Lawmakers are eyeing a health care deal this week, but it’s far from the “Great Healthcare Plan” that President Donald Trump outlined last Thursday.
Here’s a rundown of the latest developments and why Trump’s grander ambitions are looking DOA on Capitol Hill:
— The deal Republicans could get: After weeks of committee-level negotiations, congressional leadership and top appropriators on both sides of the aisle have clinched a deal on a smaller and far less contentious health care proposal that could hitch a ride on the next government funding package. Most ideas in the plan had a shot at becoming law in December 2024, but were torpedoed by Elon Musk and Trump.
The deal released early Tuesday morning as part of the $1.2 trillion funding package includes a crackdown on drug intermediaries known as pharmacy benefit managers, renewals of several public health programs and $4.6 billion in funding this fiscal year for community health centers.
The inclusion of the health agreement has swelled the bill to over 1,000 pages, so keep an eye on House conservatives who have balked in the past over being asked to vote within days on such jam-packed legislation.
— The deal they probably can’t clinch: Trump’s broader health care affordability pitch from last week appears to be largely doomed on the Hill, underscoring the extreme difficulty around uniting Republicans around any health plan.
Among the reasons: Democrats are in no mood to help after a series of health care fights with Republicans this past year, and key parts of Trump’s proposal likely wouldn’t meet the strict Senate rules for party-line legislation that could skirt a Democratic filibuster. Republicans also face major divisions over whether to even pursue more health initiatives using the budget reconciliation process in the first place.
One House Republican granted anonymity to speak candidly about conference dynamics described the appetite among GOP moderates for another major party-line bill — especially a health-focused one — as “not good.”
“You’re going to need 218 votes, which means you’re going to need to build consensus across the conference on what it is we’re pursuing,” said Rep. Mike Lawler (R-N.Y.).
Another big complication: Many senior Republicans oppose a key part of Trump’s plan — codifying “most favored nation” deals to link some U.S. drug payments to the lower prices paid abroad. Speaker Mike Johnson said last year he was “not a big fan” of the policy when White House officials attempted to squeeze it into the first GOP megabill.
What else we’re watching:
— Funding bill finalized: POLITICO reporters will continue to scrub the freshly released bipartisan, bicameral text for the Defense, Transportation-HUD, Labor-HHS-Education and Homeland Security bills through the day. The House aims to pass the shutdown-averting bill by Friday, with the Senate acting next week — just ahead of the Jan. 30 deadline.
— Voter registration action: House Majority Leader Steve Scalise is eyeing a vote on revamped legislation that would require proof of citizenship when registering to vote, potentially putting pressure on Senate Majority Leader John Thune to follow suit.
The House passed the so-called SAVE Act in April with the help of a few Democrats, but it died in the Senate. Scalise in a Fox News Sunday interview this weekend talked up a new version of the bill, which would add a photo ID requirement.
— Expanding the CRA’s reach: Republicans are attempting to use the Congressional Review Act this week to overturn mining protections on public lands for the first time. The House Rules Committee will consider a resolution related to Minnesota’s Boundary Waters wilderness at 3 p.m. Tuesday.
Benjamin Guggenheim, Meredith Lee Hill, Jordain Carney, Calen Razor and James Bikales contributed to this report.
