Please note that this update was published as of 9:30AM EST. News around Tax Plan is currently evolving. Stay tuned.

Appropriations: Congressional Democratic leaders skipped a planned meeting with President Trump and congressional Republican leaders on Tuesday—where the lawmakers had hoped to reach a deal with the White House to avoid a government shutdown.  The decision followed a tweet by President Trump stating that he did not “see a deal!” Congressional leaders are currently gauging the level of support of their members for another short-term Continuing Resolution (CR) until December 22.  As a reminder, the current CR runs out on December 8.  Congress would need to pass (and the President sign) another CR after that to avoid a government shutdown.

 Tax Plan:  On Wednesday, the Senate voted to proceed with floor debate on their tax bill, 52-48.  The effort stalled on Thursday evening over concerns about the federal deficit, leaving the Republicans without a clear plan forward with the legislation.

In many ways, the Senate tax bill is really a health care bill with major implications for millions who rely on the federal government for their health insurance.

First, the bill repeals the individual mandate, a key piece of the Affordable Care Act (ACA) that requires most Americans get health insurance coverage. Predictions are that its elimination will reduce enrollment in both the ACA’s private marketplaces and Medicaid by millions.  The Congressional Budget Office (CBO) pegs the decline in the number of insured at 13 million. The money saved will be put into tax cuts for the very wealthy.  Additionally, economists expect that premiums would rise without the individual mandate, leaving many people who would like to purchase insurance unable to afford the monthly premiums.  The CBO estimates that this would lead to a reduction in enrollment of 8 million and in Medicaid by 5 million.

Second, the bill includes tax cuts so large that they would trigger across-the-board spending cuts, including billions for Medicare.  The CBO estimated that the Senate tax bill is expected to trigger a $25 million annual cut to Medicare. The last time that Medicare was hit with cuts like this, patients lost access to critical services like chemotherapy treatment.  The Medicare cuts are not part of the tax bill itself but are mandatory spending cuts that would occur because the tax bill’s $1.5 billion increase to the deficit.

Secretary of Health and Human Services: Alex Azar, President Trump’s nominee for Secretary of Health and Human Services went in front on the Senate HELP Committee on Wednesday.  Azar said that his priorities would be: 1) curbing rising drug prices; 2) making health care more affordable; 3) shifting Medicare further toward creating incentives for good outcomes rather than volume of care; and 4) the opioid epidemic.  Additional highlights are available here and here.  The Senate Finance Committee is the Committee that must approve this nomination; a hearing in that Committee has not yet been scheduled.