Summary
With only nine days left until inauguration, Congressional Democrats begin the process, as outlined by House Speaker Nancy Pelosi (D-CA), of holding President Donald Trump accountable for inciting the deadly Capitol siege last week, starting with a request today for unanimous consent (and likely a roll call vote tomorrow) on a resolution calling on Vice President Mike Pence to invoke the 25th Amendment to remove Trump from office. Absent cooperation from Pence, the House will begin impeachment procedures. However, the actual timing, particularly of the expected Senate trial, remains in flux as Democrats seek to not hamper President-elect Joe Biden from executing his agenda and, most urgently, strengthening the federal government’s response to the coronavirus pandemic.
This week, Biden is expected to layout the groundwork for a new COVID-19 relief and stimulus package, calling the $900 billion relief measure in the year-end spending bill a “down payment.” Based on the broad strokes described by Biden at a news conference last Friday, the overall price tag of the package appears likely north of $1 trillion – an amount that was previously a nonstarter under the Republican-controlled Senate. In addition, with Democrats in control of the Senate, albeit by a razor-thin margin, Senate Republican Leader Mitch McConnell’s (R-KY) redline on liability protections is less of a threat. Biden’s proposal is expected to include billions of dollars to bolster vaccine distribution; billions of dollars for state and local governments; tens of millions of dollars for schools; additional relief for small businesses, particularly minority-owned and women-owned businesses; rental assistance; and $2,000 in stimulus payments.
While we expect earnest efforts by the new administration to rally bipartisan support for the package (to clear the 60-vote threshold to break a filibuster), budget reconciliation will be considered as a back-up pathway for delivering these measures. That legislative approach has several restrictions, however, regarding when and how it can be deployed. Current Senate rules allow separate reconciliation bills addressing spending, tax, and debt limit to move in a single fiscal year, but not multiple reconciliation bills addressing an individual subject (e.g., two reconciliation bills in the same fiscal year that include new spending would be prohibited). Plus, Congress will first need to adopt a budget resolution for the current 2021 fiscal year in order to formally begin the budget reconciliation process, which may delay getting federal aid out the door quickly. Finally, the eligibility of the discretionary spending components of the COVID relief package (i.e., those that do not implicate tax revenues or entitlement spending) is also in question.
In the meantime, the Biden transition team is pushing for Senate Republican committee chairs, who remain in control until January 20, to schedule confirmation hearings for Biden’s nominees – including Xavier Becerra for Secretary of Health and Human Services, Dr. Vivek Murthy for Surgeon General, and Neera Tanden for Director of the Office of Management and Budget (OMB). While the nominees are expected to have no trouble getting through the Democratic-controlled Senate, they are currently unlikely to be confirmed by day one of the Biden presidency.
On the regulatory front, and just days before Trump administration’s last day, the final rule for the 2022 Notice of Benefit and Payment Parameters arrived at OMB for review. The Exchange rule includes a number of wide-reaching proposals, including provisions that would allow states to use private sector entities to enroll individual market consumers in qualified health plans (QHPs). If finalized, the incoming Biden administration would have fewer options available to modify any of its more controversial provisions, though it intends to temporarily freeze the rule along with any others that have been finalized but not yet gone into effect.
Later this week (January 14), the Medicare and Payment Access Commission (MedPAC) will convene to discuss payment adequacy recommendations concerning the Medicare fee-for-service payment systems in 2022 leading up to its March Report to Congress.