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February 7, 2018

Inside budget negotiations: How lawmakers are working toward a spending bill to keep the government open

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    Senate leaders on Wednesday neared a deal on 2018 and 2019 budget caps for the federal government—a potential breakthrough in the effort to keep the government open past Thursday, the New York Times reports.

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    The longer-term agreement may be attached to a short-term, House-passed continuing resolution that would fund the government through March 23, according to the Times. Still, it remains unclear whether lawmakers can reach a consensus before the government would shut down later this week.

    Details on the short-term spending bill

    The House-passed continuing resolution would fund most of the federal government through March 23, while funding the Department of Defense (DOD) for an entire year—an approach that the Senate's 44 Democrats have rejected in the past.

    The bill also includes two years of funding for community health centers (CHCs), which provide health care services to about 27 million uninsured and low-income U.S. residents at more than 10,000 locations throughout the country. Federal funding for CHCs expired at the end of fiscal year (FY) 2017, on Sept. 30.

    The short-term spending bill also includes provisions that would extend Medicare programs that expired on Sept. 30 and delay scheduled cuts to disproportionate share hospital payments for FYs 2018 and 2019.

    The bill also includes several health care reforms, including the CHRONIC Care Act, which aims to give Medicare Advantage plans additional flexibility and expand access to telemedicine.

    The bill contains several funding offsets to pay for the program extensions. A one-pager circulated among GOP lawmakers Monday show the bill would reduce the Affordable Care Act's (ACA) Prevention and Public Health Fund levels from 2021 through 2027, rescind unspent funds in the Medicare and Medicaid Improvement Funds, and modify long-term hospital payments, among other changes.

    The Senate on Wednesday is expected to take up the House-passed bill, but Senate Republicans would need to garner support from Democrats to reach the 60 vote threshold needed to advance the bill.

    About the longer-term spending proposal

    According to the Times, as the Senate debate on the short-term continuing resolution moves forward, leaders could decide to add to it the emerging agreement on longer-term budget caps—which the New York Times reports would "set spending levels on military and domestic spending for the next two years."

    If the combined bill passes, lawmakers in the coming weeks would work on a separate long-term spending package that would fund the government through September.

    But it's unclear whether Democrats in the House would accept the deal on longer-term budget caps. House Minority Leader Nancy Pelosi (D-Calif.) on Wednesday said the new budget level deal includes many Democratic priorities, but said "the package does nothing to advance bipartisan legislation to protect Dreamers in the House." She added, "Without a commitment from [House] Speaker [Paul] Ryan [(R-Wis.)] comparable to the commitment from Leader McConnell, this package does not have my support."

    Even as lawmakers express optimism, Trump argues to 'shut it down'

    Meanwhile, President Trump on Tuesday signaled a shutdown could be possible if Democrats continued to push for changes to Trump's immigration policies, the Washington Post's "PowerPost" reports.

    At a White House event Tuesday Trump said, "I'd love to see a shutdown if we don't get this stuff taken care of," adding, "If we have to shut it down because the Democrats don't want safety ... let's shut it down" (Kaplan, New York Times, 2/7; Taylor, AP/Sacramento Bee, 2/7; Bolton, The Hill, 2/6; Everett/Ferris, Politico, 2/6; Peterson/Hughes, Wall Street Journal, 2/7; Luthi, Modern Healthcare, 2/6; Shesgreen, USA Today, 2/6; Diamond, "Pulse," Politico, 2/7; Golshan, Vox, 2/7; DeBonis/Werner, "PowerPost," Washington Post, 2/6).

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