The end of Congressional détente?

Things have been relatively quiet in Congress lately and there has even been some bipartisan work getting done, but that could change relatively soon and I am not even talking about the continued parade of ACA repeal votes that are coming down the pike in the Highway bill or via budget reconciliation. Those efforts are getting shrugged off and consigned to the realm of symbolism.  I’m talking about a series of must-do measures that could bring us back to the world of hostage-taking, and government shut-down brinksmanship. Here are three leading flashpoints:

Appropriations: It is now clear that the appropriations process will not be completed on time. That means Congress will have to pass a continuing resolution (CR) in order to avoid a government shut-down. A CR would be easy to pass except that parts of the Republican caucus seem intent on using it to make policy changes, notably to strip all federal funding from Planned Parenthood.

Social Security disability insurance: The SSA Trustees report shows that unless Congress acts, millions of people with disabilities will receive a 19 percent cut in their already meager benefits. Again, an easy fix is available for Congress—they can vote to transfer funding to the SSDI account from the larger retirement trust fund (as Congress has done several times in the past with little fanfare).  However, congressional Republicans are seeking changes in the program as the price for extending its life, setting up what is sure to be a tense negotiation.

Debt limit: Although the timing is uncertain, analysts expect the Treasury Department’s measures for making payments on government debt will be exhausted before the end of the year. As always, Congress can simply vote to raise the debt ceiling to honor the obligations that they themselves have voted to incur. Beyond that, the debt ceiling could be scrapped altogether, an approach recommended in a recent GAO report. That would remove the recurrent threat of US government default, a threat which the GAO found harms the economy. Will Congress act rationally or will we be treated to another game of chicken regarding the nation’s economic health?

The dilemma for Republican Congressional leaders in all of these cases is that a significant part of their base both in and out of Congress wants to use these must-pass bills as “hostage-taking” opportunities to extract policy changes. However, both the policy changes themselves and the repeated threats of shut-down and default tend to be unpopular with the larger voting public.

The health care tie-in?  In some of cases—e.g. limiting access to family planning services by defunding PPFA—the connection is very direct. In other cases, the impact comes more from the economic harm that could be done to vulnerable populations, via benefit cuts or government shutdown and also because each “hostage-taking” incident represents a threat to vital health and social-welfare programs. In either event, health care advocates will need to keep a close eye on these developments and be prepared to pressure Congress to do the right thing.

A funny thing happened on the way to budget reconciliation

Following the victory in King v. Burwell it seemed that the appetite for another symbolic attempt to repeal the ACA was waning, but now it appears to be back in full force. What happened? Senators went home and talked to their base voters. Although ACA repeal continues to lose steam with the general public, it still commands a majority within the Republican Party. Hence the fruitless repeal votes will continue.

More victories for CTG but some states still don’t get the message

Following on the votes in the Montana legislature to close the coverage gap by accepting federal funds to provide insurance to low income adults, two more states in the West seem poised to follow suit. Governor Bill Walker of Alaska announced that he would move ahead with closing the coverage gap and negotiators in Utah announced a breakthrough in their talks will also likely lead to expansion. That would make three states in the western part of the country moving forward this year. As the number of states refusing the overwhelming logic in favor of coverage declines it becomes harder and harder, given the geography and demography of states and people in the coverage gap, to ignore the continuing role of race in shaping our politics. While symbolic actions, such as removing the confederate battle flag in South Carolina are a step forward, more concrete actions to close disparities in health and economic wellbeing are necessary. There is no better place to start than closing the coverage gap.