Healthcare Preview for the Week of: May 30, 2023 - McDermott+Consulting

Healthcare Preview for the Week of: May 30, 2023

All Eyes on Debt Limit Votes in the House  

Over the weekend, President Biden and Speaker of the House McCarthy (R-CA) reached a deal to raise the debt limit for two years (until 2025). The deal, dubbed the Fiscal Responsibility Act, includes government spending cuts; addresses the speed of permitting for energy projects; redirects $20 billion from the Internal Revenue Services to other agencies; makes modest reforms to the student loan program, the Temporary Assistance to Needy Families program and the Supplemental Nutrition Assistance Program; and rescinds $28 billion in unspent COVID-19 funding.

Overall, the policy changes in the debt limit deal allow both sides of the aisle to pick talking points that fit their own narrative for the voting public. Republicans can state that there are several cuts and policy changes that are real. Democrats can say that there are several loopholes that may neuter the bill’s impact and that they protected Medicaid. However, as the budget process begins over the next few months, Democrats and Republicans may have difficulties agreeing to the spending caps in the deal, and ultimately agreements to fund the next fiscal year could be difficult to achieve.

The House Rules Committee is scheduled to meet at 3 pm EDT today to move the bill to the House floor for a vote. That is usually a perfunctory political process with little drama. However, three Republicans on the House Rules Committee—Reps. Chip Roy (R-TX), Ralph Norman (R-SC) and Thomas Massie (R-KY)—may vote against the deal. At least one of these three needs to vote in favor of the rule in order for the Rules Committee to send it to the floor with a Republican majority vote. It would be highly unusual to have Democrats contribute to a majority vote in the Rules Committee. And, that could also indicate bigger problems gaining Republican votes for the rule on the House floor. Assuming the bill advances out of the Rules Committee, the House is expected to vote on Wednesday. That will require passing the rule on the House floor and a vote on final passage. It is not a slam dunk that the bill advances out of the House, as both conservative Republicans and progressive Democrats are challenging the deal. The path to passage will likely require a large contingent of Republicans and Democrats—but not overwhelming majorities from either. If the bill advances out of the House, the Senate needs to pass it prior to Monday, June 5, as Treasury Secretary Janet Yellen announced that June 5 is the deadline after which the US government may not be able to pay its bills. It will be a very interesting week.