Week ahead: Lawmakers push big health care decisions to 2018


Lawmakers passed a short-term spending bill Thursday to avoid a shutdown and wrap up their year. But there will be many big health care decisions for lawmakers in 2018. Here are some of the big questions and looming fights in the year ahead.


Will the GOP turn a corner on ObamaCare?

Republicans are showing some signs they are backing off the push for repeal, although some lawmakers are keeping up the effort. Senate Majority Leader Mitch McConnell (R-Ky.) says the Senate will probably move on to other issues, though he adds that if Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) can find a way to get the votes on their ObamaCare repeal-and-replace bill, the Senate could take it up.


McConnell and other Senate Republicans are also talking about taking steps to help stabilize ObamaCare, including a pair of bipartisan bills aimed at lowering premiums. Those bills are being pushed by Sen. Susan Collins (R-Maine), who received promises from McConnell that they would come up for a vote in exchange for her support on the Republican tax bill.

But whether House Republicans will go along is an open question.

The GOP tax bill, signed by President Trump on Friday, also included a repeal of the individual insurance mandate.

The effects of the repeal, though, are unclear and the health care world will be watching closely to see how insurers react.


When will Congress provide more permanent funding for children’s health insurance?

Children’s advocates had hoped for a worry-free new year.

For months, they pressed lawmakers to pass a five-year reauthorization of the Children’s Health Insurance Program (CHIP), so they didn’t have to worry about millions of low-and-middle income children losing health insurance. And those who run community health centers — which provide comprehensive care to roughly 27 million of the nation’s most vulnerable — also urged long-term funding. Congress let federal funding for both programs lapse Sept. 30.

The stop-gap spending bill lawmakers passed before leaving Washington for the holidays provided $2.85 billion for CHIP and $550 million for community health centers through March 31. But there is still uncertainty over full funding.


Will Congress defund Planned Parenthood?

After failing to defund Planned Parenthood in 2017, anti-abortion groups are likely to make a push for Congress to do it next year. Anti-abortion groups want the defunding language to be attached to whatever reconciliation bill Congress hopes to pass in 2018 whether it’s for welfare reform or another attempt at repealing ObamaCare.

Anti-abortion groups say they’re also looking into regulatory and administrative options to defund the women’s health care provider.

The Senate is expected to vote in January on a bill that would ban abortions after 20 weeks of pregnancy. The House passed the bill earlier this year, but it’s unlikely to clear the Senate, where it needs 60 votes and Republicans only have a slim majority.

Anti-abortion groups, though, hope the vote will put vulnerable Democrats in red states on record as they head toward the midterm election.


Will Congress or Trump act on drug pricing?

Democrats are likely to keep trying to hold President Trump’s feet to the fire on drug pricing, but it’s unlikely they will get major policy changes.

Trump has blasted the pharmaceutical industry, accusing it of “getting away with murder” with steep drug prices, but his administration has done little to force the industry to change its ways, and hasn’t acted on most of the pricing promises he made during the election.

The Food and Drug Administration is expected to continue its work on the regulatory side, bringing lower-cost generics to the market quicker to trying to promote more competition. But legislatively, action on drug prices will be a tough sell.


Will the GOP act on entitlement reform?

House Republicans and the Trump administration seem anxious to tackle welfare reform next year. Speaker Paul Ryan (R-Wis.) said he wants to use the fast-track reconciliation process next year for entitlement reform, with a focus on promoting work and career-based education.

But it’s not clear that Senate Majority Leader Mitch McConnell (R-Ky.) shares Ryan’s views. Any changes will have to be bipartisan, McConnell said last week, noting that the lack of Democratic support for entitlement reform makes it highly unlikely it will move through the Senate in an election year.

McConnell understands the political tightrope that Republicans are walking. There’s broad support in the Republican conference for changing the federal safety net to impose stricter work requirements on programs like Medicaid and food stamps.

But if the reform expands to changing Medicare and Social Security, there will likely be resistance from within the GOP.



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Tags Bill Cassidy Donald Trump Lindsey Graham Mitch McConnell Paul Ryan Susan Collins

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