This week in Washington will be filled with both cabinet and judicial confirmation-related activities. On Tuesday, the Senate will vote on Betsy DeVos’ nomination to become Secretary of Education. Following a frenetic week of both grassroots organizations mobilizing against her nomination and Republican defections by Senators Susan Collins and Lisa Murkowski, it appears that DeVos is likely to win a close confirmation with Vice President Mike Pence casting the tie-breaking vote. Vice President Pence is ascribed the role of President of the U.S. Senate under Article One of the Constitution, and thus can cast a tie-breaking vote in the Senate. This would be the first time a cabinet nominee is confirmed by a Vice Presidential tie-breaking vote.
Later in the week (likely on Thursday), Senator Jeff Sessions (R-AL) will also have his own confirmation vote to become the nation’s Attorney General. Sessions’ vote was strategically timed to come after DeVos so that Republicans could count on his vote to confirm her nomination. Though Sessions’ confirmation will also be close, he will likely be confirmed along party lines with a 52-48 Senate Republican majority. Health and Human Services cabinet nominee, Rep. Tom Price (R-GA), may also have his confirmation vote later this week. The earliest his vote could take place is Friday morning.
Labor Secretary Nominee, and current CKE Restaurants CEO, Andrew Puzder, is scheduled to have his Senate confirmation hearing on Tuesday following four separate delays by the committee of jurisdiction. The Senate Committee on Health, Education, Labor & Pensions refused to consider his nomination until all of his paperwork was completed and submitted to the Office of Government Ethics.
Supreme Court nominee Neil Gorsuch is also barnstorming the Senate this week in the hopes that he too can win Senate confirmation later this spring. He’s scheduled to meet with some fourteen sitting Senators, most of whom are red-state Democrats who may control his confirmation fate.
On Wednesday, the House Democratic Caucus will head to Baltimore for a three-day retreat. Democrats are expected to hammer out a messaging and legislative strategy for the 115th Congress. They’ve branded the retreat with the theme “Fighting for All Americans.”
Stay tuned for more updates from Capitol Hill later this week.
Last week, there was flurry of activity and chatter on Capitol Hill surrounding the ACA’s repeal-and-replace. Much of the focus surrounded Congressional Republican’s three-day retreat in Philadelphia, where House and Senate Republicans were expected to plot their legislative agenda for the 115th Congress.
Congressional leaders held a special session on Thursday morning to try to reach a consensus on how to move forward on an ACA repeal and replacement strategy; unfortunately, no consensus was reached, which seemed to suggest that House and Senate Republicans were more divided on how to move forward than previously thought.
In the House, Speaker Ryan (R-WI) suggested on Thursday a more piecemeal approach towards health reform that’s focused on a “repeal and repair” of the system. Chairman Greg Walden (R-OR), a close Ryan ally, later this week will consider four separate bills that affect changes to the individual market in the House Energy and Commerce Committee. The changes would permit insurers to tighten enrollment periods, an attempt to try to ensure coverage for pre-existing conditions, and consideration on a measure to allow insurers to charge seniors higher rates. The committee will also examine potential reforms to the Medicaid program.
In the Senate, Senators Cassidy (R-LA) and Collins (R-ME) introduced the Patient Freedom Act. Hoping to chart a path that gives states options for reform, the bill would allow states to either 1) keep the ACA as is, 2) switch to a different insurance expansion plan that auto-enrolls individuals into a subsidized catastrophic plan, or 3) move forward with a repeal and no coverage expansion (meaning states would lose federal Medicaid expansion funds).
Senator Rand Paul (R-KY), also introduced his own bill. His legislation primarily focused on repealing the ACA’s employer and individual mandates, which includes a repeal of the ban on pre-existing conditions. The plan includes a two-year open enrollment period in which individuals with pre-existing conditions cannot be denied, but by and large the bill emphasizes tax credits and a more deregulated health market as an alternative to the ACA.
Stay tuned for more activity on Capitol Hill this week on the healthcare reform front.
Anxiety among both the public and lawmakers continues to rise as House and Senate Republicans last week took the first step toward their ultimate goal of repealing the Affordable Care Act. At least 5 Republican Senators have stated their support for having a replacement plan to go along with any repeal legislation. Several Republican governors who have expanded Medicaid under the ACA have also expressed their concern over a model that does not include replacement legislation. Governors John Kasich and Rick Snyder of Ohio and Michigan, respectively, have been particularly vocal; their states stand to lose a combined $86 billion in federal funding if the ACA is repealed.
Efforts to repeal the ACA were further muddied on January 17th, when the Congressional Budget Office released its report which details the impact of repealing the ACA without replacement legislation. The CBO is the non-partisan Congressional office tasked with providing independent analyses of budgetary and economic issues to support the Congressional budget process. Highlights of the report include:
- 18 million people could lose their health insurance coverage within the first year, and 32 million could lose coverage within ten years, between Medicaid and the individual insurance market
- Destabilization of the individual insurance market due to the elimination of the individual mandate and premium subsidies for low-income individuals resulting in a “death spiral”
- Half of the country would be living in areas with no insurer in the individual market in the first year, and three-fourths would live in such areas by 2026
- Premiums for health insurance coverage purchased on the individual market would be 20 percent to 25 percent higher in the first year
Congress has a daunting landscape as it moves ahead with its plans to repeal and replace the ACA. It is a near certainty that the Affordable Care Act will be altered in some way. It is less certain what those alterations might look like. ANA stands by its core principles and demands that any replacement legislation reflect our principles: universal access to a standard package of essential health benefits for all citizens and residents; utilization of primary, community-based and preventative services while supporting the cost-effective use of innovative, technology-driven, acute, hospital-based services; the economical use of health care services with support for those who do not have the means to share in costs; and a sufficient supply of a skilled workforce dedicated to providing high quality health care services.