Monday, August 21, 2017
After breaking for August recess a week later than usual, Senators returned home to face constituents still vocal about the failed health care reform efforts. Republican lawmakers are increasingly talking about working with Democrats on legislation that would stabilize ACA marketplaces rather than aiming for repeal and replace. The Associated Press reported that past Secretaries of HHS Kathleen Sebelius, Mike Leavitt and Tommy Thompson have said that market stabilization should be the priority now that efforts to repeal the ACA appear to have failed. In a recent interview, Sebelius called out the Trump administration for "sabotaging" the ACA, saying, "the notion that law is imploding is just not accurate" and that the law would be working better if Republicans would stop undermining it. One of the measures she sees as undermining the bill are blocking payments to insurance companies to help absorb the higher cost of covering people with pre-existing conditions, which was blocked by Congress. Another issue of contention surrounding the implementation of the law has been the payment of cost-sharing subsidies, which help to reduce health insurance copays and deductibles for people with modest incomes. Trump had at one point threatened to cut off the payments, but announced last week that he would allow the payments to continue for the month of August. If Congress does want to pass a bill to bolster the ACA's individual marketplaces, they will have only twelve legislative days to do so before insurance companies must commit to participating in the exchanges in 2018.
While the possibility of revisiting health care reform hangs in the air, the administration and Congress are also looking towards accomplishing major tax reform and comprehensive infrastructure legislation. These priorities are set against a backdrop that includes increasing the debt ceiling and appropriating funds to keep the government operating when the current continuing resolution runs out at the end of September. Budgetary legislation may be complicated by the Trump administration's insistence on the inclusion of funds to build a border wall across the US-Mexico border. Democrats are staunchly opposed to appropriating funds for the border wall, and at least some Democrat votes will be needed to move any appropriations bills. As has become standard operating procedure over the past several years, it is likely that a new short-term continuing resolution lasting a few months will be needed to stave off a government shutdown until a larger omnibus funding package can be approved.