CHN: What to Look for Coming from the New Congress and President-Elect Trump  

Republican leaders in Congress have suggested that they will take quick action shortly after their January swearing-in to repeal the Affordable Care Act, including its Medicaid expansion. In order to achieve this, they plan to belatedly approve a joint House-Senate budget resolution for the current fiscal year. That budget resolution will allow them to use a special legislative procedure known as reconciliation, which limits debate in the Senate, enabling certain bills to pass with only a simple majority. Only needing 51 votes instead of the more typical 60 vote supermajority makes enacting parts of the Republican agenda more likely. For more information on reconciliation, see this blog and this backgrounder from CBPP.

After passing the FY17 budget resolution early in January with reconciliation instructions that will allow them to pass legislation repealing the Affordable Care Act and the Medicaid expansion provision, they expect to take up repeal with no details about its replacement. Repeal would not take place right away, but would take effect 18 months to two years after the bill is enacted. They could then pass an FY18 budget resolution in the spring, after President Trump releases his FY18 budget proposal, followed by another reconciliation bill in the fall that could include proposals to turn Medicaid into a block grant (similar to the legislation crafted by Rep. Tom Price; see the related article in this Human Needs Report for more information on this). There could also be cuts and structural changes to SNAP/food stamps, a package of corporate and/or tax cuts for upper income individuals, an infrastructure package and another round of cuts to domestic discretionary programs likely to be disproportionately felt by low-income Americans.

Advocates are being reminded that while specific budget proposals from a Trump Administration and the new Congress aren’t yet known for certain, we do know what House Republican budgets have looked like in the past. The House Republican FY17 budget proposal, for example, threatened low-income Americans with the most severe budget cuts in modern history. Overall, the plan proposed getting 62 percent of its budget cuts from low-income programs even though they account for just 28 percent of total non-defense program spending. It would have also turned SNAP/food stamps into a block grant, estimated to cut well over $100 billion and which would inescapably lead to cuts in benefits and/or other harsh programmatic changes.

For more on what to expect in policy changes from the Trump Administration and the new Congress in 2017, see CHN’s Washington 2017 resource page, which is being updated regularly. For more information, register for The New Congress: How it Plans to Cut…And How to Fight Back, a webinar on December 16 at 12pm ET that will go into more detail on these and other upcoming challenges.

Affordable Care Act
Health Care Reform