Dear Scott, With Congress back in session this week, 2018 is officially underway. The threats to health care and anti-poverty programs this year are quite serious, and our first opportunity to block these threats right out of the gate comes at the end of the month (Jan. 31–Feb. 2), when House and Senate Republicans are holding a joint retreat to set their goals for 2018. We want to create an environment in which multiple Republican senators and House members are telling their leadership at the retreat (or leading up to it) that they do not want to repeat last year’s path of using a partisan, fast-track reconciliation process to revisit the Affordable Care Act repeal/replace efforts (especially the Graham-Cassidy proposal) or pursue cuts to Medicaid, SNAP, or other major anti-poverty programs this year. Our new toolkit can help you prepare for this flashpoint in the debate, whether your members of Congress are Republicans, Democrats (who are holding their own retreats at the end of January and beginning of February), or a mix of both. In the toolkit, you’ll find the suggested asks for members of Congress, talking points, and suggestions for media work, grasstops engagement, and grassroots activities. Below you will find additional context about the fights we expect to face in 2018, as well as updates on the continuing resolution to fund the government and the Trump Administration’s announcement about Medicaid work requirements. Thanks so much for your hard work on these issues, and please let us know if you have any questions about the toolkit or the other updates in today’s Scoop. Onward, Louisa, Victoria, Deborah & the CBPP Team As a reminder, the information in these Scoop emails is meant only for you and other state-based advocates who work on these issues. Please do not share or forward these emails to press or any legislative staff.
Today’s Scoop
Preview of 2018 policy debates and threats
As we shared on Wednesday’s webinar, we view 2018 as a marathon—sprinkled with a few sprints—as we seek to prevent harmful cuts or changes to federal health care and anti-poverty programs such as the Affordable Care Act, Medicaid, SNAP, and Supplemental Security Income (SSI) on the heels of the massive tax giveaway to the wealthy and corporations.
Specifically, our goals are to:
- Pass a spending deal (i.e., continuing resolution) in January with a responsible agreement on the Deferred Action for Childhood Arrivals (DACA) program; a long-term extension of the Children’s Health Insurance Program (CHIP) and other health programs without harmful changes to the Affordable Care Act; sequester relief; and emergency funding (especially Medicaid) for Puerto Rico and the Virgin Islands, plus additional disaster relief for Florida and Texas.
- Block a Fiscal Year 2019 budget resolution that includes ANY reconciliation instructions that can be used to jam through cuts in key assistance programs (e.g., Medicaid, SNAP, SSI) or Graham-Cassidy ACA repeal/replace legislation.
- Defeat any free-standing “regular order” legislation that cuts low-income entitlement programs and other critical programs or makes damaging changes.
- Prevent harmful changes to the Supplemental Nutrition Assistance Program (SNAP) in the Farm Bill.
- Ensure no bipartisan “fixes” to the tax bill (the bill is so deeply flawed that it must be rolled back or discarded for a much more responsible and equitable approach).
There are press reports that Majority Leader Senator McConnell may be considering bypassing the annual budget resolution exercise altogether this year. Simply put, Congress doesn’t really need a budget resolution this year, especially if they get an agreement on sequester relief to undo the coming cuts in domestic and defense appropriations. Without a budget resolution, there can’t be a final budget conference agreement with reconciliation instructions allowing health and/or entitlement-cutting (or benefit-cutting) bills to move forward with a simple majority. Of course, in that scenario we wouldn’t be out of the woods yet, as there’s a distinct possibility that House Speaker Ryan would move his entitlement-cutting proposal through regular order, which, assuming he can pass it, would then require 60 votes in the Senate.
We’re aware that Speaker Ryan today indicated he didn’t think “entitlement reform” would move this year, but we don’t know whether he considers cuts and harmful changes like work requirements to be “entitlement reform,” since he often uses the term “welfare reform” when discussing those.
Please see the NONPUBLIC slide deck from the webinar for more information on what we may be facing in 2018 and key dates to keep in mind. In particular, we wanted to flag the congressional recesses, which are great opportunities for in-district events and conversations with members of Congress and their staff. You can find a full calendar of congressional recesses here.
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Update on government funding and the continuing resolution
You may recall that before the holiday break, Congress effectively kicked the can down the road by passing another short-term continuing resolution (CR) to fund the government while they continued to negotiate several critical items, including re-authorization of the Children’s Health Insurance Program (CHIP) and other health extenders, sequester relief, the Deferred Action for Childhood Arrivals (DACA) program, and emergency funding for areas affected by hurricanes in 2017. This CR expires on Jan. 19, and Congress is still negotiating the items listed above that could ride on the next spending deal.
The fate of this CR and whether there will be a deal on these key policies largely rests on whether a bipartisan deal can be reached on DACA that the President would support. On Thursday, a bipartisan group of senators announced they had reached an agreement on DACA, border security, and related immigration issues. It remains to be seen if the White House and House Republicans will support this deal. If there is a bicameral and bipartisan agreement quickly, then it’s quite possible that a full deal will come together with the health package, sequester relief, and the emergency supplemental funding.
But time is tight leading up to Jan. 19, and a deal must be reached very quickly to allow for introducing and moving legislation by the 19th. If there is no DACA deal, then reports indicate we may well see a two-week CR (or possibly through Feb. 16) to give negotiators more time on DACA and the other issues. In that scenario, it sounds likely that congressional Republicans may add some health provisions to this next short-term CR, including a multi-year extension of CHIP, etc. However, this situation is very fluid and may not be resolved until early next week.
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Trump Administration announcement on Medicaid work requirements and waivers
The Centers for Medicare & Medicaid Services (CMS) released guidance on Thursday that opens the door for states to impose Medicaid work requirements, which could threaten Medicaid coverage for many adults and actually make it harder for some adults to succeed in the labor market due to their loss of health coverage. The fact is, the vast majority (nearly 8 in 10) of non-disabled adults with Medicaid coverage already live in working families. Those who are not working typically have health conditions that prevent them from working, are taking care of their home or family (often caring for children or other family members who are ill or have a disability), or are in school. Work requirements that can lead to the loss of health care—with potentially serious health consequences—are only going to make things worse for these adults and families, not better.
- You can find our talking points on why work requirements are ineffective and threaten health coverage here.
- For CBPP's take on the CMS guidance, please see our blog post here.
- You can find shareable graphics to help spread the message on the true impact of work requirements here and here.
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