty level. State officials must strike the right balance on affordability by attracting enough buy-in from hospitals and providers.
Since the ACA repeal efforts in 2017, federal efforts to streamline insurance options and rein in high costs have stalled. State legislatures have explored a variety of healthcare proposals – including efforts in New Mexico to explore a Medicaid buy-in and a study of the feasibility of the public option in Colorado.