December 14, 2017
As things continue to swirl here in the nation’s capital, here is a quick summary of where things are.
Alabama Election – The surprising election of Doug Jones to the US Senate potentially has major implications but not in the short-run. Why? Doug Jones will likely not be seated until after the New Year and therefore likely after the tax reform vote/budget vote. However, there has been increasing discussion that House Speaker Paul Ryan is very interested in cutting spending on Medicare, Medicaid, and ACA programs. Doug Jones’ election reduces the likelihood that Ryan’s policy agenda will happen.
Tax Reform- At the time of writing, Tax Reform remains very unclear. House and Senate Republicans are trying to pass a bill before they go home for the Christmas break. The final bill is not yet public. The expectation is that the bill will be made public today (Dec 15) and voted on early-to-mid next week. Vice President Pence changed his schedule (his vote is the tie-breaker) to be in DC next week, suggesting the vote will be close. It is very likely that the mandate repeal remains in the tax bill, and all signs point to the deficit increases being large enough to trigger additional sequestration.
Budget -Another major bill to be voted on next week is the budget. Attached to the budget bill may be important health policy issues such as CHIP funding, Medicare Extenders, Waiving Sequestration, CSR funds, and reinsurance dollars (and that doesn’t even include non- health policy issues like DACA). The House is expected to vote next week on a short term budget extension which would include funds for CHIP paid for with changes to the ACA (shortening of grace periods). The Senate will either approve of the deal or pass its own bill. At that stage the House will either accept the new bill or the government will shut down. It seems like the most likely outcome is that some of the topics will addressed with a minor extension on the budget (i.e. budget fights in January) but with so many balls in the air anything is possible.
Open Enrollment- Today is the last day of Open Enrollment for the Healthcare.gov states. The headline number could come out next week although as a reminder nearly all state-based Exchanges will have Open Enrollment continuing into January.