Outlook: It's Make-or-Break Week for Obamacare Repeal

Senate GOP leaders have vowed to hold a roll call before the July 4th recess. Can they get 50 votes?

In this March 30, 2017, photo, the U.S. Capitol dome is seen at dawn in Washington.
AP Photo/J. Scott Applewhite
June 25, 2017, 8 p.m.

Seven years ago, Mitch McConnell’s office wrote the battle cry that Republicans across the country used to capture the House, Senate, and White House—“repeal and replace” Obamacare. This week, the Senate Majority Leader could finally be in a position to pass a bill to fulfill that promise.

Still, the Republicans’ alternative isn’t ready; the Senate bill doesn’t yet have enough support to pass. McConnell has a miniscule margin of error: 50 out of 52 Republican senators have to get on board. And already, after the bill’s unveiling Thursday, four conservative senators—Ted Cruz of Texas, Ron Johnson of Wisconsin, Rand Paul of Kentucky, and Mike Lee of Utah—announced that they opposed the current legislation. A fifth, vulnerable Sen. Dean Heller, said the same Friday, though for the opposite reasons. Many others have withheld judgment, seeking to privately obtain changes to the bill.

Some conservatives say the bill doesn’t do what Republicans said they would, since it keeps much of the structure of Obamacare in place and puts off many of the most significant coverage provisions until after the next presidential election, when a Democrat could win and overturn them. Meanwhile, moderate Republicans say this isn’t what they signed up for, turned off by a plan that will kick millions off of Medicaid over time.

The House’s manifestation of the “repeal and replace” promise—the American Health Care Act—is wildly unpopular, while the support for Obamacare has increased to its highest point ever. So McConnell has done everything he can to avoid a backlash, crafting a bill without public input to a degree not seen in decades. Still, the Senate’s bill is similar to the House’s, and McConnell has bet on this week as the best time for a vote, before his members go home for a weeklong July 4 recess.

If McConnell succeeds in placating enough members of both wings of his party, the bill will still have to go to the House, where the divisions are just as stark.

House Republicans, meanwhile, will continue their budget negotiations this week, with the possibility of a markup. But as of Friday, members did not have an agreement on the top-line numbers or how much to include in mandatory entitlement cuts, so any committee action could be rolled until after the July 4 recess.

On the floor, the House will consider two immigration bills that comport with President Trump's agenda: Kate's Law and a measure dealing with sanctuary cities. The first bill, named for a woman who was shot by a man who had illegally reentered the country after being deported for a separate crime, would toughen sentences for offenders who have reentered the country illegally multiple times. The sanctuary-cities bill would punish jurisdictions that refuse to comply with federal immigration authorities.

Here’s what else is on tap:

DEFENSE AND FOREIGN POLICY

The Senate and House Armed Services committees will mark up the National Defense Authorization Act of 2018 this week, while the House Appropriations defense subcommittee will mark up the fiscal 2018 Pentagon spending bill as lawmakers continue to debate the top-line figure.

The chairmen of the House Armed Services and Appropriations panels said last week that they would move forward with legislation that would set the base budget for the Pentagon at $640 billion, which is about $37 billion above Trump's request. Senate Armed Services Committee chairman John McCain has also called for $640 billion in the next defense-spending bill. But the House Budget Committee has tried to split the difference with a $621.5 billion budget.

Elsewhere in the lower chamber, U.S. ambassador to the U.N. Nikki Haley is slated to appear before the House Foreign Affairs Committee on Wednesday, and the House Intelligence Committee will meet in a closed session on Thursday.

On the other side of the Capitol, the Senate Foreign Relations Committee will vote on the nomination of former Rep. Mark Green to be USAID administrator Wednesday, and hold a closed hearing on North Korea on Thursday. And the Senate Homeland Security and Governmental Affairs Committee will hold a hearing for two nominees for the Homeland Security Department on Wednesday.

ENERGY AND ENVIRONMENT

Environmental Protection Agency administrator Scott Pruitt returns to the Hill on Tuesday to defend his agency’s proposed budget before the Senate Appropriation Committee’s interior subcommittee. Pruitt’s budget has faced criticism from Republicans and Democrats alike for its massive cuts, including the elimination of regional grant programs protecting areas like the Great Lakes, and reductions in clean-air and clean-water enforcement.

The House Natural Resources Committee will vote on a controversial bill meant to help forest maintenance to lessen the impact of wildfires, although Democrats say it is a giveaway to the timber industry and would not help fix the government’s dwindling fire budget. Tuesday’s markup also includes Rep. Harold Rogers’s bill to help restore abandoned coal mines and Rep. Don Young’s long-stalled bill to build a gravel road through the Izembek National Wildlife Refuge.

As the Trump administration reexamines federal-land protection with an eye towards boosting private industry, the House Natural Resources Committee will hold a hearing on oil-and-gas production on federal lands. The hearing Thursday in the energy and mineral resources subcommittee will likely touch on monument protections for federal lands and offshore oil drilling. The committee’s oversight subcommittee also holds a hearing Wednesday on the impact of excessive litigation at the Interior Department.

HEALTH

Despite schisms in the party, Senate GOP leaders have vowed to vote on their Obamacare-repeal bill before the July 4th recess.

“It doesn’t get any bet­ter,” said Senate Majority Whip John Cornyn. “It doesn’t get any easi­er.”

The bill includes tax credits more generous than the House proposal but deeper overall spending cuts to the Medicaid program—and has drawn complaints from both ends of the GOP spectrum.

Conservative lawmakers very quickly announced opposition to the bill. Paul does not think that it keeps the promise of repealing Obamacare, and Lee has asserted that all of Obamacare’s Title I regulations—which includes protections for patients with preexisting conditions—need to be repealed.

On the other side, Medicaid remains a central focus for moderates. Heller announced Friday that he is opposed to the bill in its current form, citing concerns around proposed changes to the program. “It’s going to be very difficult to get me to a yes,” said Heller.

Sen. Susan Collins immediately spoke about her concerns around the deep cuts that would eventually be placed upon the Medicaid program should the draft become law. And Sen. Rob Portman is unsure whether there will be adequate resources to combat the opioid crisis. “There are some promising changes to reduce premiums in the individual-insurance market, but I continue to have real concerns about the Medicaid policies in this bill, especially those that impact drug treatment at a time when Ohio is facing an opioid epidemic,” he said in a statement Thursday.

Meanwhile, the House Judiciary Committee subcommittee on crime and investigations Tuesday will be looking at legislation to address the issue of synthetic analogues of controlled substances being trafficked into the United States.

On Thursday, the Centers for Disease Control and Prevention and the diagnostic lobby AdvaMedDx will hold a discussion on how diagnostic tests and molecular-based sequencing are responding to infectious diseases.

TAX

Key provisions of Republicans’ planned overhaul of the tax code will be under scrutiny this week.

House Speaker Paul Ryan set out to accelerate work on tax reform with a speech before the National Association of Manufacturers last week, describing it as a key pillar of his party’s 2017 agenda. Ryan, and later two White House officials, said that a tax-reform bill would be moving through Congress by the fall. But Republican lawmakers still have some big policy differences to resolve and the coming weeks are likely to be consequential for tax policy.

Ryan and House Ways and Means Committee Chairman Kevin Brady are speaking less and less about using a border-adjustment tax—a tax on certain imports—to pay for broad rate cuts. Dropping the tax would blow a hole in their plans to make tax reform revenue-neutral unless they can find another high-dollar pay-for. What’s more, Ryan has said he wants many provisions of a tax-reform bill to be permanent, a requirement not shared by some in his party and a move that again raises the bar to successfully advance an overhaul package. Ryan has an ally in Brady, but tax-writing leaders have yet to convince some in the conservative House Freedom Caucus on key parts of their proposal.

Ryan, Brady, Senate Finance Committee Chairman Orrin Hatch, and members of the administration are expected to continue their weekly meetings to hash out an overhaul bill, though legislative language appears far off.

Also this week, the House Ways and Means Committee’s Social Security Subcommittee and Oversight Subcommittee are holding a joint hearing Thursday on Social Security coverage and payroll-tax compliance for state- and local-government employees.

TECHNOLOGY

The House Energy and Commerce Committee is making a big push toward the regulation of driverless cars next week. The panel is slated to meet Tuesday to consider a 13-bill package aiming to usurp the patchwork of state and local regulations governing the development and deployment of autonomous vehicles.

The bills are designed to promote rapid growth in the driverless-car industry, and would grant the National Highway Traffic Safety Administration the final say in its oversight. The legislative package comes on the heels of the Senate Commerce Committee’s outline of its own impending driverless-car legislation, which was released this month.

The Senate Judiciary Committee will kick off its own debate Tuesday over the reauthorization and reform of portions of the Federal Intelligence Surveillance Act that are set to expire at the end of this year. Section 702 of the FISA Amendments gives U.S. intelligence agencies the authority to intercept and store the communications of non-U.S. persons outside of the United States while allowing for the incidental collection of some data on U.S. citizens. Its backers in Congress say the program is vital for protecting national security, but other lawmakers worry the program is overbroad in its collection of Americans’ communications and may violate the civil liberties of U.S. citizens.

The Senate Intelligence Committee held a hearing on the subject this month, but discussion concerning the investigation of ties between the Trump campaign and Russia largely drowned out any meaningful discussion of the program. Sen. Tom Cotton, one member of the Intelligence panel, has introduced legislation pushing for a clean FISA reauthorization without reforms.

The House Judiciary Committee is set to take a closer look at recent trends in international antitrust enforcement Thursday, with the focus almost certainly to be on the European Union’s increasing crackdown on U.S. tech companies operating on the continent. The European Commission’s antitrust division has recently filed several antitrust complaints against Google, Amazon, and Apple, which many U.S. lawmakers view as overzealous. Capitol Hill was particularly incensed by last year’s $14.5 billion fine that the commission slapped on Apple last year over allegedly unpaid back taxes to Ireland. The committee’s hearing on the subject was originally scheduled for May.

TRANSPORTATION

The House Transportation and Infrastructure Committee will vote on a Federal Aviation Administration authorization bill Tuesday, making another bid to fulfill chairman Bill Shuster’s goal of spinning off the nation’s air-traffic controllers from government control. Shuster’s bill, released last week, would create an independent air-traffic-control board and has recruited support from two Democrats and Republican Sam Graves, who previously opposed Shuster’s bill over its impact on rural airports. Shuster has said the bill could move to the floor in July, although the air-traffic-control plan may still face skepticism from appropriators who worry about losing oversight of the safety program.

The House Energy and Commerce Committee will work through a package of 14 draft bills to help regulate self-driving vehicles, including measures that would allow the federal government to supersede state laws and information on data sharing. The Tuesday markup in the Digital Commerce and Consumer Protection subcommittee marks the first significant move by Congress to pass legislation on the rapidly advancing technology.

WHITE HOUSE

Trump’s week will be dominated by domestic energy issues and meetings with foreign leaders. He will hold energy events on Wednesday and Thursday. On Monday, he meets with Indian Prime Minister Narenda Modi. On Thursday, he will have dinner with South Korean President Moon Jae-in before meetings between the two leaders on Friday. On Wednesday, he will also attend a Republican National Committee dinner.

Adam Wollner, Jason Plautz, Erin Durkin, Casey Wooten, Brendan Bordelon and George E. Condon Jr. contributed to this article.
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