Trump, Congress can’t close deal as shutdown looms

  

 As the federal government appears headed toward its first shutdown since 2013, congressional leadership and Trump administration figures have engaged in an increasingly public back and forth over which side should be held most responsible for the high-stakes stalemate. Major sticking points remain around immigration, specifically Deferred Action for Childhood Arrivals (DACA), as well as the Children’s Health Insurance Program, which has now gone more than three months since its long-term funding expired (and after Congress kicked the can down the road before the holidays late last year).

While the House of Representatives was able to pass a short-term funding bill by a slim margin, Senate Democrats refuse to support any legislation that does not include long-term CHIP funding and a solution on DACA, which the President unilaterally decided to end last year, a move ANA condemned at the time.

While the House spending bill included a long-term funding solution for CHIP, it did not address DACA, and the President rejected a bipartisan immigration deal earlier this week. With 49 Democrats currently serving in the Senate, and any funding bill needing to enjoy filibuster-proof support of 60 votes, Democratic buy-in is necessary to keep the government open.

Additionally, while inclusion of long-term CHIP funding in the House bill is heartening to see, House Republican leaders have had ample opportunity to address CHIP long before this week. Moreover, due in part to the repeal of the individual mandate as part of last year’s tax reform legislation, the Congressional Budget Office (CBO) earlier this month revised its estimate of CHIP’s cost to the federal government and showed that it now stands at $800 million, down from $8.2 billion.

The President, largely via his Twitter feed, has repeatedly attempted to pin responsibility over a potential shutdown on congressional Democrats. Polling released Friday indicates he’s enjoying little success: 48% said they would blame the President and Republicans (who control every branch of government), with just 28% placing the blame on Democrats.

On Friday afternoon, Senate minority leader Chuck Schumer (D-NY) visited the White House to meet with President Trump, a meeting at which Speaker of the House Paul Ryan (R-WI) and Senate majority leader Mitch McConnell (R-KY) were not present. Following the meeting, Schumer indicated that progress was being made but that no agreement had yet been reached; nor was it clear what deal the President could reach with Schumer that would be acceptable to more conservative House Republicans, particularly those in the Freedom Caucus.

Regardless of the outcome, this episode is just the latest reminder for congressional leadership and the administration that a bipartisan, long-term budget is sorely needed, and that any such budget should include input from experts, including America’s nurses. Families who are affected by DACA or reliant on CHIP deserve better than what Washington has so far failed to deliver.

Congress can’t keep kids covered as 2017 comes to a disappointing end

  

Congressional Republicans immediately followed their passage of a tax bill that will have a devastating impact on public health by voting for an irresponsible spending stopgap that needlessly jeopardizes the roughly nine million American children who rely on coverage from the Children’s Health Insurance Program (CHIP). While regrettable, this sequence of events was a fitting conclusion to 2017 on Capitol Hill, where majority lawmakers showed a persistent and troubling desire to limit Americans’ access to health care.

While the stopgap bill passed by the House and Senate will fund CHIP through the end of March 2018, it continues to create reckless uncertainty as state officials who manage the program are forced to run it on a month-to-month basis. Despite the widespread bipartisan support the program has historically enjoyed, congressional leaders proved unable to reach an agreement on the usual five-year long-term spending approval that CHIP has received in the past.

Republicans also chose to punt to 2018 on health marketplace stabilization efforts that are even more urgent in the wake of the tax bill’s passage. While the proposals from Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA), as well as Susan Collins (R-ME) and Bill Nelson (D-FL) will not mitigate all the damage done by individual mandate repeal, they will help lessen the negative impact from President Trump’s unilateral and dangerous decision to end stabilization funding earlier this fall.

And though both measures would have an objectively positive impact on the health marketplace congressional Republicans seem intent on destroying, it remains unclear whether the measures – together or separately – could garner a majority of support in either chamber, particularly the House of Representatives where more conservative members enjoy increasing influence.

Despite these developments, almost nine million Americans reportedly signed up for coverage during this year’s Open Enrollment period that concluded on December 15, nearly matching last year’s total. This took place despite the administration’s efforts to limit enrollment, by cutting the sign-up period in half and slashing funding for promotional efforts to educate the public. The enrollment figures are a clear sign that Washington’s focus in 2018 must turn away from creating roadblocks to health care, and instead find new ways to help Americans get and stay covered.

American Nurses Association Strongly Opposes the Tax Cuts and Jobs Act

  

Massive tax bill will significantly reduce the number of Americans with health insurance

Silver Spring, MD – The following statement is attributable to Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, president of the American Nurses Association (ANA), in response to the Tax Cuts and Jobs Act.

“The American Nurses Association is deeply concerned about the devastating impact that the Tax Cuts and Jobs Act will have on health care in this country. Under the guise of a promise to slash taxes for corporations and middle-class Americans is a clear intent to dismantle the Affordable Care Act (ACA), which has helped nearly 16 million Americans obtain health coverage. It is also no secret the actions that will be pursued to make up for the inflated deficit caused by this tax bill will be the cutting of essential anti-poverty programs as well as Medicare and Medicaid.

Eliminating the ACA’s individual mandate will lead to an estimated 13 million fewer Americans having health insurance. The resulting domino effect will be negative health outcomes, higher costs, and fewer individuals with access to critical primary care and preventive services. This is irresponsible and further proves that health care is being handled like a political game to be won at any cost. Frustratingly, this bill was pushed through without input from patients, consumers, or health care experts, including the country’s 3.6 million registered nurses, whom the public ranks as the most ‘honest and ethical’ profession.

Amid numerous failed attempts to ‘repeal and replace’ the ACA, ANA voiced strong opposition to legislation that would threaten health care affordability, access, and delivery for millions of people across the nation. ANA will continue to advocate for a health system that ensures universal access to a standard package of essential health care services for all citizens and residents.”

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