12 Days in September

  
Photo: Getty Images
Photo: Getty Images

President Trump joined with congressional Democrats yesterday to clear three major items from a jam-packed congressional agenda. The stopgap agreement will raise the nation’s debt limit, keep the government open through the end of the calendar year, and provide hurricane relief for the communities and states hardest hit this hurricane season. In doing so, however, Trump and congressional leaders have ensured that an even bigger debate awaits them in December, with an unclear outlook on how it will resolve itself.

The House also passed nearly $8 billion in disaster aid in response to the devastation wrought by Hurricane Harvey. But with Hurricane Irma bearing down on Puerto Rico and Florida, lawmakers may be called on to pass additional funding soon.

Meanwhile, lawmakers still face an overflowing agenda. Here’s a quick rundown of what else to expect this September:

  • Tax reform: The President and his administration have long signaled that they hope to pass tax reform legislation before the end of the calendar year. Their failure to pass health care reform legislation this summer, however, coupled with a long list of competing priorities, makes this increasingly unlikely.
  • Health care reform: Though congressional leaders have appeared to move on to other, more pressing issues, President Trump continues to indicate he wants lawmakers to take one more shot at repealing and replacing the Affordable Care Act.
  • Immigration: Following the President’s decision to rescind the policy of Deferred Action for Childhood Arrivals (DACA) in the event that Congress fails to craft a solution in the next six months, lawmakers on both sides of the aisle are searching for a legislative fix. Democratic leaders have asked Speaker Paul Ryan (R-WI) and Senate Majority Leader Mitch McConnell (R-KY) to bring the Development, Relief, and Education for Alien Minors (DREAM) Act to the floor for a vote, and have suggested they will attempt to attach the bill to other priority items to force leadership’s hand. Though widely championed by progressives, the legislation could face difficulty garnering bipartisan support.

Meanwhile, the Senate HELP committee will be holding a series of hearings to determine the best path forward on creating stability in the individual health insurance markets. Democrats are certain to use this forum to put a spotlight on the administration’s recent decision to slash funding used to promote the Open Enrollment period that starts November 1st. We’ll have an additional update for you later this week on these and other health care-related items.

“No”

  
Photo: Susan Walsh, AP
Photo: Susan Walsh, AP

Following a dramatic late night vote that saw Senators reject Majority Leader Mitch McConnell’s (R-KY) so-called “skinny” bill repealing the Affordable Care Act (ACA), lawmakers from both sides of the aisle are publicly calling for a fresh approach to reforming health care that embraces bipartisanship and transparency, and actively seeks solutions from experts who know health care best, including America’s 3.6 million nurses.

Sens. Susan Collins (R-ME), John McCain (R-AZ), and Lisa Murkowski (R-AK) joined with all 48 Senate Democrats to vote against legislation that would’ve stripped the individual and employer mandates introduced by the ACA, among other harmful provisions, and which was intended to pave the way for a conference committee of representatives from both chambers, who would be responsible for crafting a bill that both could pass.

But House Speaker Paul Ryan (R-WI) seemed unwilling to guarantee that his chamber wouldn’t just skip the conference process and pass “skinny” repeal itself, prompting McCain and others to publicly withhold their support early yesterday evening. While subsequent assurances from Ryan and Vice President Mike Pence were enough to win back the support of some of those Senators, McCain ultimately came to the same conclusion as his colleagues from Alaska and Maine, and voted no.

The nursing community showed up like never before in this fight, driving thousands of calls and e-mails to Congress. Hundreds traveled all the way to Washington, DC last month to deliver our message face-to-face with our legislators: The only way our country can truly reform our healthcare system is by working together. No more closed doors. No more dead-of-night deals. No more decisions made without a single nurse consulted.

While this victory is heartening, we know there are those who will continue pushing lawmakers and the administration to undermine our health system and harm those who have gained coverage as a result of the ACA. If you haven’t yet, please join our RNAction community to learn more and get the latest updates on how you can help ensure that our representatives in Washington continue to protect our care and put patients first.

The Senate hurtles toward disaster [Update: First major vote fails]

  

UPDATE: Following their successful vote on the motion to proceed, Senate Republican leadership saw a subsequent vote on a bill with amendments from Sens. Ted Cruz (R-TX) and Rob Portman (R-OH) fail. Votes are scheduled to resume Wednesday morning.


pc-quote

By the thinnest possible margin, Senate Republicans voted today to begin debate on their various proposals repealing and possibly replacing the Affordable Care Act (ACA), each of which would strip coverage from millions of Americans and devastate our country’s health care system.

Only Sens. Susan Collins (R-ME) and Lisa Murkowski (R-AK) chose to break with their party, listen to their constituents, and reject these dangerous plans. We’re hopeful that their courageous example will influence their colleagues to do the same as more pivotal votes are taken.

The 20 hours of floor debate that now follow will likely take up the rest of the week, with multiple votes expected on the different bills in play. Here’s where we stand:

  • First, Senators will debate then vote on a repeal of the ACA without a replacement. This is widely expected to fail, but will still take place after being guaranteed to Sen. Rand Paul (R-KY) in exchange for his yes vote on today’s motion to proceed.
  • Debate will then move to a modified version of the Better Care and Reconciliation Act (BCRA), which is also expected to fail due to last-minute changes that mean the bill must pass with 60 (rather than 50) votes, per Senate parliamentary procedure.
  • The Senate would then begin what’s known as vote-a-rama, with amendments from Democrats and Republicans under consideration, most likely to the House bill (the American Health Care Act, or AHCA) in the event that the previous two bills fail to pass. The final bill that results from this process will also have difficulty garnering a majority of yes votes.
  • The final expected vote will then consider a substitute put forward by Majority Leader Sen. Mitch McConnell (R-KY), and which will include a simplified version of the plan Republicans actually want to pass.
  • If successful, that bill would then be taken up by a conference of negotiators from both the House and Senate, in the hopes of producing final legislation that both chambers could pass.
  • As with today’s motion to proceed, Vice President Pence will be on hand to break any 50-50 tie.

Once again, the lack of understanding around the final plan Republicans hope to pass is a sad commentary on a process that’s been anything but transparent, and has failed to give the American people a clear idea of the ramifications both for themselves and the country’s health care system.

All nurses should urge their Senators to oppose this undemocratic process and reject the idea that reforming health care should be done in secret. We also continue to urge residents in the following states to push heavily on those Senators who have publicly expressed concern about the impact of these proposals on their constituents’ care:

  • Alaska – Sen. Murkowski
  • Arizona – Sens. Flake and McCain
  • Louisiana – Sen. Cassidy
  • Ohio – Sen. Portman
  • Nevada – Sen. Heller
  • West Virginia – Sen. Capito

Click here to make your call now. Together, we can still win this battle.