Senate Republicans appear willing to move on from health care reform just days after a failed vote to repeal and replace the Affordable Care Act (ACA) on July 28. The months-long effort to undo former President Obama’s signature health care law hit multiple snags throughout the legislative process as Senate Majority Leader Mitch McConnell and Republican caucus members struggled to reach consensus on key health insurance coverage issues. Facing a busy legislative calendar and mounting pressure to address issues such as tax reform and infrastructure, most Senate Republicans agree with Leader McConnell’s statement that “it’s time to move on.”
Lawmakers will need to move quickly on several big-ticket pieces of legislation once they return from their month-long August recess. Several health programs must be reauthorized by Congress before they expire at the end of the fiscal year on September 30. Some of these programs include the Children’s Health Insurance Program (CHIP), the Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program and Disproportionate Share Hospital (DSH) reductions. The stakes are especially high since, according to a report from the Medicaid and CHIP Payment and Access Commission (MACPAC), more than half of all states will exhaust their CHIP funds by March 2018 if Congress does not act. With just 12 days left on the congressional calendar until the new fiscal year, lawmakers will likely roll the separate reauthorization bills into one piece of legislation to help ensure their passage.
These health programs – in addition to other legislative issues – will take center stage once Congress returns on September 5. Spending bills represent another legislative vehicle in which lawmakers could attach other health-related policy provisions. However, unlike Republicans’ recent effort to pass major health reforms under budget reconciliation, each bill’s passage will require 60 votes and the support of at least eight Democrats in the Senate.
NACo is committed to ensuring the wellbeing of county residents, and programs such as CHIP and MIECHV offer crucial caretaking services in support of that goal. Without the guarantee of federal funding, it becomes difficult for states and counties to maintain their budgetary commitments to these health programs. NACo will continue to monitor the progress of any health-related spending bills and work to ensure that county priorities are represented in any upcoming legislation.