FY18 Appropriations

Yesterday, the House voted 235-192 to pass a minibus appropriations package of more than $790 billion to fund the military, energy programs and water projects, U.S. Capitol operations, veterans’ benefits and initial construction of a U.S.-Mexico border wall.  The next steps for the legislation are unclear because the defense spending allocation included would trigger across-the-board spending cuts known as a sequester because it exceeds the fiscal 2018 defense cap set in law.

It is uncertain if the package will now go to the Senate, where the funding for the wall is likely to draw fierce opposition from Democrats.  Democrats in the Senate have the power to block appropriations bills, due to Senate filibuster rules and the slim 52-seat Republican majority. In addition, Senate appropriators have also released entirely different fiscal 2018 spending levels from their House counterparts.

ACA Replacement Legislation

It was quite a roller-coaster week in regards to ACA “repeal and replace” efforts in the Senate!

On Tuesday, by a vote of 51-50, the Senate voted to open up debate on an ACA repeal and replace bill. Two Senate Republicans (Sen. Murkowski, Alaska and Sen, Collins, Maine) voted against it but Vice President Pence provided the tie-breaking vote.  The Senate voted on the Motion to Proceed without finalizing what bill the Senate would actually take up.  That night, the Senate voted down a modified version of the Better Care Reconciliation Act which had not been scored or reviewed by the Senate parliamentarian.

On Wednesday, the Senate voted down a bill to repeal the ACA without replacing it (the Obamacare Repeal Reconciliation Act that the Senate passed and then President Obama vetoed in early 2016)- the leading alternative to the Senate repeal-and-replace bill.

Finally, early Friday morning, the Senate voted down the latest proposal, referred to as “Skinny Repeal,” by 49-51.  GOP Sens. Collins, Murkowski, and McCain voted with Democrats against the eight-page measure, which was a scaled-back version of repeal compared to the legislation Republicans unsuccessfully tried to pass earlier this week.

The skinny repeal measure would have permanently repeal the health law’s mandate for most Americans to buy insurance. It would have eliminated the law’s employer mandate, requiring larger companies to offer coverage to workers, for eight years. It would have delayed the law’s tax on medical devices for three years. Additionally, it would have provided new funding for community health centers and would effectively defund Planned Parenthood for one year. The measure would have also made changes to the health law’s waivers, which allow states to waive certain regulations if they meet certain requirements. According to the new Congressional Budget Office analysis, the legislation would have left an additional 16 million people without health uninsured over the next decade, premiums would have increased by 20 percent.  NCSD joined with four colleague organizations in responding to the failure of the Senate to repeal the ACA; that press release can be found here.

What exactly the next steps are for Congressional efforts to repeal the ACA are unclear; the effort is, for the time being, dead. But these efforts have returned quite suddenly this year when their prospects were unclear, so stay tuned!