Congress
Republicans are ready to revive stalled health care legislation. Dems want the GOP to pay a price.
Republicans are eyeing an opportunity to enact a bipartisan health package by the end of the year, but Democrats aren’t exactly in a deal-making mood.
With the dust barely settled after enacting their party-line domestic policy megabill, GOP lawmakers on the Senate Finance, House Ways and Means and House Energy and Commerce committees are hoping they’ll have another shot this year at making policy changes to drug pricing long sought by both parties.
It will be a litmus test for whether lawmakers can come together during President Donald Trump’s polarizing second term — and in the aftermath of the enactment of the Republican megabill, which included the steepest cuts to Medicaid in the program’s history.
Democrats are already suggesting Republicans may have poisoned the well and are countering by playing hardball. One particular demand they’re making as a condition of engagement: a costly extension of expanded tax credits for Affordable Care Act insurance premiums that are set to expire at the end of the year.
The tax credits, which Democrats enacted over Republican objections during the Biden administration, reduced the cost of insurance on the 2010 health law exchanges for millions of middle- and upper-income people for the first time. Extending them will will be a tough pill to swallow for Republicans now, too — particularly in the House, where Ways and Means Chair Jason Smith of Missouri recently suggested it could be a nonstarter for his conference.
In an interview, Smith said there are “opportunities to do several bipartisan items in health care and tax and in trade” following the passage of Trump’s megabill. But, he added, extending the enhanced tax credits would be “a big problem for a lot of my members.”
Smith went on to blame Democrats for failing to move forward on bipartisan health policies.
“PBMs have always been bipartisan,” said Smith, referring pharmaceutical benefit managers and proposals to overhaul how they negotiate drug prices with manufacturers on behalf of health plans.
“The cancer screen has always been bipartisan, the weight loss stuff has been bipartisan,” he continued. “There’s a lot of bipartisan provisions that have always failed because the Democrats have failed to come to the table.”
Smith’s Democratic counterpart on the House tax-writing committee, ranking member Richard Neal of Massachusetts, said in an interview Thursday he’d be willing to restart negotiations — but only if an extension of the ACA subsidies is part of the equation.
Asked if it had to be included in any larger bipartisan health package, Neal said, “It has to be.”
He added: “I also think it’s a reminder of how [Republicans are] filing legislation to undo what they did three weeks ago. What’s hilarious is they are either saying they didn’t know what was in their own legislation or now they want to get away from what they voted for in their own legislation.”
Neal was referring to legislation from Sen. Josh Hawley (R-Mo.) that would roll back major changes to Medicaid — which he just voted for as part of the megabill.
There’s been chatter for months about reviving a sweeping bipartisan health care package that was on track for passage last December as part of a larger government funding bill, but House GOP leaders dropped the health care provisions after Trump and Elon Musk said that funding bill was overly broad and threatened to tank it. A major part of the health package included proposals to crack down on PBMs, who critics accuse of charging higher prices for medications to health plans than the reimbursements they send to pharmacies, among other things.
As Smith alluded to, the Ways and Means Committee is also eyeing legislation from Rep. Mike Kelly (R-Pa.) for inclusion in the new health package. Kelly’s bill, which was marked up and approved by the panel last summer, would allow weight loss drugs for treatment of obesity, like Wegovy and Zepbound, to qualify for Medicare coverage. Federal law currently bans Medicare from covering drugs for weight loss, even though Medicare covers pharmaceuticals for other conditions such as heart disease.
The drugs are expensive and a Biden administration plan to increase coverage of them, which Trump shelved in April, would have cost $25 billion over ten years, according to the agency that runs Medicare.
Another bill sponsored by Sens. Tammy Baldwin (D-Wis.) and Susan Collins (R-Maine) — which would reauthorize a partnership between the Centers for Disease Control and Prevention and state health programs to offer free breast cancer screenings to low-income, uninsured and underinsured women — is also under consideration for that package.
But Democrats are furious with Republicans for first plowing through Medicaid changes in the megabill, then passing $9 billion in funding cuts across an array of federal programs, including those related to global health initiatives.
“If we keep making progress on [appropriations] … there is a chance we can do the health care package,” Sen. Chris Coons (D-Del.) said Thursday following the Senate’s vote on Trump’s rescissions request. “But that chance got worse overnight.”
Coons has previously co-sponsored legislation with Sen. Roger Marshall (R-Kan.) to change how PBMs calculate health insurance deductibles. Marshall said last week that coming back to the table on bipartisan PBM legislation was “a top priority.”
But Democrats are also pointing out that Republicans are looking at policies that would reduce drug costs, and expand federal health insurance coverage of drugs, right after they stripped hundreds of billions of dollars from Medicaid.
“When you make changes in Medicaid, that’s going to ripple through the rest of the health care system,” said the top Democrat on the Finance Committee, Sen. Ron Wyden of Oregon. “As far as I can tell, that’s just a pipe dream, because what [Republicans] want to do is pass another partisan reconciliation bill.”
A senior Senate Democratic aide, granted anonymity to speak candidly, added: “Democrats will not be a part of any effort to selectively dismantle the American health care system after Republicans put it on life support.”
At the same time, Democrats need Republicans to help them extend the enhanced ACA tax credits they enacted as part of President Joe Biden’s American Rescue Plan Act, and then continued through 2025 in the Inflation Reduction Act. The Robert Wood Johnson Foundation, a progressive philanthropy, found that health care premiums for people at or near the federal poverty line would skyrocket as a result of the credits’ expiration. People at the poverty line could see monthly premiums grow from $1 to $24, the foundation said.
Oneestimate from the nonpartisan Congressional Budget Office found that the number of uninsured people would rise by an average of 3.8 million every year between 2026 and 2034 if the credits expire.
“It’s a hugely important priority for working families. Health costs have gone through the stratosphere,” said Wyden.
House conservatives have balked, though, at the cost of extending them. According to another CBO analysis requested by Smith and House Budget Chair Jodey Arrington (R-Texas), a permanent extension of the enhanced ACA subsidies would cost $383 billion. Republicans have argued that a chunk of the increased benefits go to higher-earners and that the subsidies artificially inflate premiums charged by health plans.
What remains to be seen, though, is whether Republicans want a PBM overhaul badly enough to trade an extension of the subsidies.
When asked whether he could tolerate such a deal, Senate Finance member Todd Young (R-Ind.) said in an interview Thursday that he would have to “think about it.”
Another Finance Republican, Sen. Steve Daines of Montana, appeared more receptive, saying his party “need[s] to” enact a PBM package this Congress.
“I think that is something that is going to have to be part of the discussion here to get to 60 votes,” Daines said.
Robert King, Jennifer Scholtes and Josh Siegel contributed to this report.
Congress
‘I’ve been taking a ton of risk’: Inside Jim Himes’ mission to save a key spy authority
Jim Himes wants to reauthorize a controversial surveillance law. He knows it comes with big risks.
The top Democrat on the House Intelligence Committee has been seeking a bipartisan deal to extend Section 702 of the Foreign Intelligence Surveillance Act while Republicans are busy fighting among themselves over how to prevent the government spy power from expiring April 30.
Fearing a lapse would be an existential crisis, he’s been empowered by House Minority Leader Hakeem Jeffries to share his perspective with fellow Democrats who are skeptical of reauthorizing Section 702 without guardrails to protect Americans from being targeted by the Trump administration. And despite his own preferences for modifying the spy authority, he’s facing criticism from progressives in his district for being open to a clean extension.
Himes has also been talking to the White House — but often finds himself out of the loop of negotiations with House Republican leaders, who are more focused on trying to squeeze a deal through their ultrathin margins than find common ground with Democrats.
“There’s been a shit ton of outreach to me” on this issue, Himes, of Connecticut, said in a lengthy interview in his Capitol Hill office Thursday. “None of it has been, ‘Come to this room to negotiate this deal today.’”

The stakes are high for Himes as he navigates the difficult politics around a surveillance law viewed with deep suspicion by many progressives and conservatives. And in attempting to broker cross-party consensus around the spy law, he has embarked on a potentially thankless mission.
He’s challenging Republicans’ appetite for bipartisan dealmaking in the Trump era — and so far, he’s being largely ignored by the GOP leaders. He’s also testing whether Democrats would attach their names to any legislation that gives even the appearance of emboldening an administration they view as corrupt — and it’s getting more difficult by the day.
“I’ve been taking a ton of risk, I’ve been doing a ton of explanations,” Himes said later Thursday.
If he succeeds in stitching together some fractured coalition to extend Section 702 with meaningful guardrails, he will have pulled off a feat of political compromise rarely seen these days. But if he is unable to help land a deal and must instead back a clean extension in the interest of protecting national security, he will undoubtedly take fresh heat from progressives, perhaps in the form of a credible primary challenger.
One long-shot candidate looking to unseat Himes in the Democratic primary based on the incumbent’s FISA stance — Joseph Perez-Caputo, a local activist — has been leading constituent protests against the lawmaker back home.
“We’ve kind of watched in abject horror,” Perez-Caputo said in an interview of Himes’ scramble to land a Section 702 agreement.
A new letter from half a dozen groups in Connecticut, shared first with Blue Light News, is calling on Himes to step down as the Intelligence Committee’s ranking member, saying he has “betrayed” obligations to his constituents and the Constitution — including by “actively lobbying other Democrats and Republicans to support the administration’s FISA agenda.”
Himes is cognizant of the dynamics, recalling that he got his “head blown off” by frustrated participants during a demonstration in his district last month, adding, “there’s an immense amount of misinformation out there that needs to be addressed.”
Ultimately, Himes says, he’s driven in this fight by a sense of duty. Over the course of the Thursday interview, he insisted — repeatedly — that he prefers extending the spy authority with policy changes, like seeking judicial review for searches under the program, to continuing on with the status quo.
Rather, Himes explained, his perch on the Intelligence panel uniquely positions him to understand the scope and stakes of a Section 702 expiration. And if it were to come down to a choice between passing a clean extension or letting the program expire, a lapse would be a nonstarter.
“Three months from now, if FISA 702 is dark and there’s a bomb in Grand Central, there will be very little doubt in my mind … that that occurred because we shut down our most important counterintelligence,” Himes said.
“So I don’t blame them,” he added of those members who would prefer the program lapse than support a clean extension. “But I just see with some granularity — actually, more granularity than pretty much anybody around here — what the risks are that we face.”
Despite Himes’ entreaties, many House Democrats remain skeptical. Rep. Stephen Lynch of Massachusetts said in an interview Thursday he will vote against a reauthorization for the first time in his 25-year tenure in the House if the legislation does not institute new guardrails on warrantless government surveillance.

Congressional Progressive Caucus Chair Rep. Greg Casar (D-Texas) said he respects Himes and appreciates that he has attended caucus meetings to share his perspective on the issue. But, he said in an interview, the decision was an easy one: “We should unify now to say, ‘No, Trump does not use power responsibly.’”
Himes said his senior role on the House Intelligence Committee means he’s inclined to never trust any administration — and he “particularly” doesn’t trust this one. But he emphasized he has not, in his role on the panel, ever been presented with any evidence that President Donald Trump or senior White House officials have sought to interfere with Americans’ privacy.
“In the last 14 months,” he said, “there has not been a single example of their attempt to abuse this database. I am conscious of something that is hard to get people to understand, which is, there is no program that is more overseen than this one. None.”
Rep. Gregory Meeks of New York, the top Democrat on the Foreign Affairs Committee who is also privy to classified information not shared with the majority of his colleagues, had a similar point of view.
“I don’t want it to be on my conscience that something happens that we could have stopped,” Meeks said in an interview. “That’s the responsibility that Jim has and the burden at times of being the ranking member, and the former chair, of Intel.”
Some Republicans downplayed Himes’ role in the FISA talks as GOP leaders go down a partisan path. House Intelligence Chair Rick Crawford questioned how much Himes is backchanneling with Republicans, while noting he considers the ranking member a friend.
“We try to be considerate of him and his concerns, and I think he extends me that courtesy as well,” the Arkansas Republican said in an interview Thursday. “So we have a good working relationship. And I think that’s helpful.”

As the April 30 deadline to extend the FISA spy authority draws nearer, Himes is continuing to make the rounds with colleagues of both parties but also think strategically about what could pass the House, and how.
He and the senior House Judiciary Democrat, Rep. Jamie Raskin of Maryland, have been workshopping possible backup plans with policy changes that could attract more Democratic support in case Republicans fail to pass their partisan bill.
He’s now also interested in finding a set of reforms that could get the support of a two-thirds majority of the House so that the legislation could advance under an expedited floor procedure known as a suspension, which doesn’t first require clearing a party-line “rule” vote.
Himes said there was a “real opportunity” to pass a bill under suspension last week, when Speaker Mike Johnson instead attempted, unsuccessfully, to pass an 18-month extension bill through the regular order process in the middle of the night. But Johnson’s failure, Himes continued, only emboldened Democrats to stand back and watch the GOP flounder.
Calling himself an “emissary” during that overnight vote, Himes was frank: “A bunch of members at two in the morning, watching the speaker fall flat on his face, does not help me.”
Congress
Mike Johnson tries again to extend contested spy law
House GOP leaders on Thursday unveiled the text of a new three-year extension of a key spy law, as Speaker Mike Johnson tried to overcome ultra-conservative resistance and pass it next week.
The proposed reauthorization of the so-called Section 702 law includes some new oversight and penalties for abuses of the spy authority but stops short of warrant requirements sought by GOP hard-liners.
Conservatives have pushed back on extending Section 702, which allows warrantless surveillance of foreigners, because of concerns about U.S. citizens being caught up in the program.
The faction that’s been opposing an extension has not yet signed off on the latest plan. GOP leaders plan to continue talks into the weekend.
Congress
House GOP leaders scramble to sell Senate’s slimmed-down budget with promises of ‘Reconciliation 3.0’
House Republican leaders want a floor vote next week on the Senate’s budget resolution, the first step in writing an immigration enforcement bill and passing it by President Donald Trump’s June 1 deadline.
“It has to be clean because it has to be quick,” Speaker Mike Johnson said Thursday, indicating that conservatives could not make major changes to the other chamber’s blueprint at this time.
But Johnson and others still have to lock in support from conservatives who are threatening to vote against it if it doesn’t encompass more top GOP policy priorities, and it is proving to be a delicate balancing act.
House Majority Leader Steve Scalise (La.) met Thursday morning with Budget Chair Jodey Arrington (Texas) and leaders of key House GOP factions, according to four people granted anonymity to share details of private meetings — an effort to quell concerns among some conservatives about the narrow scope of the current plan. Arrington and other senior Republicans have been pushing to expand the party-line bill currently under discussion.
Johnson, Scalise and others in GOP leadership are promising that as soon as Republicans pass a bill funding immigration enforcement and some border patrol activities, they will get to work on another measure through the filibuster-skirting budget reconciliation process.
“We’re going to move right to reconciliation, what will now be 3.0,” Johnson said, referring both to the current plan and the tax and spending megabill Republicans passed last summer. “We’re going to do it as quickly as possible.”
Some of the ideas that circulated during the closed-door leadership meeting Thursday included opening up the possibility for more tax policy changes, addressing the Trump administration’s request for $350 billion for the Pentagon, additional funding for the Iran war and spending cuts across social programs in another package.
Arrington, who is among those wishing to expand the upcoming reconciliation effort, is seeking steep spending reductions to social programs and hopes to revisit Obamacare spending — including cost-sharing reductions, which would reduce out-of-pocket health costs.
Leadership of the Republican Study Committee, meanwhile, is demanding that any third reconciliation bill be fully paid for. There has been limited angst over “pay-fors” for the current party-line pursuit because the measure is an attempt to fund the immigration enforcement agencies and circumvent regular appropriations negotiations, which have been stuck for months.
But many Republicans are doubtful their party will be able to pass another party-line bill ahead of the midterms and see the immigration funding bill as their last bite at the apple. Some of them, including Rep. Warren Davidson of Ohio, are threatening to vote against the Senate budget resolution that would unlock the reconciliation process for the immigration funding measure unless it can incorporate more items from the hard-liners’ wishlist.
GOP leaders are now scrambling to stave off defections. Adoption of identical budget resolutions in both chambers will unlock the ability for lawmakers to write and pass a bill through reconciliation that would send tens of billions of dollars to immigration enforcement operations run through the Department of Homeland Security, which has been shuttered since February.
Republicans are on a very tight schedule to send this bill to Trump’s desk and pave the way for ending the record-setting DHS shutdown, given White House demands.
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