Medicare

Budget Deal Could Bust Caps by $200 Billion
Two-year agreement expected to draw motley crew of supporters

Marc Short, left, White House director of legislative affairs, and Nebraska Sen. Ben Sasse at the Capitol on Dec. 1. (Tom Williams/CQ Roll Call)

Congressional negotiators have moved well north of $200 billion in their discussions of how much to raise discretionary spending caps in a two-year budget deal.

The higher numbers under consideration follow an initial Republican offer several weeks ago to raise defense by $54 billion and nondefense by $37 billion in both fiscal 2018 and 2019 — a $182 billion increase in base discretionary spending.

Consumer Choice for Health Care Lags Behind Rhetoric
Experts urge consumers to “shop around,” but pricing is dizzyingly complex

House Ways and Means Chairman Kevin Brady has said he wants health care to be like a “backpack” that consumers can take with them throughout their lives. “You decide what to put in the backpack,” he wrote in 2016. (Tom Williams/CQ Roll Call)

When Chris Raymond called her insurance company recently to get the price of a brain scan, she came prepared. Or so she thought.

Raymond’s experience as a former medical reporter for the Journal of the American Medical Association gives her an edge over the typical patient trying to navigate the fractured health care system. As an active middle-aged woman who still plays recreational basketball, Raymond has also suffered enough injuries to understand the system from the patient perspective.

Opinion: Fiscal Order Goes Way of the Dinosaur in Tax Debate
Latest actions show Congress isn’t serious about debt and deficits

Senate Majority Leader Mitch McConnell speaks at a press conference Thursday on small-business taxes. Pay-as-you-go requirements do not apply to the current tax reconciliation bill. (Tom Williams/CQ Roll Call)

There was a time when members of Congress expressed concerns over the country’s level of debt and deficits. Laws were enacted to create speed bumps and stop signs to establish fiscal discipline. That now seems like a distant memory. Exhibit A is the current tax reform effort.

The permanent pay-as-you-go law is in effect, as is the Senate’s pay-as-you-go rule. The requirement that increased federal spending or tax cuts be matched by reduced spending or revenue increases to avoid expanding the budget deficit dates to the Reagan administration.

At the Races: ‘I Want to Spend More Time With Family’
With holiday recesses, come congressional retirement announcements

Rep. Rosa DeLauro, D-Conn., points at Michigan Rep. John Conyers, Jr., during a 1999 press conference. Conyers is facing multiple allegations of sexual harassment, and is now hospitalized for stress. Minority Leader Nancy Pelosi called Thursday for him to resign. Despite relinquishing his ranking member post on the Judiciary Committee, the longest-serving lawmaker hasn’t said he’ll step aside. The 13th District is a Solid Democratic race, but Conyers barely made the ballot in 2014 after failing to file the necessary signatures. Local reports suggest the 88-year-old dean of the House will announce in January he won’t seek re-election. If he does try to run again, expect to see a primary here. (Scott. J. Farrell/CQ)

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This week … two more lawmakers announced their retirements, red-state Democrats took a stand on taxes, an Indiana super PAC jumped into the Alabama Senate race and liberals started attacking Democrat Dan Lipinski.

Collins: Republican Leaders Expected to Back ‘Pay-Go’ Waiver
Maine Republican also raised concerns over SALT deduction

Maine Sen. Susan Collins wrote to Senate Majority Leader Mitch McConnell over her concerns with the GOP tax plan. (Bill Clark/CQ Roll Call file photo)

Sen. Susan Collins said Republican leaders have assured her that automatic cuts to entitlement programs that would be triggered if the GOP tax overhaul becomes law would be stopped.

The reductions, which could amount to $25 billion in cuts to Medicare, would occur under the 2010 statutory pay-as-you-go law unless Congress approves a waiver.

Opinion: Ensuring We All Count
If we don’t act fast, many people will be uncounted in 2020 census

From left, Census Bureau Director Robert M. Groves, acting Deputy Commerce Secretary Rebecca Blank and Commerce Secretary Gary Locke in December 2010 at an event announcing the U.S. population. (Scott J. Ferrell/CQ Roll Call file photo)

When the Founding Fathers drafted the Constitution, they knew that for our country to be the true democratic republic they envisioned, it must reflect the ever-changing makeup of its people.

To meet this need, they enshrined, in Article I, Section 2, the decennial census. This exercise stands alone as the only constitutionally mandated task of the federal government, required by the framers to be renewed every ten years, to make sure each and every person living in the United States is counted.

HHS Pick Grilled on Drug Prices
Azar pledges to lower cost of prescriptions, but Paul has “doubts”

Alex Azar, nominee to be Health and Human Services secretary, takes a seat for his hearing before the Senate Health, Education, Labor and Pensions Committee on Wednesday. (Bill Clark/CQ Roll Call)

The nominee to lead the Health and Human Services Department, Alex M. Azar, told a Senate panel that his top priority would be addressing the high price of prescription drugs. But there was skepticism from both sides of the dais at Wednesday’s Health, Education, Labor and Pensions Committee hearing that Azar, a former pharmaceutical company executive, would live up to that promise.

While it was mostly Democrats who took aim at Azar’s tenure working for and running the U.S. affiliate of Eli Lilly & Co., Sen. Rand Paul said he would also need to be convinced. The Kentucky Republican pressed Azar on whether he would work on a system to safely import lower-cost prescription drugs from places with comparable systems, like Canada and Europe.

Bernie Sanders Gets a Grammy Nomination
Vermont senator co-narrated his book with actor Mark Ruffalo

Sen. Bernie Sanders, I-Vt., was nominated for a Grammy for his book “Our Revolution.” (Tom Williams/CQ Roll Call file photo)

Sen. Bernie Sanders might have failed to earn the Democratic presidential nomination last year, but the socialist independent from Vermont can add Grammy nominee to his name.

Sanders was nominated for Best Spoken Word Album for the audiobook version of his book “Our Revolution: A Future to Believe In.”

An Old Saw’s New Twist: Death (of the Deficit Hawks) and Taxes
A few Republicans clinging to old party orthodoxy could doom Trump’s big win

Office of Management and Budget director Mick Mulvaney has said “a lot of this is a gimmick,” referring to the tax bill’s expiration dates for some of the lower rates. (Tom Williams/CQ Roll Call file photo)

This apparent contradiction confronts Congress as it returns for a grueling month of legislating: The Republicans who run the Capitol, so many of whom came to Washington as avatars of fiscal responsibility, are going to spend the rest of the year working to make a worsening federal balance sheet look even worse.

December holds the potential for a productivity breakthrough, but it also threatens to end in embarrassing deadlock — which is why the clear consensus within the upper reaches of the congressional GOP is that it’s the right time to get comfortable with any feelings of hypocritical guilt.

States Face Children’s Health Coverage Uncertainty
Federal funding could soon run out

Oregon governor Kate Brown recently wrote to her state’s two Democratic senators warning that federal funding for the Children’s Health Insurance Program will  run out in December. (Photo by Scott Olson/Getty Images)

About two months after federal funding lapsed for the Children’s Health Insurance Program, state officials still don’t know exactly when they’ll run out of money or when Congress will renew funding — leaving families that depend on the program increasingly anxious about their benefits.

At least a few states say that they could exhaust funds as soon as next month. States are growing more concerned about the program with just a few days left on the congressional calendar until December and no signs that lawmakers plan in the immediate future to renew funding.