President Donald Trump is “considering options” on travel restrictions on citizens from countries considered by the Homeland Security Department to be noncompliant or uncooperative with new screening standards, administration officials said Friday.

His revised executive order banning travelers from six majority-Muslim countries from entering the United States expires Sunday.

The possible countries were included in a report required by the March 6 order and given to Trump last week. Those countries were given 50 days to “step up their game,” said Miles Taylor, a counselor to acting DHS Secretary Elaine Duke, during a conference call with reporters.

The countries on the list were notified and are “deliberately unwilling to comply,” Taylor said. “The proposed restrictions are conditioned-based, not time-based.”

Get breaking news alerts and more from Roll Call on your iPhone or your Android.

12,000 Read more...

A federal health exchange the government spent over $1 billion to create would likely be made obsolete by the recent GOP proposal to gut the 2010 health law.

Policy experts say the Department of Health and Human Services would still be required to maintain healthcare.gov under the proposal from Republican Sens. Bill Cassidy of Louisiana, Lindsey Graham of South Carolina, Ron Johnson of Wisconsin and Dean Heller of Nevada.

But the bill would axe a provision in the current law that addresses the website’s role in determining eligibility for insurance subsidies. The removal of that provision, experts say, would likely prevent any state from utilizing it for the purposes of operating their own insurance exchange.

It is unclear though exactly what impact the bill have on healthcare.gov specifically. Several aides and policy analysts said there is still confusion over several provisions of the overall proposal.

Spokespersons for Cassidy and Graham did not respond to questions about the bill’s impact on the federal platform.

The health law required HHS to create what is now known as healthcare.gov, an online platform to allow most consumers to purchase insurance in states that did not opt to create their own exchange marketplace.

The website plays a critical role in administering the law. It is the portal that many consumers use to purchase insurance plans and calculate the amount of subsidies he or she would qualify for.

The office of inspector general at HHS previously estimated that the federal government has issued grants totaling $1.7 billion to develop and operate the marketplace. The Centers for Medicare and Medicaid Services has spent $500 million so far, the report said.

In 2014, former HHS Secretary Sylvia Burwell told senators the agency had spent nearly $1 billion on the website that year alone.

While the recent proposal from the GOP quartet would drastically upend much of the current law, health policy experts say states could still utilize the healthcare.gov platform under the bill.

“The requirement on HHS to maintain healthcare.gov would remain, and presumably if a state wanted to funnel their block grant/subsidy funds through the exchanges … they could do so,” Chris Jacobs, founder and chief executive officer of Juniper Research Group, said over email on Thursday.

But Tim Jost, emeritus professor at the Washington and Lee University School of Law, said the legislation would repeal the measures in the current law that address healthcare.gov’s role in determining eligibility for tax credits, effectively preventing states from routing consumers to the platform.

That verification system is vital to the current law, and the federal government spent upwards of $73 million developing it, according to the HHS report.

There are several other important features of healthcare.gov the government has spent millions of dollars developing — like mechanisms to secure Social Security numbers and other personal information provided by users.

The onus could now be transferred to the states to create those systems themselves should they choose to create their own insurance exchange. It is considered unlikely that every state would choose to create their own online marketplace and some are expected to instead spend the money on programs like high-risk pools.

But there have been concerns raised over whether there would ample time or resources necessary for states to build their own exchange from scratch if they so choose in the two years allotted before the legislation kicks in in 2020.

Get breaking news alerts and more from Roll Call on your iPhone or your Android.

12,000 Read more...
sponsored content
Airlines for America
Heard on the Hill

Word on the Hill: Ayotte Joins Bono’s Board

By Alex Gangitano
12,000
12,000
12,000
12,000

Republican senators face the prospect of retreating from their previous public stances in order to support fast-moving legislation that would significantly overhaul the U.S. health care system.

Concerns about the impact on people suffering from opioid addiction, drastic cuts to Medicaid and the lack of robust analysis from the nonpartisan Congressional Budget Office appear to have vanished as the GOP hopes to advance a bill to repeal the 2010 health law before the fast-track budget reconciliation mechanism they are using expires on Sept. 30.

Lawmakers say any concerns are addressed by the state flexibility included in the proposal from Sens. Bill Cassidy of Louisiana, Lindsey Graham of South Carolina, Ron Johnson of Wisconsin and Dean Heller of Nevada.

“We have a real problem with [opioid abuse] in our state, obviously, which is why I’ve talked a lot about it,” Sen. Shelley Moore Capito of West Virginia said. “What our state would find in a Graham-Cassidy situation would be the flexibility to put an emphasis on that and the dollars behind it as well.”

Capito is one of several lawmakers who expressed serious concerns about prior GOP repeal proposals that would have gutted federal Medicaid funding. Under the Graham-Cassidy model, federal money for the entitlement program would drop by billions of dollars over the next 10 years, according to an analysis by consulting firm Avalere Health.

Capito also worked alongside Sen. Rob Portman of Ohio and others to add billions more in funding for opioid treatment into previous versions of the repeal legislation. No similar measure is currently included in the Graham-Cassidy bill.

Portman, whose state has been one of the hardest hit by the opioid problem, struck a tone similar to Capito’s.

“Giving the states more flexibility is something I generally have been supportive of,” he told USA Today.

Ohio’s governor appears to disagree.

Graham/Cassidy/Heller/Johnson eliminates the guardrails that protect some of the most vulnerable among us. 2/

While the bill would give states significant leeway to spend federal health care money, many would have to grapple with notable funding cuts over the next 10 years, according to several outside analyses.

By the same token, other states — namely Republican-run states that did not expand Medicaid under the 2010 health care law — would see a partial influx in money from the government. But experts have questioned whether some would be able to effectively manage the increased funding.

Democrats argue that Republicans are asking most states to do more with less, and say the legislation would lead to a significant loss of insurance coverage and increased health care costs for the most vulnerable.

That claim will not be verified or refuted by the CBO before a vote. The office said earlier this week that a full analysis of the proposal would not be available for several weeks.

Voting without that report is something the bill’s sponsor previously criticized.

A bill -- finalized yesterday, has not been scored, amendments not allowed, and 3 hours final debate -- should be viewed with caution.

Niels Lesniewski contributed to this article.

Get breaking news alerts and more from Roll Call on your iPhone or your Android.

12,000 Read more...

Republican hopes for moving an ambitious tax package in a closely divided Senate may hinge on a number of incumbents on the ballot, including Luther Strange of Alabama, who faces a tough primary runoff on Sept. 26.

The vulnerability of Republican incumbents like Strange underscores the challenges facing Senate Majority Leader Mitch McConnell as he tries to hold together at least 50 votes in his 52-member conference to pass a partisan tax plan under a filibuster-proof reconciliation bill.

Senior Republicans praise Strange, appointed in February to the seat vacated by Jeff Sessions when he became attorney general, as a team player. They voice doubts about his primary rival Roy Moore, a former state Supreme Court chief justice, in potentially crucial floor showdowns on taxes and other issues.

Senate Majority Whip John Cornyn pointed to Moore’s record of being twice removed by a judicial ethics panel in Alabama for defying federal court orders: once in 2003 for refusing to remove a Ten Commandments monument from a state building and again last year for urging probate judges to deny marriage licenses to gay couples.

“Getting thrown off the Supreme Court of your state twice I don’t think is a credential that commends you for membership in the United States Senate,” said Cornyn, a former Texas Supreme Court justice.

Of the prospect for more GOP primary challengers like Moore during the 2018 midterm elections, Cornyn said, “We’ve seen that sort of thing happen before. And it’s not a pretty picture.”

Ross Baker, a political science professor at Rutgers University, said a tough political environment would ensure an uphill slog for a GOP tax package.

“I would put the probability of their completing a tax bill at about 30 percent. It is arguably the most complex public policy area, and touches the largest number of interest groups of any issue,” Baker said.

President Donald Trump plans to campaign for Strange in Alabama on Friday, and has recorded a robocall telling voters that Strange is “going to get the tax cuts for us.” On the other side, Moore has criticized McConnell as a creature of the “Washington swamp” and accused the top Republican of running a “slime machine” that fails to reach conservative goals.

The stalled push to uproot the 2010 health care law has angered Republican conservatives and energized primary challengers such as Moore, who are urging GOP voters to hold incumbents like Strange accountable for not delivering legislative victories.

Since Alabama is a GOP stronghold, the winner of the runoff will be the favorite in the special general election against Democrat Doug Jones on Dec. 12 and will serve the remainder of Sessions’ term. The Alabama Senate seat would be up again in 2020.

Steven L. Taylor, a political scientist at Troy University, said Moore or Strange would be likely to weigh home-state concerns first in deciding on components of a GOP tax package.

“The reality is that any tax vote is going to affect different constituencies in different ways. If you have a revenue-neutral bill, that by definition will make the vote difficult. For example, if there’s a reduction in the mortgage interest deduction to pay for a lower corporate rate, that would be difficult,” Taylor said.

Baker believes the GOP base will play a role in the tax debate.

“I would be very astonished if they came up with something heavily in favor of the top 1 percent,” he said about Republicans crafting a tax package. “The party base is really riled up by populists. I don’t think that would be acceptable.”

The Alabama runoff could provide a preview of what lies ahead next year for the eight Senate Republicans up for re-election. Some Trump allies, including former White House strategist Steve Bannon, are considering whether to recruit or assist GOP candidates to the right of incumbents such as Bob Corker of Tennessee, Jeff Flake of Arizona, Dean Heller of Nevada and Roger Wicker of Mississippi next year.

Corker, who has questioned Trump’s competence for the presidency, has said he is undecided about running for another term.

Earlier this summer, Corker helped lead an effort to remove a proposal that would have repealed the 3.8 percent net investment tax for wealthy taxpayers from the Republican bill to repeal and replace the 2010 health care law. Now, the Budget Committee member is making the case for a revenue-neutral tax package, instead of pursuing one that would add to the deficit.

“I’m willing to give them some headroom here on the way things are scored and some of the things that we go through here. But, at the end, I want to make sure myself that it’s going to generate growth, we have broadened the base and, importantly to me, we are not going to do something that is going to increase our deficit,” Corker said Tuesday about a tax bill.

Heller, a Finance Committee member, has voiced support for exploring a bipartisan tax accord, but made clear he would work with party leaders if they opt to move a GOP-only tax plan.

“I’m going to guess that at the end of the day, it’s going to be a partisan exercise,” the Nevada Republican said.

Get breaking news alerts and more from Roll Call on your iPhone or your Android.

12,000 Read more...

Senate leaders are preparing to hold a vote on an alternative to the 2010 health care law next week, although 50 Republicans have not confirmed they would vote for the proposal.

“It is the Leader’s intention to consider Graham-Cassidy on the floor next week,” Don Stewart, a spokesman for Majority Leader Mitch McConnell of Kentucky, said Wednesday in an email.

The push to vote on the plan crafted by Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., comes ahead of a crucial Sept. 30 deadline when Republicans would lose their chance to repeal parts of the law under the fiscal 2017 budget reconciliation rules. McConnell had told lawmakers he would not bring the measure to the floor without 50 votes.

The measure would dramatically restructure the individual health insurance market by giving states block grants to fund health insurance coverage, replacing current federal funding that covers tax credits to help people purchase insurance, and cost-sharing reduction payments. Funding for Medicaid expansion in 31 states and the District of Columbia through 2026 also would come from those allotments.

The bill would also transition traditional Medicaid, which is an entitlement, to a system that gives states a capped amount of funding based on their Medicaid population.

It would repeal the health law’s individual and employer mandates and a tax on medical devices. The repeal would allow states to waive certain regulations, including one that bars insurers from charging higher premiums to individuals with pre-existing conditions.

Cassidy has defended that aspect of the measure, saying that states applying for waivers must ensure that individuals with pre-existing conditions have access to “affordable and adequate coverage.”

“I think the price will actually be lower,” he said Wednesday on CNN’s New Day. “What is being circulated is by those who wish to preserve Obamacare and they are doing everything they can to discredit the alternative.”

Sen. Rand Paul, R-Ky., has announced his opposition to the plan. Three Republican senators who voted against the repeal effort in July — Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona — have not declared which way they would vote on the new proposal.

mccain-graham

The Senate Finance Committee is set to hold a hearing Monday afternoon on the proposal, and a preliminary analysis by the Congressional Budget Office is expected early next week.

A Wednesday analysis by the Avalere Health consulting firm showed 34 states and the District of Columbia would face cuts to the funding they receive from the federal government.

If the Senate does bring up the Graham-Cassidy plan, it would effectively pick up where it left off in July with a vote-a-rama — a series of amendment votes that can go on for hours under the budget reconciliation process.

Republicans are now contending with widespread backlash to the last-minute effort, similar to what they faced earlier this year to the House-passed bill and the Senate GOP alternatives. Groups representing patients, hospitals, doctors and health insurance plans have criticized the proposal and left-leaning groups are intensifying efforts to pressure Republicans to oppose the plan.

On Wednesday, the Blue Cross Blue Shield Association said they “share the significant concerns of many health care organizations about the proposed Graham-Cassidy bill.”

“The legislation reduces funding for many states significantly and would increase uncertainty in the marketplace, making coverage more expensive and jeopardizing Americans’ choice of health plans,” the group’s statement read. “Legislation must also ensure adequate funding for Medicaid to protect the most vulnerable.”

Later Wednesday afternoon, America’s Health Insurance Plans sent a letter to Senate leaders stating that the group and its members “cannot support this proposal” but would continue to work to find common ground on mutual goals like lowering costs and increasing coverage.

Other groups including the American Medical Association, the Federation of American Hospitals, AARP and the American Heart Association all voiced opposition to the plan this week.

Save My Care, a coalition of groups that favor the health law, released a series of advertisements this week targeting swing votes including Murkowski, McCain, and Sen. Shelley Moore Capito, R-W. Va.

Conservative groups have called the Graham-Cassidy proposal a step towards repeal. The conservative Club For Growth stopped short of endorsing the plan earlier this week, saying it’s not a full repeal of the health law.

“We hope that the Graham-Cassidy amendment will be considered a step toward that goal, not the end, because, whether this amendment passes Congress or not, it’s not ‘repeal,’” FreedomWorks President Adam Brandon said in a Wednesday statement.

Get breaking news alerts and more from Roll Call on your iPhone or your Android.

12,000 Read more...
12,000
12,000

 

 

 

 

 

 

 

 

 

 

 

 Click Here