A final budget omnibus package and the annual tax-extenders bill are predicted to be ready for a vote Monday or Tuesday, but negotiations Friday were expected to extend into the weekend.
The House passed a continuing resolution last week, already approved by the Senate, that would keep the government open past the original Dec. 11 deadline. The budget must now be passed by Dec. 16. Negotiators said they hope to come to agreement in talks over the weekend, but were not certain the bills would be ready for the floor by Monday. House Majority Leader Kevin McCarthy (R-Calif.) said Friday that the first House votes next week will be Tuesday.
Edwin Park, vice president for health policy at the left-leaning Center on Budget Policy and Priorities, said the budget could be tied to the tax bill or they could be moved separately. Either way, lawmakers have been holding their cards close. “We don't have a good sense of what the controversial riders are,” Park said. “It seems like everything is still in flux.”
House Speaker Paul Ryan will tackle his first big test as he faces pressure to tack on a host of GOP policy provisions to the $1.1 trillion spending bill.
Much is still to be decided in the tax-extenders bill that includes measures both parties find appealing. If lawmakers cannot agree on final language for a larger bill, a two-year extenders bill is available as a backup. Either bill could delay implementation of the medical-device tax and the “Cadillac plan” tax under the Affordable Care Act. The Cadillac tax on high-end insurance plans has drawn ire from many Democrats, but there have been no proposals from either party on how to replace the funding it would provide if it is repealed or delayed.
However, Larry Levitt, senior vice president for special initiatives with the Kaiser Family Foundation, said the proposed changes would have a modest long-term effect and “wouldn't affect the core of the ACA,” which is the expansion of insurance coverage to millions of Americans.
The changes could have a political effect, however. Democrats have been unwilling to tweak the law until now, and Republicans may see the proposals as a chance to start chiseling away at its provisions. “It would be the first major change to the ACA,” Levitt said. The Cadillac tax, set to begin in 2018, has always been controversial, even among supporters of the ACA. Labor unions consider generous health benefits the fair and hard-won fruits of decades of collective bargaining.
Even though the tax is widely supported by health economists, lawmakers are likely to see more of a political upside in killing or delaying it. “Voters want dessert and not their vegetables,” Levitt said. “The Cadillac tax is definitely in the vegetable category.”
Republicans have also been trying to pass a budget that eliminates the risk-corridors program that was included in the ACA to help insurance companies deal with the initial uncertainty of how many people would sign up for coverage under the law and how many medical claims they would file.
Republicans, particularly presidential candidate Sen. Marco Rubio of Florida, have railed against the risk-corridors program as a taxpayer “bailout” to protect insurance company profits. Rubio has claimed credit for striking a blow to the law by inserting the provision in last year's budget deal that limited the Obama administration's ability to fund the program.
House Minority Leader Nancy Pelosi (D-Calif.) on Thursday pushed for a repeal of the ban on funding for gun-violence research to be included in the budget package. She said it was a top priority for Democrats, but did not offer any ultimatums.