December 21, 2017
Congress is racing to finish up the last bit of business for 2017 this week before shutting down for the remainder of the year.
Here is a quick summary of what happened this week, what is happening before the end of the week, and what to keep an eye for early 2018.
Tax Reform: Tax Reform was passed today (Thursday) and will be sent to President Trump. The bill repeals the individual mandate effective 2019. It also increases the deficit to a large enough extent that automatic cuts (sequestration) will kick in unless Congress waives certain rules (PAYGO). It’s been reported that President Trump may sign the bill next year, in which case the sequestration rules would not go into effect until 2019. If he signs the bill this year, they will go into effect in 2018.
Spending Bill: The current spending bill expires this Friday. Without a new spending bill the government will shut down. Since there is huge pressure to the pass the bill, various people have attempted to attach other provisions to the spending bill. In summary:
CSRs/Reinsurance- Initial optimism on these provisions have plummeted. There is next to no chance they will be voted on this year. Instead of passing an annual budget, Congress is likely to pass a short term budget (until mid-January) and its possible reinsurance provisions will be taken up then. CSR funding is a very low likelihood event.
HIT- An insurance tax delay does seem to have bipartisan support but will most likely not be included in the December budget deal (if it happens) and instead pushed until January.
Sequestration Delay/Medicare Extenders – If sequestration does not kick in until 2019 it is unlikely Congress will include a sequestration delay for 2019 in this budget cycle and instead push that topic to next year. Medicare Extenders does have support but it is unclear if it would be included in a budget deal in December or wait until January
Overall Bill- As a common theme, it is likely that a short-term budget bill will be passed and outstanding issues will be handled in January as part of a longer term agreement. The second most likely outcome is a shutdown.
CHIP- Unfortunately one of the issues that may be punted into the next year is CHIP funding. CHIP has been without funding since September and state programs have reached critical levels. A good tracking website of where states are in the process of closing their program can be found here. As many as two million children could lose access to coverage if no short term funding is included in the budget bill. As of this writing, it is unclear if that funding will be included.
Next Year- While the agenda for next year is unclear, there continues to be discussion of welfare/entitlement reform. Paul Ryan appears to be focused on enacting cuts to programs including Medicaid. This would potentially be taken up in the early Spring.