Category: Featured
Updates: Health Bill, Social Security, Budget, Debt Ceiling, Appropriations

  • Senate GOP released a revised health care bill on Thursday which tentatively includes the controversial Cruz amendment that gives insurers the ability to circumvent consumer protections with low-cost, low-coverage plans. The revised bill drops tax cuts for high-income earners, but leaves in place deep cuts in Medicaid.  At the same time, GOP Senators Graham and Cassidy are working on a different alternative that would also keep ACA tax increases but send revenues to the States....
    • President’s Budget Runs $720 billion deficit:  The nonpartisan CBO released its annual re-estimate of the President’s Budget, concluding that the President’s Budget would generate a $720 billion deficit in 2027 rather than the balanced budget predicted by the President’s budget office....
    • Social Security Insolvency in 2034:  The Social Security Trustees released their annual report projecting that the Social Security Trust Funds will have insufficient resources to fully cover retirement and disability benefits beginning in 2034....
    • Medicare HI Insolvency in 2029:  The Trustees also released their annual assessment of the Medicare Trust Funds, finding that the Hospital Insurance Trust Fund -- which is funded by payroll taxes -- will have insufficient revenues to cover expenses in 2029....
    • GOP House leaders are having trouble assembling 218 votes for a 2018 Budget Resolution because conservative Freedom Caucus members want more entitlement cuts than the $200 billion proposed by Budget Committee leaders, while moderates want fewer cuts....
    • House Appropriations Committee continues to move FY ’18 Appropriations bills through subcommittee and full committee even though bipartisan negotiations have not yet begun on new top-line (“statutory cap”) levels for defense and non-defense discretionary spending. When new cap levels are eventually agreed to, all committee bills will have to be significantly revised....
    • Debt Ceiling:  In announcing the Senate would shorten its traditional August recess by two weeks, Senate Majority Leader McConnell hinted he may try to address the debt ceiling in August....

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Heavy Agenda as Congress Returns: Health, Budget, Spending Caps, Debt Ceiling, Tax Cuts, Appropriations

As Congress returns from July 4th recess, Members face a barrage of six major issues…

  1. Medicaid and Health Insurance Cuts….

  2. FY 2018 Budget….

  3. Revised Spending Caps or Shutdown....

  4. FY 2018 Appropriations....

  5. Hard Power vs. Soft Power….

  6. Debt Ceiling….

  7. Background on Senate Health Bill:  50 Votes May Be Out of Reach as CBO Projects 22 Million Uninsured and a 35% Cut in Medicaid

    As Congress returns from the July 4, recess, 50 votes in the Senate to pass Leader McConnell's ACA repeal-and-replace bill may be out of reach as CBO projects 22 million more uninsured Americans and a 35% cut in Medicaid -- causing a deep divide between GOP moderates and conservatives....
McConnell Postpones Health Bill While Looking for 50 Votes; Senate Bill Adds 22 Million Uninsured, Cuts Medicaid 35% by 2036

June 29:  CBO: Longer Term Effects of Senate Health Bill Would be a 35% Cut in Medicaid in 2036   New CBO Report


The Process is Not the Problem; the Problem is the Problem

Here we go again.  In a hearing on Tuesday, as reported by Congressional Quarterly, Sen. David Perdue, R-GA, told the Budget Committee, “it’s almost guaranteed that we will not have a budget process” this year. Treasury Secretary Steven Mnuchin agreed, “it is completely broken.”

Administrations and Members of Congress have been “blaming the budget process” since the current process began in 1974.

Former Congressional Budget Office Director Rudy Penner hit the nail on the head when he observed over 30 years ago, “The problem is not the process, the problem is the problem.”

This year’s “problem” is that the House and Senate Appropriations Committees have started writing the 12 regular appropriations bills for FY 2018, which begins October 1st, without having top-line numbers to work from (see Appropriations Portal)....

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The Dangers of Distraction: Health Care, Debt Ceiling, Dodd-Frank Repeal, Shutdown, Tax, Infrastructure

Special Counsel Mueller's investigation and all the related and rapidly unfolding developments deserve our highest level of attention and concern. The stability, integrity, and future of our democracy is at stake.

At the same time, we cannot afford to lose sight of vital matters of governance that continue to unfold and have profound implications for tens of millions of Americans and future generations.

Over the coming weeks, public policy matters of the greatest importance will be addressed in Congress: (1) the health care of tens of millions of Americans will be directly impacted by critical decisions made on Medicaid, health insurance subsidies, pre-existing conditions and other insurance protections; (2) the stability of our economy will be at risk if Congress fails to raise the debt ceiling and leaves the Treasury unable to honor U.S. financial obligations; 3) the federal government will shut down October 1st if Republicans and Democrats remain seriously divided on appropriate spending levels for defense and non-defense programs; (4) the stability of our banking and financial sectors are at stake as Congress works through changes to the Dodd-Frank reforms; (5) dozens of critical federal programs--from medical research to low-income energy assistance--are on the chopping block as work on the FY 2018 budget moves forward; and (6) our nation's ability to compete in a complex global economy will be compromised if we fail to invest in a 21st century infrastructure and a skilled & educated workforce.


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CBO Projects 23 Million Uninsured, More Instability

The Congressional Budget Office on May 24, 2017 released its analysis of the Obamacare repeal-and-replace legislation passed by the House of Representatives 217-213 on May 4, 2017 (H.R. 1628, "American Health Care Act of 2017").  Following are essential facts, findings, and estimates:

Background on the ACA:  Obamacare is aimed at providing access to health care for uninsured Americans through: (1) expanding Medicaid to cover all Americans up to 138% of the federal poverty level; (2) government subsidies to purchase private health insurance on State or Federal exchanges for people between 138% and 400% of federal poverty level; (3) barring discrimination on coverage or premiums due to pre-existing conditions; (4) barring annual and lifetime limits; (5) requiring all health policies to cover essential health benefits (EHBs); (6) limiting premiums for older Americans; and (7) stabilizing the private insurance market through individual and employer mandates....

"CBO and JCT estimate that in 2018, 14 million more people would be uninsured under H.R. 1628 than under current law. The increase in the number of uninsured people relative to the number projected under current law would reach 19 million in 2020 and 23 million in 2026.... The increase would be disproportionately larger among older people with lower income—particularly people between 50 and 64 years old with income of less than 200 percent of the federal poverty level...."
FY 2018 Trump Budget: Top 10 Things You Should Know

The Trump Administration released the President's FY 2018 Budget on Tuesday, May 23, launching a contentious and consequential debate over America's priorities.

Most analysts would agree that projected deficits are unsustainable.  Annual federal deficits, under current policies, are projected by the nonpartisan Congressional Budget Office (CBO) to increase from nearly $500 billion in FY 2018, to $1 trillion in 2022, to $1.4 trillion in 2027. Federal debt (owed to the public) is projected to rise from 77% of GDP in 2018 to 89% in 2027, 113% in 2037, and 150% of GDP in 2047; and within 10 years, annual federal interest payments will exceed three-quarters of a trillion dollars.

All of this underscores the need for long-term stabilization of debt as a percent of GDP. However, as explained below, the Trump Budget's claim to balance the Federal budget is based on unrealistic economics, dubious savings, unfunded investments, ignoring trillions in tax cuts, and spending cuts impacting the most vulnerable Americans and those who have fallen on hard times. ...

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FY 2018 Budget: Major Clashes Expected on Appropriations, Tax Cuts, Entitlement Cuts

Administration will release the President's FY 2018 Budget on Tuesday, May 23, launching a contentious and consequential debate over America's priorities. OMB Director Mulvaney will testify at House Budget Committee on 5/24 and Senate Budget Committee on 5/25.

Five Major Pieces to this Year's Contentious Budget Debate: [1.] Appropriations Impasse or a New Bipartisan Budget Deal? [2.] Cutting Entitlements $500 - $800 billion over 10 Years [3.] Individual and Business Tax Cuts, Reforms [4.] Balancing the Budget vs. Investment & Infrastructure [5.] Debt Ceiling...

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Healthcare: ACA Repeal-and-Replace

The House on Thursday, May 4, narrowly approved 217-213 a revised bill (HR 1628, "American Health Care Act") to repeal and replace the Affordable Care Act (Obamacare), although the measure faces uncertainty in the Senate. The House passed the bill without Congressional Budget Office (CBO) estimates of the number of Americans likely to lose health insurance coverage or the legislation's overall cost. Below is a summary of the bill's impact and cost approximations based on previous versions of the bill.

First, it is useful to put Obamacare in context. America has a diversity of healthcare approaches:
  • About half of all Americans have employer-provided insurance.
  • About 1-in-5 have Medicaid, which is an entitlement for low-income Americans, under which the Federal and State governments share the cost of paying healthcare providers.
  • About 1-in-6 have Medicare, which is government-provided national health insurance (otherwise known as "single payer"), paid for by payroll taxes, general tax revenues, and premiums.
  • About 2%, most Veterans, Military, and some Indian Tribes, receive care at government facilities from government physicians.
  • Others, who can afford it, purchase private health insurance.
  • Obamacare is aimed at providing access to health care for uninsured Americans through a hybrid approach: (1) expanding Medicaid to cover Americans up to 138% of the federal poverty level (31 States and DC participate); and (2) government subsidies to purchase private insurance on State or Federal exchanges for people between 138% and 400% of federal poverty level.
The House-passed bill would:...

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