Future Health Bills Could Be Caught in Obamacare-Repeal Fight

Even if the current GOP effort dies, must-pass legislation coming down the pike could be vehicles for Affordable Care Act changes.

President Trump meeting with Republican senators on health care in the East Room on June 27. Seated with him, from left, are Sens. Dean Heller, Susan Collins, Lisa Murkowski, and Orrin Hatch.
AP Photo/Susan Walsh
Erin Durkin
Add to Briefcase
Erin Durkin
July 19, 2017, 8 p.m.

Even if the Senate GOP measure to repeal and replace Obamacare can’t be resurrected, future must-pass health legislation will offer Republicans smaller stabs at the law if they are unable to bridge the divide within their party.

The current Republican effort to repeal portions of the Affordable Care Act was still in limbo Wednesday night. After Senate Majority Leader Mitch McConnell scrapped a repeal-and-replace measure that had been in the works for weeks, President Trump pushed for the effort to be revived at a lunch with lawmakers Wednesday afternoon.

“We have no choice; we have to repeal and replace Obamacare,” Trump said at the lunch. “We can repeal it, but the best is repeal and replace, and let’s get going.”

But it’s unclear if leadership will be able to get the votes together on the bill that aims to loosen insurance regulations, repeal Medicaid expansion, and slow the spending growth rate for the entire program. And McConnell’s Plan B—a straight repeal bill that initially passed Congress in 2015—appeared to be dead on arrival Tuesday. McConnell left the door cracked open Wednesday to still pursue either option.

As lawmakers have been preoccupied with Obamacare repeal, deadlines for other bills are looming in September, and could possibly offer Republicans a vehicle to get smaller changes passed.

One such measure is the extension of funding for the Children’s Health Insurance Program, also known as CHIP or SCHIP, past Sept. 30. The program has broad bipartisan support, but is ripe to carry smaller changes such as adding work requirements to Medicaid, experts say.

“I think CHIP has been held hostage with no action as they’ve been debating repeal and replace. … It’s clearly a vehicle that they’ve left out there,” said Diane Rowland, executive vice president at the Kaiser Family Foundation. Rowland noted that even the contours of the CHIP legislation by itself are unknown.

While some lawmakers sounded skeptical about using the CHIP funding bill as an option for health reform, Senate Finance Committee Chairman Orrin Hatch has considered that option.

“Yeah, that would be another route because that’s a bill that everybody wants. That’s my bill,” Hatch told National Journal. He did not provide details on what changes he would be interested in including.

Even if Republican lawmakers do not attempt to include health reform measures in the CHIP bill, the length of time for which the program is extended can be telling. Ilisa Halpern Paul, president of the District Policy Group, said a shorter-term reauthorization could provide a hint that Republicans may still try to reform the Medicaid program.

“If they do a very long reauthorization, it could suggest they are letting go of Medicaid reform for now,” Paul said.

Sen. Mike Rounds also floated the possibility of using the CHIP bill—but as a means to continue tweaking the law after a Senate repeal bill was passed.

“If we were to come to a solution on this particular part, then SCHIP could be used to fine-tune items that you can’t do by reconciliation because you have broad support for the renewal or continuation of the SCHIP plan. So you gain some more supporters, Republicans and Democrats alike,” Rounds said. “But if you lose on the reforms that we’re proposing in this particular plan, then I don’t think there’s going to be a huge amount of support for simply adding benefits or modifying things in SCHIP, but it’s possible.”

Another potential vehicle for health care changes could be legislation to renew the Food and Drug Administration’s authority to collect user fees from the drug and medical-device industries.

Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities, said there’s been a strong bipartisan commitment not to attach non-germane amendments to the user-fee legislation—but that could change.

“Who knows whether the broader politics, post-whatever happens on the repeal vote, could change things?” Park said.

Even if Obamacare repeal were to die next week on the floor, Park said changes included in the measure, such as the proposed Medicaid cuts, could return in the Republican tax-reform efforts. And that may be GOP lawmakers’ best bet if they cannot bridge the divide over a large repeal measure.

Sen. Susan Collins, one of the Republicans who have helped derail the Senate repeal efforts, sees opportunities to fix the Affordable Care Act through the committee process, beginning with the Health, Education, Labor, and Pensions panel chaired by Sen. Lamar Alexander.

“I’ve encouraged Senator Alexander to hold hearings in the HELP Committee, he’s agreed to do so, and I hope those hearings will begin shortly,” Collins said. “We can then look at issues such as what can we do to moderate the increases in premiums, how can we bring stability to the market, how can you give people more choices in insurance.”

What We're Following See More »
“VAULT 7”
Additional Charges Added in Wikileaks Case
21 minutes ago
THE LATEST

"Federal prosecutors have charged a former software engineer at the center of a huge C.I.A. breach with stealing classified information, theft of government property and lying to the F.B.I. The engineer, Joshua A. Schulte, 29, of New York, had been the main suspect in one of the worst losses of classified documents in the spy agency’s history. Government investigators suspect that he provided WikiLeaks, the anti-secrecy organization, with a stolen archive of documents detailing the C.I.A.’s hacking operations, but they had not initially charged him in that crime."

Source:
BUT HE ASKS FOR $200 BILLION MORE IN TARIFFS
Senate Defies Trump on ZTE
21 minutes ago
THE LATEST

"The Senate voted Monday to reimpose the U.S. ban on Chinese telecom giant ZTE, in a rebuke to President Donald Trump and his efforts to keep the company in business. The provision targeting ZTE was part of the National Defense Authorization Act, a must-pass defense spending bill that cleared the Senate by a vote of 85-10. It must now be reconciled with the House version of the measure, which takes a narrower approach to ZTE." Separately, Trump is directing U.S Trade Representative Robert Lighthizer to identify $200 billion more in tariffs on Chinese products.

Source:
OFFERED TO SELL DIRT ON CLINTON FOR $2 MILLION
Roger Stone Says He Forgot About Meeting with Russian
19 hours ago
THE LATEST

"Two longtime associates of President Donald Trump are now acknowledging a previously undisclosed contact in May 2016 with a Russian who they say offered dirt on Hillary Clinton. Roger Stone and Michael Caputo say they forgot to tell investigators about their contact with a Russian national who goes by the name Henry Greenberg — even though they say Greenberg offered to sell incriminating information to the Trump campaign for $2 million."

Source:
MCCONNELL WANTS A TREATY
Senators Want to Rubber Stamp Any North Korean Deal
6 days ago
THE LATEST

"As Trump signed a joint statement with Kim Jong Un that offered few details on how the North Korean leader would make good on his vow to denuclearize, Republicans on Capitol Hill said Tuesday that they want and expect the White House to submit any final agreement for their approval." Senate Majority Leader Mitch McConnell called for any agreement to be in the form of a treaty.

Source:
UNLESS NEGOTIATIONS GO BADLY
Trump To Halt “War Games” On Korean Peninsula
6 days ago
THE LATEST

President Trump announced that the United States will suspend "war games" with South Korea, which are "inappropriate" given his meeting with North Korean leader Kim-Jong Un. "We will be stopping the war games which will save us a tremendous amount of money," said Trump, "unless and until we see the future negotiation is not going along like it should." The military exercises "carried out each year by the US and South Korean militaries have been consistently cited by Pyongyang as a US rehearsal for war, and a reason it needs to build a nuclear arsenal."

Source:
×
×

Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.

Login