/>iAs the calendar turns to November, pressure continues to grow in Congress to pass a CHIP package. The relevant House and Senate committees each passed different versions of CHIP, and finding payfors continue to be the main impediment to a final bill inclusive of all the MACRA health care extenders.
Let’s turn the clock back to 2015. The House learned that when they coalesce on a bipartisan bill, they can roll the Senate. Right now, the Senate is waiting to see what the House does. The Finance Committee marked up CHIP without paying for it and released a draft of other minibus provisions with no payfors last week. While this allows the Senate to take the field on policy, without stepping up to pay for the bill, they are effectively ceding final decisions to the House now or waiting until December’s megadeal. If the House finds a way to ‘yes’ on payfors this week, the Senate will need to take up and pass the House bill. The pressure to fund CHIP will be too great for them to say ‘see you in December.’
For House Republicans and Democrats, it’s cut a deal now that is win-win (because it will become law) or wait until December when it might be much more difficult to control outcomes. That’s what this week comes down to.
THIS WEEK IN THE HOUSE
No hearings scheduled in the House.
THIS WEEK IN THE SENATE
On Tuesday (10/31), the Senate HELP Committee will hold a hearing titled, “Implementation of the 21st Century Cures Act: Achieving the Promise of Health Information Technology.”
THIS WEEK AT MACPAC
Starting on Thursday, the Medicaid and CHIP Payment and Access Commission (MACPAC) will hold its latest public meeting. For more details on the agenda please click here.
OPEN ENROLLMENT BEGINS THIS WEEK
The current Administration is doing nothing to promote the upcoming open enrollment, which begins Wednesday. No late night appearances, or viral YouTube hits, no radio interviews, no Cabinet-level events. This open enrollment period is expected to be far less than the 12.2 million people who signed up during the last open enrollment period.
The President has taken several steps this fall to undermine the ACA and sow confusion on the eve of his Administration’s first open enrollment period. There seems to be a remarkable amount of openness about these efforts. One New York Republican told Politico, “to some extent, perhaps [Trump is] expediting the implosion.” The Administration will use the poor enrollment numbers to show that the ACA is failing, and pressure vulnerable Republicans to get in line with his agenda.
The political calculation on the ACA remains unclear. Democrats believe that declining numbers of the ACA are the fault of the Trump Administration. The Trump Administration appears quite comfortable arguing that the ACA has always been doomed. While the Alexander-Murray bill attempts to improve the ACA in advance of the 2019 open season, it’s fair to ask if either side would be better off politically accepting a bill that tries to make things better. When you are comfortable in your narrative, it’s hard to agree to change.
