Connect with us

Congress

Republicans want a health care plan. They don’t know what will go in it.

Published

on

Republican lawmakers are looking to craft their own health care policy overhauls by the end of next week, when Senate Democrats get a vote on expiring Obamacare subsidies. So far they don’t agree on what their competing plan should look like.

In separate closed-door meetings Tuesday, House and Senate Republicans debated what they could put forth as they face the reality that health insurance premiums will skyrocket if enhanced Affordable Care Act tax credits lapse after Dec. 31. Speaker Mike Johnson for the first time definitively promised his anxious members he would put forward some kind of health care blueprint in the coming days, while Senate Republicans discussed how to lower health care costs including through a revamp of health savings accounts.

But GOP leaders in both chambers face deep divisions within their ranks about how to proceed, including whether to extend the credits at all and force Republicans to vote for the first time to affirm Obamacare. With Tuesday’s conversations producing little clarity, GOP lawmakers said they are still far away from a plan they could unite behind by the end of next week.

“Have you ever heard of a Rorschach test? Let’s smear it all over the wall,” Sen. John Kennedy (R-La.) said about the state of the GOP’s health care discussions.

Some Republicans on Capitol Hill worry that the failure to come up with any plan in the coming days could be a political nightmare heading into the 2026 midterms, with GOP candidates being dogged by questions about increased health care costs.

Retiring Sen. Thom Tillis (R-N.C.) Tuesday warned of a potential backlash during the midterms if the subsidies expire, predicting Democrats would pummel Republicans in 2026 by highlighting a “number of sympathetic cases” where Americans have seen their health insurance costs go up.

“There’s a lot of harmonization that needs to be done,” he said about the GOP’s health care talks.

During their weekly lunch Tuesday, Senate Republicans heard from Finance Chair Mike Crapo and HELP Chair Bill Cassidy about their progress in developing a Republican proposal that could be put on the floor alongside the Democratic plan. Senate Majority Leader John Thune is giving Democrats a vote as part of a deal he struck to re-open the government.

As part of the lunch, Republicans discussed providing more flexibility for how health savings accounts are used, imposing income caps on ACA subsidies and requiring ACA enrollees to make minimum payments on premiums, according to senators in attendance.

Cassidy, a physician, has been an evangelist for boosting health savings accounts as an alternative to extending the tax credits. He’s poised to use a HELP Committee hearing on the topic Wednesday to tout this proposal.

Thune is facing competing pressures within his conference over whether the ACA subsidies should be extended or allowed to sunset. Some GOP senators said after Tuesday’s lunch they expected there would be a vote on some kind of Republican health care measure next week, but Thune wouldn’t commit to that timeline, telling reporters only that his members would continue to discuss ideas.

Crapo, in an interview, said it would be a “collective decision” from the Senate GOP Conference about whether his proposal with Cassidy would get a vote next week.

Republicans are also still waiting to see what the Democratic proposal will be. Senate Minority Leader Chuck Schumer told reporters after a closed-door lunch with his own caucus that they discussed the idea and to “stay tuned” on where they would land. Democrats are likely to offer a clean extension of the subsidies, but haven’t said how long that extension would be.

Across the Capitol, Johnson pledged Tuesday for the first time that House Republicans will put forward a health care plan soon. Many House Republicans left a closed-door conference meeting with the sense that GOP leaders could produce a framework by the end of this week.

But House GOP leaders are confronting their own internal squabbling, with one person close to leadership, granted anonymity to speak candidly, describing that goal as “ambitious.”

Leaders of the House Republican Conference have also pushed to omit any ACA subsidy extension from their upcoming health care plan, alarming GOP moderates who worry their reelection prospects hinge on the subsidies’ survival.

House Majority Leader Steve Scalise got an earful on the concerns about proceeding without an ACA extension during a lunch meeting with the centrist Republican Governance Group, according to four Republicans in the room.

One of the Republicans, granted anonymity to discuss the private conversation, said that nearly every member of that caucus complained to Scalise that “something needs to be done” on health care before the end of the year. Many of the members present advocated for an ACA subsidy extension.

Scalise didn’t make any promises but said the “will of the conference” would decide whether Republicans could back health care provisions like an extension of the ACA subsidies — though a majority of House Republicans don’t support it.

“We had a good conversation about all the work that’s been done by the three committees of jurisdiction,” Scalise said in an interview after the meeting, referring to House Energy and Commerce, Ways and Means and Education and the Workforce.

“Of course, members that aren’t on those committees, you know, haven’t been aware of some of the things that have come out, but we also wanted to get their feedback,” Scalise added.

Some Republicans are holding out hope for a bipartisan breakthrough, as GOP leaders pursue what would likely be party-line options.

House Problem Solvers Co-Chair Brian Fitzpatrick (R-Pa.) is working on a bill that reflects the leaked health care framework the White House was planning to reveal last week but held back amid conservative backlash. He told reporters Tuesday he has discussed the bill with the White House and it is “not addressing” abortion restrictions — a bid to entice Democrats.

“We’re trying to get a bill that can get 218,” Fitzpatrick said. “I think it’s the most serious attempt out there.”

Benjamin Guggenheim and Mia McCarthy contributed to this report.

Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

Congress

Trump seems to wave the white flag on his US attorneys gambit

Published

on

For months, President Donald Trump has used unconventional tactics to install loyalists as top federal prosecutors across the country, and battled challenges to their authority. Now, he appears to be conceding defeat.

The Trump administration has signaled in recent days that it may refocus its efforts on trying to eliminate a Senate procedural tool used to block U.S. attorney nominees, rather than continuing to challenge the disqualifications in court. The move comes after New Jersey U.S. Attorney Alina Habba resigned from her post following a court ruling upholding her disqualification along with a handful of other U.S. attorneys who have been stripped of their positions by federal judges.

On Friday, Delaware U.S. Attorney Julianne Murray also left her post, citing the Habba ruling.

The administration’s tactics with U.S. attorneys — bypassing the Senate or sidestepping federal judges to keep unvetted prosecutors in place — are a crucial component of Trump’s effort to deploy the Justice Department against his perceived enemies. He has relied on loyalist U.S. attorneys to pursue what critics call baldly political investigations and prosecutions, including those against New York Attorney General Letitia James and former FBI Director James Comey.

On Thursday, Trump called the so-called “blue slip” process, in which home-state senators can veto judicial or U.S. attorney nominees, a “scam.” It’s his latest attack after Trump has spent months pressuring Senate Republicans to review the practice.

“‘Blue Slips’ are making it impossible to get great Republican Judges and U.S. Attorneys approved to serve in any state where there is even a single Democrat Senator,” Trump wrote in a social media post. “So unfair to Republicans, and not Constitutional.” He directed Senate Majority Leader John Thune “to get something done, ideally the termination of Blue Slips.”

Thune quickly rejected that call, and Senate Judiciary Chair Chuck Grassley has indicated no interest in scrapping the practice. Grassley also blamed the administration for failing to advance more U.S. attorney nominees, saying he has been “hamstrung waiting for background investigations and other paperwork from the administration.”

Asked for comment, a White House spokesperson referred to Trump’s public statements.

Earlier in the week, Trump appeared to acknowledge that the court rulings disqualifying his U.S. attorneys will ultimately force them out of their offices, even though many have remained there following the rulings.

Trump-installed federal prosecutors in the Los Angeles area, Nevada and in the Eastern District of Virginia, for example, have continued working in those offices despite being deemed disqualified. Trump, however, seemed to predict that may not continue.

“We have about seven U.S. attorneys who are not going to be able to keep their jobs much longer because of the blue slip,” Trump told reporters Monday.

Next stop: SCOTUS?

Carl Tobias, a law professor at the University of Richmond, said the administration appears now to have only two options: continue to try to install temporary U.S. attorneys, only to repeatedly have those choices disqualified by courts, or attempt the traditional process of Senate confirmation.

Tobias said he suspects the administration doesn’t want the U.S. attorney gambit to reach the Supreme Court. “I think the last thing they want is to have the Supreme Court say no, right? Because then the game is over.”

That way, he said, “they can continue to do what they’ve been doing, and that is avoiding advice and consent, which is in the Constitution, which they’ve done in more than half the districts, and continue to play games with the system.”

But other legal experts said it wasn’t clear how the Supreme Court might rule. Nina Mendelson, a professor at the University of Michigan Law School and an expert on acting officials, said she could envision the court leaning either way.

“If [the administration] does appeal, the Supreme Court may, on the one hand, be interested in preserving the Senate’s constitutional function of advice and consent and thus narrowly interpret the President’s authority to appoint acting US Attorneys,” she wrote in an email. “On the other hand, the Supreme Court has, in a series of cases, expressed its concern for presidential control and flexibility, which might prompt it to more generously interpret the President’s power.”

Though the administration can appeal the rulings disqualifying the prosecutors, it hasn’t in two key instances. In the Habba case, the Justice Department has said publicly that it will pursue an appeal, but asked the 3rd Circuit Court of Appeals for an extension to decide how it will proceed. New Jersey’s Democratic senators, Cory Booker and Andy Kim, have urged the White House to work with them to select Habba’s replacement.

In the case involving Lindsey Halligan in the Eastern District of Virginia, Attorney General Pam Bondi said in late November that it would pursue an “immediate”appeal — but it hasn’t.

Instead, it kept Halligan in place and attempted, but twice failed, to re-indict James. On Thursday, in a sign the White House may be adopting a more traditional approach to installing U.S. attorneys, the administration began seeking Senate confirmation for Halligan by submitting her questionnaire to the Judiciary Committee.

A spokesperson for the committee, however, noted that Halligan doesn’t have blue slips from Virginia’s senators, and “nominees without blue slips don’t have the votes to advance out of committee or get confirmed on the Senate floor.”

The administration is appealing disqualification rulings in the Los Angeles area and Nevada. In the Northern District of New York, a federal judge appears poised to disqualifyJohn Sarcone III, the Trump-aligned U.S. attorney whose office is pursuing a separate investigation of James.

Despite Trump’s griping about having his choices blocked, he is on pace to match the Biden administration for the number of U.S. attorneys confirmed during its first year. To date, Trump has seen 13 U.S. attorneys confirmed by the Senate, up from just two in September, and 18 more are expected to be confirmed next week, bringing the total to 31.

“ATTN WH; SEND MORE NOMS,” Grassley wrote on social media on Thursday.

Legal experts said the uptick in Senate-confirmed top federal prosecutors is a welcome development, even if they aren’t in some of the highest-impact districts.

“That’s promising for the system,” Tobias said.

Continue Reading

Congress

Inside Republicans’ new health bill

Published

on

House Republican leaders plan to take a vote next week on conservative-friendly health policies they’ve pursued for years. It’s the latest GOP counter to Democrats’ push to extend expiring Obamacare subsidies.

Here is what’s in the bill, the text of which was released Friday.

CHOICE accounts
Oklahoma GOP Rep. Kevin Hern’s CHOICE legislation would allow employers to offer workers tax-advantaged funds to pay for individual health insurance, in lieu of offering a traditional group plan. It would also offer tax incentives for employers who adopt the arrangements.

Both Republicans and Democrats like the concept because it promotes individual choice in health coverage while also encouraging Obamacare sign-ups.

Funding cost-sharing reductions
When Obamacare was first implemented in 2014, the federal government paid insurers directly to offset cost-sharing reductions, or discounts on deductibles that insurers must offer to people making between 100 and 250 percent of the federal poverty level.

In response to a lawsuit filed by congressional Republicans, a federal judge in 2016 ruled the government’s payments were illegal because the funding wasn’t explicitly appropriated by Congress. The Obama administration appealed, but the first Trump administration dropped the case and stopped the payments.

Insurers are still required to offer the cost-sharing reductions, they just no longer get reimbursed by the federal government.

To make up for the loss of federal dollars, insurers substantially increased silver premiums, a process known as “silver loading.” That’s driven up the amount of federal premium subsidies the government pays insurers, because the subsidy amounts are tied to the second-lowest-cost silver plan in the marketplace.

Republicans now want to put an end to that practice and start funding the cost-sharing reductions again, which is expected to lower premiums for silver plans, thus lowering the amount Obamacare enrollees receive in premium subsidies, regardless of what type of plan they’re enrolled in.

Association health plans
Association health plans enable several small businesses to band together to get health insurance. The framework includes a bill from Education and Workforce Chair Tim Walberg (R-Mich.) that would permit self-employed people to buy an association health plan.

Democrats oppose the idea. In addition to not guaranteeing essential benefits, the plans can distort the insurance market by drawing away healthy, young people, according to a statement from Virginia Rep. Bobby Scott, the top Democrat on the Education and Workforce Committee.

Stop-loss policy
The Self-Insurance Protection Act from Rep. Bob Onder (R-Mo.) would expand access for employers to “stop-loss” policies that enable them to protect against catastrophic health costs from just a few employees.

The bill would ensure that such policies are not classified as traditional health insurance by the federal government. But it has generated pushback from Democrats because it can also restrict states from regulating them.
Pharmacy benefit managers
The bill aims to overhaul how pharmacy benefit managers operate. Those are companies that negotiate drug prices on behalf of insurers and large employers. Pharmaceutical companies and lawmakers have long blamed them for high drug prices.

A push to change the rules governing the PBMs fell apart last year after Trump adviser Elon Musk tanked year-end legislation, but there continues to be overwhelming bipartisan interest in advancing changes that shed light on the PBMs’ business practices.

Continue Reading

Congress

Comer threatens the Clintons with contempt for refusing to be deposed in Epstein probe

Published

on

House Oversight Committee Chair James Comer has threatened to pursue contempt charges against former President Bill Clinton and former Secretary of State Hillary Clinton if they do not sit for depositions in Congress’ probe of the Jeffrey Epstein investigation.

His warning Friday came after the committee released new photos from the estate of the late convicted sex offender, including a signed photo depicting the former president smiling alongside Epstein and Ghislaine Maxwell, who is serving 20 years in prison for her role in his child sex trafficking operation.

Comer excoriated the Clintons in a statement for apparently refusing to participate in the investigation. The House Oversight Committee subpoenaed the Clintons in August, and has requested they sit for depositions next week.

“It has been more than four months since Bill and Hillary Clinton were subpoenaed to sit for depositions related to our investigation into Jeffrey Epstein and Ghislaine Maxwell’s horrific crimes. Throughout that time, the former President and former Secretary of State have delayed, obstructed, and largely ignored the Committee staff’s efforts to schedule their testimony,” Comer said.

He said the House Oversight Committee will seek to hold both Clintons in contempt of Congress if they do not appear for depositions or reschedule in the coming weeks. Comer scheduled Bill Clinton’s deposition for Wednesday and Hillary Clinton’s deposition for Thursday.

“If the Clintons fail to appear for their depositions next week or schedule a date for early January, the Oversight Committee will begin contempt of Congress proceedings to hold them accountable,” said the statement.

Bill Clinton’s ties to Epstein have been publicly known for years. His association included traveling on Epstein’s private plane after he left office. A spokesperson for the former president has said he cut off ties with Epstein prior to his 2019 arrest and was unaware of Epstein’s alleged crimes.

Continue Reading

Trending