Spending bills, debt ceiling complicate Hill Republicans’ efforts on taxes, ObamaCare. Can Anything Get Accomplished?

18671015_1205100692952921_772843101433169364_nFox News reported that the GOP-controlled Congress returns Monday in what members and top staffers say will be one of the busiest Junes in years —  as Republicans try to pass ObamaCare reform or another top item on President Trump’s legislative agenda.

Their goal to give Trump — and themselves — a major win during the president’s first year in office continues to be complicated by additional legislative challenges and the ongoing Capitol Hill investigations into whether the Trump campaign colluded with Russia during the 2016 presidential elections.

Lawmakers are way behind on the annual spending legislation to keep the government fully operational past September and likely will have to pass another stop-gap measure.

In addition, they recently were informed by Treasury Secretary Steven Mnuchin that they will have to raise the federal government’s borrowing limit before August, a daunting task ripe for brinkmanship.

Senate Republicans say they are working daily behind closed doors to craft an ObamaCare overhaul bill, following the House last month passing its version. However, Republicans appear less than optimistic about crafting a bill that at least 51 of its 52 senators will sign.

“I don’t see a comprehensive health care plan this year,” North Carolina GOP Sen. Richard Burr, chairman of the Senate’s Intelligence committee, on Friday told a hometown TV station. “At the end of the day, this is too important to get wrong.”

Still, Trump and essentially every elected Washington Republican campaigned on repealing and replacing ObamaCare. So failing in that effort would be a big problem with voters, ahead of the 2018 midterm races in which Democrats are trying to win about two dozen more House seats to retake the chamber.

“We just need to work harder,” Texas Sen. John Cornyn, the Senate’s No. 2 Republican, told KFYO radio in Lubbock over the week-long congressional recess that ends Sunday. And he pledged to complete the health care “by the end of July at the latest.”

Congress has yet to unveil a plan to overhaul the U.S. tax code — another Trump campaign promise — even though the president recently tweeted that the plan is ahead of schedule.

“The president keeps saying the tax bill is moving through Congress. It doesn’t exist,” House Minority Leader Nancy Pelosi, D-Calif., said mockingly on Friday.

Seven legislative weeks are left before Congress scatters for the five-week August recess.

Healthcare and taxes are enormously difficult challenges, and the tax legislation must follow — for procedural reasons — passage of a budget, no small task on its own.

Looming over everything is the investigation into allegations of Russian meddling in the 2016 campaign and connections with the Trump campaign and the former FBI Director James Comey, who was fired by Trump, is scheduled to testify before the Senate on Thursday.

“The Russia investigation takes a lot of oxygen, it takes a lot of attention,” said Republican Rep. Tom Cole of Oklahoma, a veteran lawmaker and President Trump has hired an outside attorney and reportedly dedicated an entire team to the issue — in an apparent attempt to limit the amount of distraction the issue is creating for his legislative agenda.

Cole also argued that Republicans have not gotten the credit they deserve to date for what they have accomplished: voting to overturn a series of Obama regulations and reaching compromise last month on spending legislation for the remainder of the 2017 budget year that included a big increase for defense. But I’m not sure the angry masses, especially the Democrats haven’t gotten over that they really lost the election and these accomplishments are attacks on their “god”, former president Obama.

The biggest bright spot for the party and for Trump remains Senate confirmation in early April of Supreme Court Justice Neil Gorsuch, whose elevation goes far to placate conservatives frustrated with inaction on other fronts.

Historically, Capitol Hill has been at its busiest and most productive in the early days of a new president’s administration, during the traditional honeymoon. But with his approval ratings hovering around 40 percent, Trump never got that grace period, and although his core supporters show no signs of abandoning him, he is not providing the focused leadership usually essential to helping pass major legislation.

In the Senate, Republicans’ slim 52-48 majority gives them little room for error on healthcare and taxes, issues where they are using complicated procedural rules to move ahead with simple majorities and no Democratic support. Trump’s apparent disengagement from the legislative process was evident this past week when he demanded on Twitter that the Senate “should switch to 51 votes, immediately, and get Healthcare and TAX CUTS approved, fast and easy.”

In fact that’s exactly how Republicans already are moving. But the trouble is within their own ranks as Senate Republicans disagree over how quickly to unwind the Medicaid expansion under Obama’s health law as well as other elements of the GOP bill. And remember I discussed the importance of Mediciad as a safety net for the poor and those not covered by third party payers.

For some Republicans, their sights are set on the more immediate and necessary tasks of completing the annual spending bills that are needed to avert a government shutdown when the budget year ends September 30, and on raising the debt ceiling to avert a first-ever default.

Sen. Richard Burr, R-N.C., said Thursday that he thinks it’s unlikely that the Republican bill to repeal and replace Obamacare will pass through the Senate this year.

“I don’t see a comprehensive health care plan this year,” Burr told WXII 12 News, adding that he’s spent the majority of his time brainstorming solutions to Iowa’s Obamacare marketplace, which is shedding insurers. “It’s a bad plan,” he said of the House bill in another part of the interview.

The House Republicans narrowly passed early last month a bill that would repeal and replace portions of the Affordable Care Act (ACA). But that vote was just the beginning of a long road ahead for Republicans to deliver on their long-held campaign promise to overhaul the Obama-era policy.

Republicans hold a narrow 52-48 majority in the Senate, meaning that they can risk losing only two votes to pass the bill. Democratic senators appear unified against any bill to repeal the ACA, and the House plan has already been bombarded by criticism from both moderate and conservative Republican senators.

Like other Republican senators, Burr called the House bill “dead on arrival” in the Senate, which has vowed to write its own law on the matter.

The Iowa GOP delegation, Sen. Chuck Grassley and Sen. Joni Ernst, also lowered expectations for a successful health care plan Wednesday, saying that a complete repeal of the ACA is unlikely.

Senate Majority Leader Mitch McConnell told Reuters last month that he was uncertain about how Republicans will win the 50 votes needed to push the health care bill through the Senate.

That all seems like a lot to tackle, especially when you consider the summer recess coming up in August. How do they think they can master a health care bill and tax reform in 2 months?

The only sanity comes from Illinois Senator Dorbin, the chamber’s No. 2 Democrat, who last Sunday kept open the possibility of a partisan deal to rework ObamaCare, with the task now totally in the hands of the Senate.

What a significant change in party politics when he announced- “Let’s sit down together,” he told “Fox News Sunday.” “I don’t agree with many aspects of [the Republicans’] starter plan. But it’s a good faith effort to do two things: Reduce the cost of health insurance and expand the reach of health insurance. That should be our national goal.”

Durbin spoke after the nonpartisan Congressional Budget Office on Wednesday released a final audit on the GOP-led House’s ObamaCare overhaul bill.

Though the report found that 23 million Americans would lose health insurance by 2026 and that premium costs would increase under the chamber’s American Health Care Act, it also concluded the plan would reduce the federal budget by $119 billion over 10 years.

That’s more than enough savings to allow the GOP-led Senate to pass its overhaul version under special budget rules that prevent Democrats from stopping passage with a filibuster.

Senate Democrats have repeatedly acknowledged that the 2010 Affordable Care Act, known as ObamaCare, has problems, particularly increasing premiums with few policy options.

However, Democrats are largely trying to use Republicans’ repeal-and-replace attempts against them in the 2018 elections and beyond, pointing out that millions could lose insurance under the current GOP plan.

“The Senate will write its own bill,” Louisiana GOP Sen. Bill Cassidy, a doctor and member of the Senate Committee on Health Education Labor and Pensions, told “Fox News Sunday.”

“Right now, there are families sitting around their kitchen table. They’re paying $20,000, $30,000 and $40,000 a year for premiums,” continued Cassidy, who has an ObamaCare replacement bill with Maine GOP Sen. Susan Collins. “I think the Senate product, I’m hopeful, will be more likely to address their needs.”

Durbin argued Sunday that the Trump administration should at least try to keep ObamaCare from toppling before it can be fixed.

And he criticized Senate Majority Leader Mitch McConnell, R-Ky., for creating a 13-member group to lead the overhaul effort without including a single Democrat and neither Cassidy nor Collins.

“I’m sorry that the two of them are not in the room with the 13 apostles that Senator McConnell’s chosen to come up with the Republicans plan,” Durbin said.

Cassidy and Durbin appeared to agree that Justice Department special counsel Robert Mueller will get to the bottom of whether President Trump’s inner circle colluded with Russia during the 2016 presidential elections, but that Americans appear equally if not more concerned about heath care and the economy.

“I agree with Dick’s assessment,” Cassidy said. “When you speak to folks back home, voters across the nation, they’re more concerned about their climbing health care premiums and the need to have jobs with better wages and better benefits. This will play out. We will know eventually. Right now, Americans need help with their premiums.”

I’m hoping that this attitude takes over the Senate and yes, even the House so that they can accomplish something good for those that they represent, “we the people.” I agree that it will be shocking if the Senate gets a “new” health care bill approved by the end of the year. But we can only dream. They all need to read our new, book or at least a few of the chapters in our book-“The Search for Excellence in Clinical Practice: A Handbook for Clinical Practice Improvement for Providers.” They all could learn much from this simple manual!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s