This Week on the Hill: McConnell Makes Final Push for Health Care Bill; House to Consider Approps Minibus to Close Summer Session

Once again, the fierce negotiations on the Republican plan to repeal and replace the Affordable Care Act (ACA) are scheduled to come to a head this week with Senate floor consideration of the House-passed American Health Care Act (AHCA). While every weekly preview for the past month has seemingly promised that event, Senate Majority Leader Mitch McConnell (R-KY) and Republican leaders appear to be set on using this week as a do-or-die period for the health care overhaul. A vote on the motion to proceed to the bill could come as early as tomorrow, but it remains unclear exactly what package Republican leaders ultimately want to move forward after last week’s collapse in support for the Better Care Reconciliation Act (BCRA) as originally drafted. The two apparent options are 1) a “repeal and delay” bill that would more completely repeal the ACA after a two-year period in order to provide Republicans time to design a replacement, or 2) a revised version of the BCRA that would include further changes designed to convince skeptics on both the moderate and conservative side of the spectrum.   

A vote on repeal and delay appears inevitable to prevent Sens. Rand Paul (R-KY) and Mike Lee (R-UT) from blocking the motion to proceed. This vote would be expected to fail due to opposition from moderates. Leaders will also need to assure moderates that a vote on the BCRA as a substitute amendment would follow the procedural vote and that the plan deserves support despite the Medicaid cuts and coverage losses estimated by the Congressional Budget Office. Because the final construct of the bill is still unknown, it is difficult to predict exactly how senators will react when put under the limelight of a public vote on the Senate floor.

To be clear, the path forward on health care reform remains decidedly narrow. Given the seemingly immovable opposition of Sens. Rand Paul (R-KY) and Susan Collins (R-ME),  Leader McConnell will likely need to run the table on undecideds and hope that Sen. John McCain (R-AZ) can make it back to Washington after his recent brain cancer diagnosis. While those significant factors continue to make passage difficult, many variables are still at-play and the GOP’s long-held goal to undo the Obama health care legacy is still alive – if only barely.

With all of the excitement in the upper chamber, the House is set to leave for the August recess at the end of the week and will try to end its summer session by passing the first fiscal 2018 appropriations bill to make it to the floor of either chamber. House leadership has teed up a four-bill “minibus” (H.R. 3219) that would include the Defense, Legislative Branch, Military Construction-Veterans Affairs, and Energy and Water Development appropriations bills. House leadership is hoping that the more narrow minibus will provide rank-and-file Republicans with key victories on issues such as funding for a border wall and a significant increase in defense spending.

House lawmakers start the week with a set of 17 suspension bills to be considered today, focusing on minor policy changes to the Department of Veteran Affairs. Additionally, the House will consider a disapproval resolution (H.J. Res. 111) later this week for a recently finalized rule from the Consumer Financial Protection Bureau (CFPB) governing the use of mandatory arbitration clauses in contracts with consumers.