Congress worked late this week…

House Republicans unveiled and advanced legislation to repeal and replace the Affordable Care Act. President Trump signed revised executive order focused on visa limitations and refugees. Lawmakers began talking about the debt limit, with suspension expiration fast approaching in mid-March. Congressional Review Act stayed in the spotlight, with four more disapproval resolutions headed to President Trump for approval. Senate invoked cloture on Verma nomination for CMS administrator, teeing up final confirmation vote for Monday.

House Republicans unveiled and advanced legislation to repeal and replace Obamacare

This week House Republicans unveiled legislation to repeal and replace the Affordable Care Act (ACA), following last week's secrecy. The plan, the American Health Care Act (AHCA), includes refundable tax credits and changes to Medicaid. The AHCA maintains some provisions from the ACA, such as allowing children to stay on their parents' insurance plans until age 26 and rules prohibiting insurers from denying people coverage based on preexisting conditions.

Significant changes to the Affordable Care Act include the elimination of both the individual mandate (aka the penalty for individuals who do not obtain health insurance) and employer mandate (aka the penalty for larger businesses that fail to offer coverage to employees).

Here are some resources you'll need to wade into the legislation:

On Wednesday, two House committees began marking up the provisions under their jurisdictions, and on Thursday, both committees reported the legislation favorably. That's right, Thursday. Committees held overnight marathon markups, with some congressional staffers staying on the Hill for over 27 hours without sleeping. At one point, Congressman Joe Barton tried to wrap up the markup after 20 hours with an offer to buy everyone Waffle House.

The plan met mixed reviews, with conservatives in the House and Senate opposing the legislation. The Conservative House Freedom Caucus called for repealing the Affordable Care Act without replacing it, as did Senator Rand Paul. Four moderate Republican senators said they would vote against any ObamaCare repeal bill that eliminates the ACA's Medicaid expansion

President Trump supported the plan, saying he was "proud to endorse the replacement plan." Health and Human Services (HHS) Secretary Tom Price sent a letter to his former colleagues calling for the bill's passage:

"We look forward to working with you throughout the legislative process, making necessary technical and appropriate changes, and ensuring eventual arrival of this important bill on the President's desk."
-Secretary Price

However, Chief Medicaid officer Dr. Andrey Ostrovsky broke with the Department of Health and Human Services (HHS), saying he opposes the American Health Care Act. 

Meanwhile, House Minority Whip Steny Hoyer launched a new microsite to gather constituent feedback. This week several lawmakers read messages from constituents during committee marks and on the House floor. We've uploaded the full proposal, so you can start messaging your lawmakers (even before the legislation is formally introduced and assigned a bill number). Be sure to submit your input!

Looking for significant differences to weigh in on? The American Health Care Act would:

  • End the ACA’s Medicaid expansion by 2019 
  • Raise health savings account limits and allow spouses to make additional contributions
  • Block Planned Parenthood from receiving Medicaid reimbursements 
  • Prohibit insurers from charging older customers more than five times as much as younger customers, and states would be able to set their own specific ratios. (as opposed to cap of charging three times as much)
  • Overhaul Medicaid by giving states capped payments based on their number of Medicaid enrollees (as opposed to current open-ended federal entitlement)
  • Require that individuals maintain continuous coverage or face a financial penalty the next time they obtain insurance (as opposed to the individual mandate)
  • Age-based tax credits (as opposed to income-based subsides)

So what now? Well, next week the White House will host conservative critics of the legislation for dinner and bowling. In terms of the legislative process, next up is House Budget. The committee marks up the bill next week (March 15). Then it heads to Rules and the House floor for full consideration. On the Senate side, we've got a votearama on our hands, but we're getting ahead of ourselves. Follow POPVOX on Twitter and Facebook, and we'll keep you posted every step of the way!

President Trump signed new travel ban executive order

On Monday, President Trump signed a revised executive order focused on visa limitations and refugees. Similar to the original order, the new order will impose a 90-day ban on new visas to people from six countries — Iran, Somalia, Sudan, Libya, Syria, and Yemen.

So what's different? Iraq is no longer included in the list of countries and this order will not indefinitely block Syrian refugees. The 120-day halt to the U.S. refugee program now applies to all countries. The new order is scheduled to take effect on March 16 at 12:01 am. Lawful permanent residents as well as people with valid visas will not be affected by the order. This includes people whose visas were revoked as a result of the original travel ban.

Senate Democrats introduced legislation to block the revised travel ban by withholding necessary funding to implement the order.

Lawmakers began talking about the debt limit, suspension set to expire in mid-March

This week lawmakers began talking about raising the borrowing ceiling as the mid-March deadline approaches. That's right, it's time to talk about the debt ceiling again (I know, I know). The current debt limit suspension will expire and reset to about $20 trillion on March 16. It's important to remember that Congress sets the debt limit and only Congress can raise it.

So what even is the debt limit? It's the total amount of money the federal government is authorized to borrow to meet its existing legal objections (think: Social Security and Medicare benefits, military salaries, tax refunds, and interest on the national debt). 

On average, Congress raises the debt ceiling at least once a year. The amount varies, from small to large increases, and sometimes it's a temporary provision that will eventually "snap back" to a lower level. Then there's suspensions that Jeanne Sahadi of CNN explains really well in this old article:

"A suspension is a wink and nod maneuver that basically lets Treasury borrow as needed to pay bills without regard to the limit. Then, when the suspension ends, the debt limit instant-presto resets to the old cap plus whatever Treasury borrowed during the suspension period."

Raising the debt ceiling doesn't allow Congress to spend more. Instead, it allows the Treasury to pay bills on time and in full. These bills are for services already performed or benefits already approved by Congress. The debt ceiling has been raised 74 times since 1962, with 51% of those increases happening since 1981. The greatest number of increases occurred during Ronald Reagan's presidency. Check out these graphs from The Guardian, as well as this report from the Congressional Research Service for more information about the debt ceiling.

Treasury Secretary Steven Mnuchin sent a letter to lawmakers this week, encouraging Congress to raise the debt limit. Congress last voted to do so in October 2015 as part of the two-year bipartisan budget deal (then Speaker John Boehner's promise to "clean the barn" before departing). See how your (then) representative and senators voted on the measure.

House Minority Whip Steny Hoyer said Democrats would vote for a debt limit increase as long as the bill is clean, meaning the bill would raise the debit limit without any extraneous conditions.


Great question! You hear "clean bill" a lot and reconciliation is something that lots of people (even staffers) don't fully understand.

Here's the deal:

A "clean bill" is legislative slang for a straightforward bill without a lot of unrelated amendments or policies. You often see calls for a "clean bill" when must-pass legislation is under consideration, like a bill to raise the debt ceiling, renew expiring provisions, or extend funding for the government with a "continuing resolution." A clean bill in those cases would just address the main issue without including other provisions. Those bills, however, are very tempting legislative vehicles for other provisions. Precisely because they are "must-pass," and lawmakers want their priorities to cruise through the legislative process with the must-pass provisions. The additions can also come into play when the underlying bill needs a little help getting over the finish line. "Sweeteners" can be added to attract additional votes.

A reconciliation bill is a completely different animal and can only be used once per fiscal year as a budget resolution. The budget resolution sets spending levels and may have "reconciliation instructions" telling committees to go back and get to work coming up with policies that will meet those spending levels laid out in the budget. Those policies (in response to the reconciliation instructions) are rolled into a reconciliation bill that gets expedited consideration and is not subject to a filibuster. BUT the reconciliation bill cannot contain extraneous provisions unrelated to the instructions. So, in a sense, a reconciliation bill must be "clean" since it can only contain provisions responsive to the instructions in the budget resolution. 

Hope that answers your question, Edmond! Thanks for asking!




Ask us anything and see your questions answered in future editions!

Senate sends four more CRA disapproval resolutions to President Trump for approval

If you've been following Congress (shameless plug: subscribe to our daily emails), you know that the Congressional Review Act (CRA) is having a moment. Typically, it's a rarely-used law to invalidate recent regulations, but Congress has been using the CRA to reverse several Obama-era regulations.

The Senate spent the week on disapproval resolutions previously passed by the House. These resolutions now head to President Trump.

Senate invoked cloture on Verma nomination for CMS

This week the Senate debated Seema Verma's nomination to serve as administrator of the Centers for Medicare and Medicaid Services (CMS). Today, Senate ended debate on her nomination by a vote of 54-55, mostly along party lines. This tees up a final confirmation vote for Monday evening.

Last week we recapped the Senate's progress in confirming Trump nominees. President Trump has now nominated 7.4% of the total number requiring Senate confirmation, and the Senate has confirmed 43% of the total nominees. The Cabinet, however, is shaping up with 71% confirmed. All that remains is Sonny Perdue for Secretary of Agriculture and Alexander Acosta for Secretary of Labor, both nominated relatively recently. Be sure to message your senators!


Please keep in mind that highlighting specific legislation does not imply POPVOX endorsement in any way. As always, our goal is to offer one more way to help you stay informed about the complex U.S. legislative system.