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Health Care Will Determine Progress of Rest of Agenda

Spending debate, tax code rewrite all interrelated

Senate Finance Chairman Orrin G. Hatch, R-Utah, whose panel has jurisdiction over much of any health care package, says the chamber will take a more deliberative approach aiming at 51 votes. (Tom Williams/CQ Roll Call File Photo)
Senate Finance Chairman Orrin G. Hatch, R-Utah, whose panel has jurisdiction over much of any health care package, says the chamber will take a more deliberative approach aiming at 51 votes. (Tom Williams/CQ Roll Call File Photo)

Last week’s legislative victories — finishing an omnibus spending bill and getting the rollback of the 2010 health care law through the House — are the foundation for the months of battles to come on Capitol Hill. 

Appropriators can begin to turn their attention toward the first full fiscal year of Donald Trump’s presidency, but their Senate colleagues will also have to deal with the procedural morass that comes with trying to reinvent the health care system through budget reconciliation.

Indeed, the fate of the health care measure will likely determine what sort of progress can be made on everything Congress faces this year, from the basic task of funding the government to the more herculean one of rewriting the tax code, all in a time of increasing partisan tension in Washington.

After the House vote, Senate Finance Chairman Orrin G. Hatch said the chamber would focus on goals of reducing costs and increasing choice in health care, all with an eye toward majority support. At the same time, the Utah Republican acknowledged there would need to be compromises, which have been elusive so far.

“Coupled with the constraints imposed by the budget reconciliation process, we must manage expectations and remain focused on the art of the doable as we move forward,” he said.

Senate Majority Whip John Cornyn said last week there was “no timeline” for moving forward with a Senate version of legislation to partially repeal and replace the Obama-era health care law, but the Texas Republican added that once they had 51 votes, the Senate would proceed.

That won’t happen until senators and staff receive cost estimates from the Congressional Budget Office and understand the effect of the House-passed bill. This is because, in part, it would seem impossible to know if budgetary effects violate the Byrd Rule, which is key to reconciliation’s expedited floor procedure that allows a measure to pass the Senate without having to navigate a filibuster.

All that could take weeks, and it is during this time that lawmakers are likely to see the presentation of the Trump administration’s first fully detailed budget request, with work beginning on fiscal 2018 spending on a truncated timeline.

“I think that they are going to have a heck of a time coming to an agreement on their budget outline. Put aside the issues of what’s going to be put into the reconciliation package — in some ways that may be the easier part for them than actually putting the budget together,” Sen. Chris Van Hollen said of the 2018 work.

The Maryland Democrat, who joined the Appropriations Committee upon arrival in the Senate in January and who previously led Democrats on the House Budget Committee, questioned the feasibility of moving ahead on fiscal 2018 spending bills without a budget resolution.

The timing of the fiscal 2018 budget resolution depends on what happens in health care debate. That’s because Republican leaders chose to use the fiscal 2017 budget resolution and the subsequent reconciliation instructions as the vehicle for their health care measure. If they were to pass a fiscal 2018 budget resolution, it could obviate the fiscal 2017 resolution. That’s important, because they want to use the fiscal 2018 resolution and its subsequent reconciliation process to tackle changing the tax code. In essence, health care needs to happen first, and it needs to happen before the current fiscal year is over Sept. 30, when the fiscal 2017 resolution expires. But it’s complicated because the fiscal 2018 budget resolution sets the top-line numbers for the appropriations process.

So the process might be disjointed for as long as the health care debate goes on. Further complicating matters is that absent a new budget resolution’s top-line numbers, the automatic budget cuts known as sequestration bounce back, which would slash spending below levels generally acceptable to most members on both sides of the aisle.

But Sen. Roy Blunt, the chairman of the Labor-HHS-Education subcommittee of Appropriations, suggested that members of that committee may get to work on the 12 Appropriations bills after Memorial Day.

The Missouri Republican said he thought the process of crafting the fiscal 2017 omnibus was useful for the chairmen and vice chairmen at the Appropriations Committees on both sides of the Capitol because it handed them, “an opportunity to really work together and figure out how to negotiate a bill, which hadn’t happened in a while.”

Cornyn echoed that sentiment, suggesting it might bode well for future spending discussions.

“I think we should acknowledge that it actually represents a win, because it demonstrates the ability to negotiate something with Democrats in both houses of Congress that the White House agrees with, and there’s a lot of good things in there,” the Texas Republican said. “It’s always easy to find things to criticize in spending bills, but we’ve been forced to do this through an omnibus by the Democrats and this is the hand we’ve been dealt.”

Cornyn was one of several Republicans to chastise Democrats for their opposition to calling up a standalone bill funding the Pentagon this year.

“It’s not that I blame Mitch McConnell or anybody else. The Democrats would not allow us to move forward on the Defense appropriations bill. That’s got to stop. So, I just want everybody to have their say, have their amendments, get a vote and go back to normal order,” said Sen. Lindsey Graham, the State-Foreign Operations Appropriations Subcommittee chairman. “We’re all in the same boat together. It’s not a good way to govern the country.”

The South Carolinian ended up being one of the GOP appropriators to vote against the omnibus, citing key local concerns, including the status of the Export-Import Bank.

It’s the nature of McConnell, who for years led Republicans on the subcommittee funding foreign operations, to want to prioritize appropriations bills, and Blunt said he expect the same in the upcoming summer when the Senate is not mired in the health care debate.

“Many of the members will feel good about the ability to explain how we’ve prioritized. And I hope it drives more of an interest to have these bills actually on the floor,” Blunt said. “Some of our bills, I think, still could be ready to be on the floor in the June timeframe, and my guess is Sen. McConnell will want to allocate a lot of time to the appropriations process.”

Sen. Patrick J. Leahy, the top Democrat on the Appropriations panel, signaled that he would be on board with such an effort.

“It is my goal … to return to regular order, where we consider each appropriations bill in committee, debate each one publicly on the floor, and pass them individually. That is the way we should operate,” the longtime Vermont lawmaker said Thursday. “That is what the American people deserve. I look forward to working with the chairman to make this a reality when we turn, in very short order, to the fiscal year 2018 bills.”

For Democrats, the wildcard won’t be Republican appropriators, but the Trump budget request — and the president himself.

“I will say that it’s alarming to hear this president talk about a ‘good’ government shutdown. There are no good government shutdowns,” Van Hollen said, referring to a recent Trump tweet. “Normally, you would think only a hostile foreign power would want the United States government to shut down. It cost our economy $24 billion a few years ago for a 16-day shutdown.”

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