FY 2018 Budget and Appropriations Update
The House Budget Committee, chaired by Congresswoman Diane Black (R-TN), is expected to proceed with a markup this week of its FY 2018 budget resolution. Members of the House Republican Caucus continue to clash over the resolution, as conservative members call for deeper cuts over the next 10 years, and moderate members object to deep cuts in mandatory spending. House leaders will also be working this week to determine if there is support to bring an omnibus spending package to the floor before the August recess.
Despite the lack of a budget resolution, the FY 2018 appropriations process has been moving along at a steady pace. A draft of the FY 2018 Agriculture Appropriations bill, which sets funding for WIC, was passed by a voice vote in the House Appropriations Committee, chaired by Congressman Rodney Frelinghuysen (R-NJ), last Wednesday. The full Committee’s bill does not deviate from the Subcommittee’s bill with regard to WIC. You can read our overview of the WIC portions of the bill in our blog post from July 10.
The Senate Appropriations Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies, chaired by Senator John Hoeven (R-ND), will markup their Agriculture Appropriations bill tomorrow, and the bill will be marked up by the full Appropriations Committee, chaired by Senator Thad Cochran (R-MS), on Thursday.
Affordable Care Act Repeal Update
A revised version of the Senate’s Affordable Care Act (ACA) replacement bill was released last Thursday. The revised bill includes the following changes: $70 billion more for state stability and innovation funds; the preservation of certain ACA tax increases on the wealthy; and the inclusion of $45 billion to address the opioid epidemic. Some of the changes are intended to appeal to moderates concerned about increasing premium costs predicted by the Congressional Budget Office (CBO) under the previous bill.
However, the revised bill also includes provisions that appeal to more conservative Republican senators. One such provision is an amendment proposed by Senators Ted Cruz (R-TX) and Mike Lee (R-UT). The Cruz/Lee amendment would allow insurance companies to offer inexpensive, limited plans that would not meet the comprehensive coverage requirements of the ACA alongside a single, more expensive plan that would. The proposal would essentially put people with pre-existing conditions in the ACA insurance pool at significantly higher costs to the insured and allow young, healthy people to buy cheaper, though far less effective and comprehensive plans, in a separate pool.
Health insurance companies have said the Cruz/Lee plan would destabilize the insurance market and undermine protections for sick people. The BlueCross BlueShield Association called the Cruz plan “unworkable”, and America’s Health Insurance Plans (AHIP), the industry’s main lobbying group, said dividing healthy and sick people into separate groups would wreak havoc on the market. The sick people would face extraordinarily high premiums or might not be able to find coverage, AHIP said.
The revised bill quickly drew two firm no votes: Senators Rand Paul (R-KY) and Susan Collins (R-ME). Senator Paul is concerned that the bill looks too much like the ACA, while Senator Collins is concerned about the Medicaid cuts, which were not mitigated or removed in the revised bill.
Senate Majority Leader Mitch McConnell (R-KY) said late Saturday that he is postponing plans to begin Senate debate in the next few days on the revised bill after Senator John McCain (R-AZ) said he would be recovering this week from an unexpected surgery.
Due to the delay, the CBO will not release a score on the revised bill today, as many had expected. The CBO’s score of the last version of the bill predicted that 22 million people would lose health insurance by 2026 under that legislation. Republicans are hoping the report for the revised bill will look better than the earlier estimate. The delay will give the CBO more time to score the latest bill and Leader McConnell more time to gain the support of a number of Republican Senators who have voiced skepticism, including Lisa Murkowski (R-AK), Dean Heller (R-NV), and Rob Portman (R-OH).