What will Democrats do on health care in budget negotiations?

What will the Democrats do on health care and other social justice fronts to start the 2nd Session of the 115th Congress? Democrats have major leverage in negotiations over keeping the government open, as the budget requires 60 votes to pass. But, how the Democrats’ leverage translates into policy still remains unclear.  Will Republicans be able to take advantage of their majority as they look to confirm new cabinet members and move forward with the Trump Administration agenda? The Republican caucus is fractured, and 2018 might be enough to break them apart for good.    ​

As much as the Republicans would like to repeal and replace the Affordable Care Act, they now hold only 51 Senate seats, which undermines their likelihood of success. Their repeal attempts were unsuccessful in 2017, when they held 52 seats. So, Republicans are considering other moves that could undermine consumer protections in the insurance market. The Administration is proposing association health plans, which would allow businesses in a geographic area or in an industry to come together to provide their members health insurance that does not have to cover the essential benefits required by the ACA. Other consumer protections would also fall by the wayside, including the rule requiring insurers to spend at least 80 percent of premium dollars on health care. This proposal would likely drive up health care costs for older adults and people with pre-existing conditions in the health insurance exchanges.

Republicans also want to confirm former prescription drug executive Alex Azar as head of HHS. Democrats could use their leverage to block Azar’s confirmation.

According to Politico, the Democrats’ number one priority in budget negotiations is a deal to help Dreamers. In addition, Senator Schumer tweeted that the Senate Democrats are focused on “fighting the opioid crisis, supporting America’s veterans and protecting the pensions American workers have earned.” On the health care front, House Minority Leader Nancy Pelosi has said the Democrats are fighting for renewed funding of the Children’s Health Insurance Program and community health clinics.

In related news, the Trump Administration is reported to want to slash social welfare programs, including food stamps and housing subsidies. Speaker Paul Ryan has confirmed his desire to support these cutsalong with cuts to Medicare.

And, Senate Republicans are proposing a $492 million cut to the Social Security Administration (SSA). These cuts, which come on top of millions in SSA cuts Republicans have already made since 2010, would restrict Social Security services as well as erode confidence in Social Security.

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