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December 19, 2019

What Trump's impeachment by the House could mean for health care

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    The House on Wednesday voted nearly along party lines to impeach President Trump for abuse of power and obstruction of Congress, setting the Senate up for a trial on the articles of impeachment, the New York Times reports.

    What an impeachment inquiry could mean for health care policies

    The impeachment proceedings represented a major undertaking, and industry observers believe they likely played a role in the stalled progress of health care legislative proposals, including measures to address so-called "surprise" medical bills and lower prescription drug prices.

    Senate lawmakers had set their sights on including a compromise bill to address surprise medical bills in a fiscal year 2020 spending package that Congress must pass this week. However, the leading proposals to date have faced opposition from the provider industry, and last week lawmakers on the House Ways and Means Committee called on Congress to delay legislative action on surprise medical bills until 2020 to give lawmakers more time to work on a final compromise package.

    It's unclear to what extent the House's impeachment proceedings played a role in the delay, but industry observers have noted how difficult it can be to pass legislation amid the investigative process. Raymond James health care policy analyst Chris Meekins in September wrote, "When an administration and a chamber of Congress are at war, rarely does anything other than what is absolutely required get done. That means anything that is not on a firm deadline (like government funding), is unlikely to get done (think drug pricing)."

    While the Post reports that House Democrats appear excited to refocus their attention on health care, including addressing rising prescription drug prices, in the Senate the impeachment process has yet to begin, suggesting key health care legislative priorities could be stymied until the process is concluded.

    What the House vote means

    The Constitution states that a president can be removed from office for "treason, bribery, or other high crimes and misdemeanors," NBC News reports.

    In September, the House launched a formal impeachment inquiry in response to a whistleblower complaint alleging Trump pressured Ukraine to investigate former Vice President Joe Biden, who is seeking the 2020 Democratic nomination for president, and Biden's son.

    On Wednesday, the House voted 230 to 197 to approve an article of impeachment for abuse of power regarding the alleged Ukraine incident, and 229 to 198 on a second article of impeachment for obstructing the House's impeachment investigation. In the first vote, two Democrats joined all Republicans in voting against impeachment, while a third Democrat joined the opposition for the second vote.  Rep. Tulsi Gabbard (D-Hawaii) voted "present" both times, according to the Washington Post.

    But the House vote does not mean Trump must step down from office. Under the Constitution, only the Senate can issue that judgement. Two-thirds of senators present would need to vote for conviction in order remove Trump from office, according to Washington Post's "The Fix."

    What happens next

    Before the Senate can vote, it must hold a trial in which senators serve as jurors, House lawmakers serve as prosecutors, and the Supreme Court's chief justice presides, the Washington Post reports.

    How exactly the Senate will go about holding a trial is not yet known. According to the Post, a majority of senators must agree on the rules for the impeachment trial before it can begin. Senate Majority Leader Mitch McConnell (R-Ky.) and Senate Minority Leader Chuck Schumer (D- N.Y.) will likely negotiate those proceedings, including whether to call witnesses and what witnesses would be called, the Post reports.

    However, it's not clear when the Senate's trial will begin. According to the Post, if the House immediately sends over the articles of impeachment against Trump, senators would likely choose a date for the hearing in January and work six days a week until the chamber has casted votes on both articles.

    But House Majority Leader Nancy Pelosi (D-Calif.) shortly after the impeachment vote on Wednesday suggested the House would not send the articles of impeachment against Trump to the Senate until both parties in the Senate have agreed to a process for the trial.

    McConnell has been critical of the House's impeachment proceedings. On Tuesday, he told reporters, "I'm not an impartial juror. This is a political process. There's not anything judicial about it." He added, "The House made a partisan political decision to impeach. I would anticipate we will have a largely partisan outcome in the Senate. I'm not impartial about this at all."

    According to the Post, 20 of the Senate's 53 Republican members would need to join all the Democrats in voting to convict Trump, and given how united Republicans have been in their opposition to the process, it is unlikely so many would vote in line with Democrats (Phillips, "The Fix," Washington Post, 12/19; Fandos/Shear, New York Times, 12/19; McPherson, Roll Call, 12/18; Williams, NBC News, 9/24; Rieger/Schaul, "The Fix," Washington Post, 12/19; Rucker et al., Washington Post, 12/18; Pathé, Roll Call, 12/18; Corasaniti, New York Times, 12/17; Diamond, "Pulse," Politico, 12/19; Snell, NPR, 12/17). 

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