Outlook: Amid Delay, Scrambling for Votes on Obamacare Repeal

Senate Republicans have only the narrowest of paths to advance their health reform bill, and a vote is no longer planned for this week.

Sen. Shelley Moore Capito and other lawmakers head to the Senate on Thursday for a meeting on the revised Republican health care bill that has been under attack from some within the party, including by Capito.
AP Photo/J. Scott Applewhite
Alex Rogers
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Alex Rogers
July 16, 2017, 8 p.m.

The final showdown over health care will have to wait a bit longer.

With Sen. John McCain resting in Arizona after surgery to remove a blood clot above his eye, Senate Majority Leader Mitch McConnell said he would delay a vote on a bill to repeal and replace the Affordable Care Act. Even before the McCain news, Republicans were unsure whether they could deliver after riding that promise to capture the House, Senate, and White House. Two GOP senators—Rand Paul of Kentucky and Susan Collins of Maine—object to the bill, so every other Republican senator—50 in all (including McCain)—would need to vote yes for it to pass.

After the revised bill’s unveiling Thursday, a group of Republican senators representing states that expanded Medicaid under the ACA said they were undecided, including Sens. Dean Heller, Rob Portman, and Shelley Moore Capito. Although the latest version did address some of their concerns, adding $45 billion to fight the opioid crisis and an additional $70 billion to help stabilize the insurance markets on the federal marketplace, it did not address their primary one: how to take care of those on Medicaid.

Heller, Portman, Capito, Collins, and other Republicans said they opposed the initial draft of the bill, known as the Better Care Reconciliation Act, because it would devastate the health care of the poor and disabled Americans who rely upon Medicaid. According to the nonpartisan Congressional Budget Office, the BCRA would cut $772 billion from Medicaid and cover 15 million fewer people through it over the next decade. That version had a less than 20 percent approval rating, according to multiple polls.

The CBO was expected to reveal its new score for the revised bill as early as Monday, but that announcement has reportedly been delayed along with the vote. If the bill is shown to have a similar impact for those on Medicaid as the previous version, there will be substantial pressure on Heller, Portman, Capito, and others to vote against the bill, pointing to their comments criticizing the measure.

If 50 Republican senators stick together when the vote does occur , they’ll then have an extended amendment process and eventually vote on final passage. They’ll have kept a promise to their base, but also provoked a backlash from many others.

The House, meanwhile, this week will be the first chamber to move on President Trump’s plan to privatize air-traffic control—if supporters can find enough votes. Although the Senate and Democrats in both chambers remain opposed to the proposal, a plan sponsored by Transportation Committee Chairman Bill Shuster would reauthorize the Federal Aviation Administration for six years while transferring the country’s air-navigation system to a private corporation overseen by a board of governors. The bill also seeks to integrate drones into U.S. airspace, ban e-cigarettes on flights, and includes consumer protections, in response to public outrage after a man was violently dragged from a flight this year.

The House will also take up a series of energy bills aimed at spurring the construction of cross-border energy infrastructure with Mexico and Canada, simplifying the review of natural-gas pipelines, and slowing the implementation of federal ozone regulations.

Here’s what else is on tap:

DEFENSE AND FOREIGN POLICY

House leaders will continue negotiations on a Russia-sanctions bill that the Senate approved overwhelmingly last month. The legislation, which also places additional sanctions on Iran, has stalled in the lower chamber due to a series of procedural and political hurdles. At the moment, House Democrats are concerned with language in the bill that would allow only the majority party to force a vote on any rollback of Russia sanctions by the administration. The White House has expressed opposition to this congressional-review portion of the measure altogether. Meanwhile, some House Republicans have argued that a provision in the legislation could put U.S. energy companies at a disadvantage.

In an interview with National Journal on Thursday, Eliot Engel, the top Democrat on the House Foreign Affairs Committee, said he was still hopeful that he and his colleagues could strike a deal before the August recess. “I don’t think a lot of these things that have to be ironed out are intractable,” Engel said. “I think we could come to a meeting of the minds if we really wanted to.”

After the House passed its 2018 National Defense Authorization Act by a 344-81 margin Friday, attention will shift to the Senate’s version. The House’s bill costs $696.5 billion, while the Senate’s costs $700 billion. Both are more than $70 billion above the current defense-spending caps.

The Senate will vote Monday evening to advance the nomination of Boeing executive Patrick Shanahan to be deputy secretary of Defense. Current Deputy Defense Secretary Bob Work’s last day on the job was supposed to be last Friday, but he will remain in the post until Shanahan is confirmed. The Senate Armed Services Committee is set to hold hearings for five more Defense Department nominees Tuesday.

The Senate Foreign Relations Committee is scheduled to hold a hearing Monday on the State Department’s reauthorization bill for fiscal 2018 and reorganization plans. The panel will meet again Tuesday to consider Callista Gingrich’s nomination to be U.S. ambassador to the Holy See.

ENERGY AND ENVIRONMENT

While the House considers a series of energy bills on the floor this week, the House Energy and Commerce Committee holds a hearing Tuesday on the state of the electricity industry, with several power company executives set to testify. The Senate Energy and Natural Resources Committee has a session the same day on energy security in North America, and a confirmation hearing Thursday for several of Trump’s nominees for positions at the Energy and Interior departments.

On Wednesday, the House Natural Resources Committee marks up a series of bills related to endangered species. The Senate Environment and Public Works Committee has a hearing that day on wildlife protection.

HEALTH

While this week will be pivotal for the Senate Obamacare repeal, the Senate will also soon have to handle legislation to reauthorize the Food and Drug Administration’s ability to collect user fees from drug and medical-device markets. The House passed such legislation last week, and Sen. Lamar Alexander said in a statement that it’s time for the full Senate to consider the user-fee agreements.

House committees, meanwhile, will be looking at a drug-discount program and ways to improve Medicare.

On Tuesday, the House Energy and Commerce Committee’s Oversight and Investigations Subcommittee will get an update of the 340B drug-discount program, which allows eligible entities to purchase outpatient drugs at reduced prices.

Starting Wednesday, Medicare will take center stage. The House Ways and Means Committee’s Subcommittee on Oversight will have a hearing on efforts to combat waste, fraud, and abuse in the program. Then on Thursday, the E&C Health Subcommittee will review bills that aim to improve Medicare.

TAX

House Ways and Means Chairman Kevin Brady is beginning to feel pressure to address some Obamacare taxes in his broad overhaul of the tax code, which he says will come later this year.

The fate of the Senate effort to repeal the health care law is still unclear, but the current version would keep several taxes, including a 3.8 percent tax on investment income and .9 percent Medicare surtax on payroll, both targeting top earners. If the Senate bill fails, all Obamacare taxes would remain.

House Speaker Paul Ryan singled out the investment tax in a July 13 press conference, saying that taxes on capital gains are critical to the broader tax-reform effort. Other taxes that directly affect health care, he sees “as part of Obamacare,” Ryan said. Ryan previously said Congress shouldn’t address any Obamacare taxes as part of tax reform.

Mark Meadows, chairman of the conservative House Freedom Caucus, has also suggested repealing some Obamacare taxes as part of a broader rewrite of the code.

With some Obamacare taxes likely to remain whether or not the Senate repeal bill passes, the onus is on Brady to decide what to do with them. So far, he’s resisted addressing them in tax reform. But until now, it’s all been theoretical.

Congressional tax-writing committees will be in full swing this week.

The Senate Finance Committee is set to hold a Tuesday hearing on “prospects and challenges” of tax reform, with four former assistant Treasury secretaries for tax policy on the witness list. Later that day, the committee will hold a nomination hearing for David Kautter to become the assistant Treasury secretary for tax policy. Kautter is a partner at the Washington tax practice of RSM, an audit, tax and consulting firm.

The House Ways and Means Committee is set to hold a Wednesday hearing on simplifying the code though tax reform.

TECHNOLOGY

The Senate Commerce Committee will hold a three-for-one confirmation hearing Wednesday to reconfirm Republican Federal Communications Commission Chairman Ajit Pai and fill the two remaining slots on the five-person commission. Pai will be joined by former Democratic commissioner Jessica Rosenworcel—whose renomination stalled amid partisan wrangling in the Senate last year—and Republican Brendan Carr, who is now general counsel at the FCC. Commerce Chairman John Thune has said he hopes confirming Rosenworcel will dissipate any bad blood lingering between Senate Republicans and Democrats, allowing a slate of tech and telecom bills to move forward.

The comment-filing period for the FCC’s net-neutrality order ends Monday. The “Restoring Internet Freedom” order—which would roll back the legal underpinnings of the FCC’s net-neutrality rules—attracted over 7.5 million consumer comments, smashing the FCC record for most comments held by the previous commission’s net-neutrality order. Pro-net-neutrality activists held several protests designed to flood the FCC’s website with comments in favor of the current rules, and controversy ensued after the comment-filing system was hacked and bots posted thousands of identical comments in favor of the order. The FCC will continue to collect replies to the comments until August 16.

The Senate Judiciary Committee will vote Thursday to confirm Christopher Wray, Trump’s pick for FBI director. Wray’s confirmation hearing was last week, and senators from both parties grilled the former assistant attorney general over whether he can maintain his independence in the face of an ongoing investigation into whether the Trump campaign colluded with the Russian government during the 2016 presidential election. The previous FBI director, James Comey, was abruptly fired by Trump earlier this year.

WHITE HOUSE

This is “Made in America” week at the White House as Trump tries to focus attention on American products. On Monday, the president will view an exhibition of such products from all 50 states. On Wednesday, he will issue a proclamation on the topic. On Friday, Trump will hold a credentialing ceremony with newly arrived ambassadors. He will also meet with two of the five surviving members of the crew of the battleship Arizona, which was hit at Pearl Harbor. The men are trying to secure a posthumous Navy Cross for a sailor on a nearby ship who helped crewmen escape after the Arizona was struck. And on Saturday, Trump will go to Newport News, Virginia, for the commissioning of the USS Gerald R. Ford, the first of a new class of aircraft carriers.

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