Healthcare & Social Safety Net - Meet the Freshmen

Healthcare & Social Safety Net

In the 117th Congress, Democrats’ signature legislation, the Inflation Reduction Act, combined tax policy, climate change provisions, and healthcare improvements – in particular, the ability for Medicare to negotiate prescription drug costs as a way to bring down consumer costs.[i]

The topic of universal healthcare promises to remain in the public eye during the 118th Congress. Last year, Democratic Rep. Ro Khanna of California introduced the State-Based Universal Healthcare Act of 2021[ii]–a bill that would provide federal funds for states to create their own public, universal healthcare options to citizens. The bill died in committee, but its provisions will likely be reintroduced in the new Congress.

With concerns about COVID-19 waning, Congress has been tighter with purse-strings when it comes to COVID relief funds and vaccine accessibility.[iii] Additionally, with a reduction in public concern over COVID, Medicaid administrators are anticipating a decline in Medicaid enrollment.[iv] This will dovetail with Republicans’ intent to reduce entitlement spending.[v]

While a divided government could make passing new, sweeping legislation difficult, prominent Republicans see an opportunity to impose limitations through the debt-ceiling and government funding process. Rep. Kevin Hern (R-OK), head of the Republican Study Committee’s Budget and Spending Task Force, and Rep. Jason Smith (R-MO), who was the ranking member on the House Budget Committee and is seeking to be the Chair of the Ways and Means Committee in 2023 and beyond, both pointed to the debt limit negotiations as “obviously a leverage point,” and “one of those tools that a Republican-controlled Congress will use” to enact their priorities.[vi]


[i] Alex Rogers, Clare Foran, Ali Zaslav & Manu Raju, “Senate passes Democrats’ sweeping health care and climate bill,” CNN Politics, August 7, 2022, available at https://www.cnn.com/2022/08/07/politics/senate-democrats-climate-health-care-bill-vote.

[ii] HR 3775 – State-Based Universal Health Care Act of 2021, June 8, 2021, https://www.congress.gov/bill/117th-congress/house-bill/3775?s=1&r=26.

[iii] Katie Lobosco & Tami Luhby, “Here’s what’s in the $10 billion Covid-19 aid bill,” CNN Politics, April 4, 2022, available at https://www.cnn.com/2022/04/04/politics/covid-19-aid-bill-whats-in-it.

[iv] Chris Lee, “State Medicaid Officials Anticipate the COVID-19 Public Health Emergency Will End During State FY 2023, Leading to Medicaid Enrollment Declines, Slower Total Medicaid Spending Growth and a Sharp Rise in States’ Share of Costs,” Kaiser Family Foundation, October 25, 2022, available at https://www.kff.org/medicaid/press-release/state-medicaid-officials-anticipate-the-covid-19-public-health-emergency-will-end-during-state-fy-2023-leading-to-medicaid-enrollment-declines-slower-total-medicaid-spending-growth-and-a-sharp-rise/.

[v] Jim Tankersley, “Republicans, Eyeing Majority, Float Changes to Social Security and Medicare,” New York Times, November 2, 2022, available at https://www.nytimes.com/2022/11/02/us/politics/republicans-social-security-medicare.html.

[vi] Jack Fitzpatrick, “Entitlement, Spending Cap Plans Linked by GOP to Debt-Limit Deal,” Bloomberg Government, October 11, 2022, available at https://about.bgov.com/news/entitlement-spending-cap-plans-linked-by-gop-to-debt-limit-deal/.

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