May 11, 2018

 

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President Trump Asks Congress for $7 Billion in Cuts to Children’s Healthcare
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President Trump Asks Congress for $7 Billion in Cuts to Children’s Healthcare

On Tuesday, the White House released a proposal to rescind $15.4 billion in federal spending, including nearly $7 billion in cuts to the Children’s Health Insurance Program. The spending cuts are in response to the $1.3 trillion omnibus appropriations package that was signed into law by President Trump on March 23, that the president initially considered vetoing and has since expressed regret over and sought to roll back some of the funding. The Congressional Budget Office indicated that the impact to the deficit would largely be negligible because much of these funds are deemed to have technically expired and can't be used, and there would therefore be no coverage changes to CHIP. The proposal will next be considered by Congress, which will have roughly a month to act on the president’s request.

The budget act provides the president with the authority to request the rescission of discretionary, but not mandatory, federal spending. The request is
open for a period of 45 days, during which time, that funding cannot be spent by the federal agencies, and Congress is tasked with consideration of the request. Congress can choose to do nothing with the proposal, in which case the recessions do not take effect following the 45-day period, or they can mark up the legislation to include the cuts as proposed or a lesser extent of the proposed cuts. Congress cannot make additional cuts beyond the president’s proposal. Unlike the appropriations legislation which requires a three-fifths majority in the Senate for cloture, the final rescission  package only needs to be approved by a simple majority in both chambers, allowing Republicans to theoretically pass the cuts without any Democratic support.

The House Appropriations and the Senate Appropriations and Budget committees oversee the initial consideration of the proposals. However, on Wednesday, House leadership confirmed that they would bypass the committee process and advance the legislation directly to the floor for consideration. House Majority Leader Kevin McCarthy (R-CA) has been working directly with the White House on developing the package and has led the effort for its passage in the lower chamber. Despite misgivings by some Republicans, particularly over CHIP and opioid response funding, it is expected to have enough votes for passage.

It is unclear if it will have enough support for passage in the Senate, let alone to be considered on the chamber’s floor. The package is required to go
to the Senate calendar, but it is up to the Majority leader to determine whether it will face a full consideration. Both Republicans and Democrats in the chamber are hesitant to bring up the package, because the likely result would be a vote-a-rama. While the package would be considered with limited debate time under that scenario, it would be open to an unlimited number of amendments that may have nothing to do with the package. These are almost always designed by the parties to embarrass the other members, particularly the most vulnerable members of the other party facing re-election, by forcing them to take votes that make for campaign-style sound bytes but otherwise have no effect on the actual legislative deal.

The Senate’s version is further in question simply because of the vote math. While the package only requires a simple majority of 51 votes, or 50 votes plus the vice president in event of a tie, and there are 51 Republican senators, it is not guaranteed they will have enough for passage. Senator John McCain (R-AZ) has missed all votes so far this year attending to cancer treatments and is unlikely to return to Washington, D.C. to cast any votes for this package. And moderate Republicans Susan Collins (R-ME) and Lisa Murkowski (R-AK) may not fall in line to support the package, given their defection on numerous party-line votes over the past year, particularly with regards to CHIP funding. Without a guarantee on the vote math, Leader McConnell may opt against bringing the package up for consideration, thus dealing it a quiet death.
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