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Reading Between the Lines: A Final Push on Health Care


Editor’s Note: Sandra Swirski and Sara Barba of the Washington, D.C., advocacy firm Urban Swirski & Associates offer regular analysis of public policy developments of interest to Southern grantmakers – reading between the lines so you don’t have to.

You may have noticed recently that health care has become the centerpiece of conversations in Washington… again. Earlier this year, in July, the Senate tried and failed to pass a bill that would repeal and replace the Affordable Care Act, and most folks in Washington thought Republicans were done trying to gut the health care law. Then, last week, Senators Lindsay Graham (R-SC) and Bill Cassidy (R-LA) revived the effort (pun intended).

This week, we’ll take a closer look at what this last-ditch effort on health care could mean for tax reform. Here are the headlines.

Details Will Come Later

Following clear frustration from rank-and-file Republicans in the House, Ways and Means Chairman Kevin Brady (R-TX) told members they would receive more details of the Republican tax reform plan the last week of September. The Senate Finance Committee also scheduled two hearings on tax reform over the past two weeks for its members – but that was before the health care revival, and tax reform’s oxygen has been sucked away once more, this time by the Graham-Cassidy bill.

So maybe there will be some details next week, but we don’t expect anything eye-popping, such as how the bill will raise revenue (a camp philanthropy doesn’t want to be in). After the health care smoke has finally cleared – September 30th is the deadline to go/no-go on health care – Republicans will be able to focus on passing a budget and tax reform.

Bipartisanship Is Possible…

Since lawmakers returned from the August recess, we’ve gotten some rare glimpses of bipartisanship. First, President Trump made a deal with congressional Democratic leaders on an extension of government funding and the debt ceiling, along with disaster relief. Then, even if it was brief, a bipartisan pair of senators were working on a bill to fix some failing parts of the Affordable Care Act. So, it is possible.

However, Democrats have exerted a lot of energy to protect the Affordable Care Act. If the new Graham-Cassidy push succeeds next week, it will be a lot less likely that Democrats will play nice on tax reform. If it fails, though, bipartisan tax reform efforts – or at least substantive discussions – might be more than just a moderate’s pipe dream. As you might recall from August, three Democratic Senators notably didn’t sign onto a letter drawing hard lines in the tax reform sand, which indicated to many in Washington they’re still willing to work with Republicans.

A Win-Win for Tax Reform

Whether or not Senators Graham and Cassidy are successful, tax reform is likely to come out ahead. If the health care bill passes, Republicans could finally have some momentum to work as a unified party and fulfill their next campaign promise – tax reform. If they fail to pass the replacement, Republicans will need to accomplish some sort of tax reform to have a notched win going into the 2018 campaign season.

What that reform will look like is anyone’s guess, and we don’t expect a detailed plan next week. But we do expect whatever happens with health care to inform the process. Stay tuned.

Sandra Swirski is a partner at Urban Swirski & Associates; Sara Barba is assistant vice president at the firm.

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