Congress
Medicare is a target as Senate GOP faces megabill math issues
Senate Republicans are eyeing possible Medicare provisions to help offset the cost of their megabill as they try to appease budget hawks who want more spending cuts embedded in the legislation.
Making changes to Medicare, the federal health insurance program primarily serving seniors, would be a political longshot: It would face fierce backlash from some corners of the Senate GOP, not to mention across the Capitol, where Medicare proposals were floated but didn’t gain traction.
But Senate Republicans are now seriously considering it as they race to pass their party-line tax and spending package before a self-imposed July 4 deadline. The idea came up in closed-door meetings this week and, crucially, some Republicans believe President Donald Trump is on board with touching the program as long as it’s limited to “waste, fraud and abuse.”
“I think anything that is waste, fraud and abuse are obviously open to discussions,” Senate Majority Leader John Thune (R-S.D.) said Thursday when asked about Medicare.
Cracking down on some smaller areas of the vast program could net significant savings for Senate Republicans. The other main area they’re planning to tap is ratcheting down the House-negotiated state-and-local-tax-deduction cap – as Thune first acknowledged to POLITICO Tuesday. Both are politically explosive areas that will trigger serious blowback in the House.
“I think the focus, as you know, has been on addressing waste, fraud and abuse in Medicaid,” Thune added when pressed on Medicare. “But right now we’re open to suggestions if people have them about other areas where there is clearly waste, fraud and abuse that can be rooted out in any government program.”
Sen. Ron Johnson (R-Wis.), who was among the Republicans on the Senate Finance Committee who went to the White House Wednesday to meet with Trump about the tax portion of their megabill, told reporters he believed the president was more amenable to making Medicare changes than he might have previously let on.
“I think the president is actually open to any elimination of any waste, fraud and abuse … wherever,” he said, though added that Trump “doesn’t want to cut benefits.”
Finance Committee Republicans wanted to use their audience with Trump to press their case for making certain business tax incentives permanent, but a significant chunk of the conversation instead focused on senators pitching their individual ideas for how to inject more savings into their version of the House-passed bill.
A band of House moderates is deeply uncomfortable with the idea of touching Medicare in the megabill, even if it is in the name of “waste, fraud and abuse.” Speaker Mike Johnson said in a brief interview Thursday that he wouldn’t “address hypotheticals.”
But he reiterated he doesn’t want to inject any more major political fights into the already fractious talks. Johnson said the House GOP’s “work reflects more than a year of very careful and deliberate discussion and ideas and so, you know, we’re very satisfied with the product we’ve sent over there, and I hope they’ll change it as little as possible.”
Some House lawmakers briefly floated the idea of overhauling Medicare Advantage — which enables older Americans to buy private plans offering health coverage — to garner savings. Critics have accused Medicare Advantage plans of using financial gamesmanship to increase federal payments, but targeting the program would likely draw the ire of the insurance industry.
The search for more cuts comes as GOP senators look for areas where they can go beyond the House’s $1.6 trillion in cuts. But the push is being complicated because some Senate committees, including the Agriculture panel, are likely to scale back the savings found by their House counterparts.
Leadership is pushing the Agriculture Committee to net $150 billion in cuts as they work to scale down a controversial House plan to shift billions in food aid costs to states, according to four Republicans with direct knowledge of the matter. That’s half of the $300 billion in agriculture cuts from the House bill, and GOP senators are still trying to fit in a $70 billion farm bill package.
As part of an effort to generate more savings, Republicans have floated several ideas related to Medicaid, including tightening the House’s work requirements and trying to roll back — not just freeze — the use of state provider taxes. Both of those ideas would face their own block of opposition within the Senate GOP.
But they also raised Medicare as part of a lengthy debate Senate Republicans had among themselves Wednesday, when they met first with CMS Administrator Mehmet Oz and subsequently got briefed by the chairs of the Armed Services, Banking and Commerce Committees on their pieces of the megabill.
“There was legitimate debate about: Can we do more with Medicaid? Are we doing too much with Medicaid? How much waste, fraud, abuse is there in Medicare — why don’t we go after that? I think we should,” Sen. Kevin Cramer (R-N.D.) said about the discussion Wednesday.
Asked if there was any consideration of including Medicare as part of the megabill, Sen. Roger Marshall (R-Kansas) said, “There is on the Senate Republican side.”
The Senate Saturday confirmed Todd Blanche to be attorney general, following a weeks-long struggle with a handful of wary Republicans.
The Senate voted 50-49 to approve him, with GOP Sens. Susan Collins of Maine and Lisa Murkowski of Alaska joining with Democrats in opposition.
Blanche, President Donald Trump’s former personal attorney, has been serving as acting attorney general since Pam Bondi’s ouster in April. Questions about Blanche’s potential conflicts of interest from representing Trump, as well as his role in the creation of a $1.8 billion “Anti-Weaponization Fund” as part of Trump’s settlement this spring with the IRS, created headwinds to his confirmation among a key group of Senate Republicans.
Sen. Bill Cassidy, the Louisiana Republican who lost re-election after Trump endorsed a primary challenger, helped Blanche clinch his 50th vote Friday. He said Blanche wasn’t perfect but that he wasn’t sure Trump would pick someone better to lead the Justice Department.
“The choice is not between perfection and Mr. Blanche,” Cassidy said on the Senate floor. “It is between Mr. Blanche and another acting attorney general who may not run the department effectively under President Trump and who indeed may not be as good as Mr. Blanche.”
Cassidy’s support came after Blanche had already spent weeks negotiating with Sens. Thom Tillis of North Carolina and John Cornyn of Texas, who vetted his nomination as members of the Senate Judiciary Committee. Cornyn struck an agreement with Blanche Sunday for the DOJ to curtail the payout fund and rein in a deal to exempt Trump from IRS audits.
Cassidy’s support came hours after Murkowski announced that she would oppose Blanche’s nomination, putting it on the brink of potential failure. Between unified opposition from Democrats and Sen. Mitch McConnell’s absence for health reasons, Blanche could only lose two Republicans and still be confirmed.
Hours before Friday’s vote, Murkowski told reporters she spoke with Blanche multiple times but that she was “good with where I am.” She said there was no “one” thing that motivated her decision.
“If there was one thing, we might be able to go back to the White House and say ‘Hey, can we work on this one thing,’” she said. “But for me it was a compilation.”
She added that she believed the anti-weaponization fund is “pretty dead” but “what is not so clear” are the audit immunity provisions of Trump’s IRS agreement, “which I just think are viewed by so many in this country as kind of a special and sweet deal for the president and his family.”
The Senate passed a bill Saturday to fund the government beyond the midterm elections, putting the onus back on the House to head off a shutdown looming Oct. 1.
The Senate approved the measure in a bipartisan 90-6 vote, with Sen. Darline Graham of South Carolina voting present. The bill would fund federal agencies through Dec. 11 at current levels, with some exceptions. Senate leaders sped up consideration of the legislation as part of an agreement reached Saturday morning to allow members to leave for August recess.
The House and Senate have now each passed different bills aimed at averting a shutdown at the end of the fiscal year. The House bill would fund the government through Dec. 4.
The Senate legislation sets up a year-end standoff over the Trump administration’s controversial plan to put political appointees in charge of approving federal grants. The bill would block the administration from finalizing that rule during the length of the stopgap — and lawmakers are already expecting a December brawl over the issue.
Sen. John Kennedy (R-La.) said this week that he’s going to “fight like hell” in December to ensure Congress doesn’t further obstruct the grant overhaul.
But lawmakers on both sides of the aisle are resistant to the White House approach to grants. Senate Appropriations Chair Susan Collins (R-Maine) said she will “continue to oppose” the Trump administration plans “because I think they politicize the grants process, and I don’t want that to occur.” Sen. Patty Murray of Washington, the top Democrat on Senate Appropriations, said she too would “welcome the fight.”
The Senate rejected an amendment from Sen. Ted Budd (R-N.C.) intended to ensure that a ban on intoxicating hemp products kicks in come November, after Senate leaders at the White House’s urging included language in the funding bill to delay it.
The Senate bill includes language Democrats sought to ensure Immigration and Customs Enforcement and the Border Patrol don’t get any new funding under the patch. Republicans enacted $70 billion for those agencies along party lines earlier this year.
That prohibition could be contentious in the House.
Rep. John Rutherford (R-Fla.) said in an interview that the provision “could be a dealbreaker” and that he’s “not a fan” of the Senate version. Rep. Jeff Van Drew (R-N.J.) said Tuesday that he would say he’s undecided if GOP leadership whipped his vote on the Senate stopgap.
“I do not like the Senate language,” Van Drew said, noting the grant approval provision. “It’s one I would want to know what the president thinks.”
The White House issued a statement of administration policy in support of the Senate’s funding bill. No such memo was issued for the House bill, which did not include the funding increases and authorizations the White House requested.
“Every Member of Congress should support passage of this [continuing resolution] to keep the Government open as discussions on full year appropriations continue,” it reads.
Rep. Rosa DeLauro (D-Conn.), the top Democratic appropriator in the House, praised the Senate measure for including the grant and immigration enforcement language.
“This bill is a clear improvement over the House Republican continuing resolution, but we are still nearly two months away from the end of the fiscal year and should be working together to pass full-year funding bills,” she said in a statement.
Mia McCarthy and Jennifer Scholtes contributed to this report.
The Senate is aiming to leave Washington for a five-week recess early Saturday after Republicans cut a deal with President Donald Trump to punt some of their priorities, including a framework for a party-line spending plan.
The Senate is trying to lock in an agreement that would set up votes on a college sports bill, a stopgap government funding bill, Todd Blanche’s attorney general nomination and GOP voter ID legislation, according to a copy of an internal notice reviewed by Blue Light News.
The Senate would then leave Washington until mid-September.
Any one senator could object to the tentative deal, forcing it to be altered or dragging the Senate deeper into the weekend. Senators believe there are still objections to advancing the college sports bill. Democrats are also waiting to see if one of their own will prevent speeding up Blanche’s confirmation.
The breakthrough is a U-turn from earlier Friday evening, when Republican senators emerged from a closed-door meeting predicting they would have to spend Saturday trying to break a stalemate within the party about how to wrap final votes before recess.
Shortly after that meeting, Trump spoke by phone with Senate Republicans including Ron Johnson of Wisconsin, Rick Scott of Florida and Mike Lee of Utah about the path forward for the GOP’s lengthy to-do list.
During the call, according to Johnson, Trump agreed to punt a vote on a budget blueprint for a third party-line spending bill until later in the year. Lee, who has been pushing for action on the separate SAVE America Act, also agreed to drop his demand for a formal, roll call vote on adjourning given the understanding with the president.
“I think the conclusion of the conference – and we had a discussion with the president and he agrees – [is] don’t take the vote tonight,” Johnson said after the meeting in Thune’s office.
Republicans were in talks with the White House throughout Friday. A White House official granted anonymity said Friday evening that “we’re continuing to have productive conversations with senators to advance several legislative priorities.”
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