Republicans Scale Down Agenda for Safety-Net Programs, Health Law

By Kristina Peterson and Stephanie Armour Features Dow Jones Newswires

Republicans are scaling back their ambitions to overhaul safety-net programs and dismantle the Affordable Care Act following President Donald Trump's weekend retreat with GOP leaders, due to concerns they can't muster enough support ahead of the 2018 midterm elections.

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Instead, Republican lawmakers are likely to embrace a slimmed-down agenda focused on the basics, including funding the government, raising the government debt limit and striking a deal on immigration, according to GOP lawmakers and aides.

House Speaker Paul Ryan (R., Wis.) last year mentioned ambitious plans to tackle government assistance programs, including food stamps and other programs tied to income, that he says discourage recipients from working. But Senate Majority Leader Mitch McConnell (R., Ky.) has warned in recent days that he has little interest in pursuing a partisan overhaul in a chamber where Republicans hold a narrow 51-49 majority.

After meeting with GOP leaders at Camp David, Mr. Trump appeared more aligned with Mr. McConnell, saying Republicans would look at whether discrete changes to safety-net programs could attract Democratic support. "Otherwise we'll be holding it for a little bit later," he said.

Republicans took control of Washington a year ago with hopes of repealing the ACA, overhauling the tax system, revamping social-net programs and undertaking other sweeping changes. But after narrowly passing a tax overhaul late last year, Republicans are entering an election year when tough votes will be tougher as a Democratic Party that senses improving fortunes becomes more eager to resist GOP initiatives.

At risk of losing one or both chambers in November, Republicans say they want to avoid controversy over policies that stand little chance of passing the Senate, where most bills need 60 votes to clear procedural hurdles. Voters are especially wary of plans to overhaul safety-net programs, which polls show remain highly popular. Republicans say they are confident the surging economy will help their electoral prospects.

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"You can get it through the House, but if you're going to run into a logjam in the Senate, why go down that path?" said Brian Walsh, a former Senate GOP aide.

Instead, Republicans may need to spend much of their time trying to sell voters on their biggest accomplishment of last year: a tax overhaul that remains unpopular with much of the public.

"Republicans still need to educate Americans broadly on the tax bill," Mr. Walsh said. "We're still a long way off from closing that sale."

Mr. Ryan, who has talked for years about focusing on programs that address poverty, may not be completely ready to abandon a safety-net overhaul yet, Republican lawmakers said. And Mr. Trump may use administrative actions to pursue work requirements and other changes across a variety of federal programs. At Camp David, Mr. Ryan talked about workforce training programs, Sen. John Cornyn (R., Texas) said Monday.

Still, some House Republicans said they see no downside to pushing a safety-net overhaul, even if it fails to secure a majority. Rep. Jim Jordan (R., Ohio) said there were benefits in having a "national discussion" ahead of 2018 elections. But centrist Republicans, who are among the most vulnerable, haven't shown the same eagerness.

Given the political risks of taking on safety-net programs, leaders like Mr. McConnell say any change must be embraced by both parties. "The sensitivity of entitlements is such that you almost have to have a bipartisan agreement in order to achieve a result," Mr. McConnell said in late December.

Finding Democrats willing to consider GOP-favored changes to Social Security Disability Insurance or work requirements or drug-testing for various programs, for example, would be tough in the current climate. In the Senate, at least nine Democrats would have to join such efforts to hit the 60-vote threshold.

Sen. Bob Casey, a Democrat up for re-election next year in Pennsylvania, said GOP proposals to overhaul safety-net programs "always ends up being very ideological on their side. I haven't heard anything that seems to be the subject of consensus" between both parties.

While some red-state Democrats up for re-election might consider such proposals, Democratic leaders are likely to dig in against changes they may brand as attacks on the middle class.

Republicans also appear poised to largely move on from their largely unsuccessful push last year to dismantle the ACA. That effort failed when Republicans had a 52-48 Senate majority, an advantage that narrowed when Sen. Doug Jones (D., Ala.) won a recent special election.

But conservative activists are signaling their displeasure if Republicans delay their more sweeping agenda items. "The danger is pretty acute for congressional Republicans," said Dan Holler, vice president of Heritage Action for America. "It's a bad recipe for midterms."

About 40 leaders from conservative groups, including Heritage Action and the Club for Growth, urged Mr. Trump last week to support a renewed ACA repeal push.

But for now, the changes may come through administrative actions rather than legislation.

The Centers for Medicare and Medicaid Services is weighing state requests to impose work requirements and other new mandates on Medicaid beneficiaries.

A proposed rule by the Department of Labor would allow self-employed people and small businesses to band together in associations that provide insurance plans that don't comply with all ACA requirements. Another proposal is expected that would likely lead to a proliferation of slimmed down but lower-cost insurance plans on the individual market.

Taken together, these changes, and Congress' recent repeal of the ACA's requirement that most people have insurance, would undo major components of the ACA. While the ACA's Medicaid expansion would still stand, adding work and other conservative requirements would likely lower the number of beneficiaries.

--Louise Radnofsky contributed to this article.

(END) Dow Jones Newswires

January 09, 2018 05:44 ET (10:44 GMT)