Since much of the President-elect Trump’s agenda was wrapped less around specific domestic issues and more around the larger issues such as immigration and trade, it is not clear what the domestic policy agenda will look like. As a result, the priorities may be wrapped around a few big Trump initiatives and a Republican congressional agenda. President-elect Trump did indicate his top priorities would be immigration, health care and the economy. On health care, there may be unanimity to repeal the Affordable Care Act but how and when that happens remains to be seen. This week should offer some of the first clues and some of the key policy areas that could attract early attention and legislation in the new 115th congress.
That agenda may in fact be shaped by the leaders in the Republican Congress. Speaker Paul Ryan has created an entire agenda that he unveiled earlier this year. That “better way” document was more general than previous initiatives he has released but in the recent past his proposals have included some controversial ideas such as converting programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP) into block grants to give states more flexibility. The following could very well be on the agenda early in next year:
Immigration issues. It’s not clear that that there will be reforms of immigration beyond candidate Trump’s call for tougher enforcement and building a wall between the United States and Mexico. Some things can be done by executive order or by repealing executive orders by President Obama. Front and center could be repeal of the DACA (Deferred Action for Childhood Arrivals) an executive order that allowed children who had been brought into the country before age of 16, to stay legally in the country under certain conditions such as attending school. The order was issued when Congress failed to adopt what had once been a bipartisan “DREAMERs Act that would have helped young students. Another contentious immigration issue will be the impact on families if stronger deportation efforts are executed. CWLA has joined other advocacy groups in supporting efforts to keep families together and protecting children when raids and other enforcement efforts have taken place. On the new transition website priorities include:
- Build a Wall on the Southern Border
- End Catch-and-Release
- Zero Tolerance for Criminal Aliens
- Block Funding for Sanctuary Cities
- Cancel Unconstitutional Executive Orders & Enforce All Immigration Laws
- Suspend the Issuance of Visas to Any Place Where Adequate Screening Cannot Occur
- Ensure that Other Countries Take Their People Back When We Order Them Deported
- Finally Complete the Biometric Entry-Exit Visa Tracking System
- Turn Off the Jobs and Benefits Magnet
- Reform Legal immigration to Serve the Best Interests of America and its Workers
The Affordable Care Act and Health Care. For congressional Republicans, this has probably been an even bigger agenda item then it was for candidate Trump until the end of the campaign. In fact, Friday reports indicated some flexibility on the part of the President-elect. Repeal is a clear goal now for Republican leadership and President-elect Trump said repeal is near the top of the agenda.
Repeal can be done in parts through a fast-track reconciliation process that voids a Senate filibuster but that will not eliminate all of it. There are additional challenges not the least of which is how to replace it—if they attempt to replace it. Repeal of the ACA is projected to increase the deficit by approximately $350 billion and leave more than 22 million Americans without health insurance.
Opponents have never been clear on how to replace it beyond allowing people to set aside pre-tax income in accounts to pay for bills or premiums. They have also talked about a “high-risk” pool for people who cannot get insurance but a short-term risk pool that was part of the ACA had very limited use or impact. In addition, it has been proposed that current ACA regulation of insurance companies be repealed and instead allow people to buy policies across state lines. There are no projections that these changes would offer the same level of health insurance coverage. In addition, some issues get tricky such as what to do with people who received health insurance despite having a pre-existing health condition. Repeal of the ACA could push such individuals back into the uninsured and unprotected category. CWLA has been a long-time supporter of the ACA.
There does seem to be some early indication that the S-CHIP children’s health insurance program, that must be reauthorized this year, will escape the attacks on the ACA. Other controversial health care issues involve Medicare and potential proposals to raise the eligibility age to 67 and to turn it into a voucher or partial voucher program. The Transition website states that they will seek to modernize Medicare.
Families USA is already organizing more than 1000 groups to protect the ACA.
Spending caps. Current budget law has capped both domestic and defense spending at a little more than $1 trillion split between defense and all other domestic spending. Candidate Trump has said he wants to get rid of the cap at least for defense. He said on several occasions that we needed to increase defense spending. A budget cap that simply allows defense increases will put pressure on cutting domestic spending.
Entitlement reform. This has been a high priority for Speaker Paul Ryan and other Republican members. President-elect Trump has talked about not touching Social Security which doesn’t aligned with some of the past Republican congressional ideas. That might leave other areas of entitlement changes as prime targets to find savings. Some of the bigger proposals in past Ryan platforms have included converting Medicaid into a block grant and the SNAP program into a block grant to provide states with more flexibility and more innovation. Speaker Ryan and House Republicans have also targeted SSBG for elimination because it is a block grant. Another target for dramatic changes could be the Supplemental Security Income (SSI) program that assists disabled adults and children.
Family Services Prevention Act and Child Welfare. Child welfare has not been something listed on the Trump agenda or House Republican agenda but the Families Services Act remains from the pre-election recess. What happens with this legislation? The legislation provides HHS with a great deal of flexibility to interpret the expansion or restrictions of in-home services and treatment. How broadly would an HHS department under budget pressure to find savings interpret access to mental health, substance use and in-home services? If it doesn’t pass, the cuts under residential care now in the bill could also be used for other purposes, so could the current delay in the expansion of adoption assistance since some in the child welfare community have embraced those cuts. Title IV-E is also an entitlement and so changes could be rolled into an entitlement reform proposal. Many of the current waivers under IV-E are “fixed allocations” or block grants of money. Something could happen with the Families First Act yet but at the same time, there may be those who want to start all over with the new leadership.
Infrastructure. One area of agreement by both candidates was the need to invest in the country’s infrastructure whether that includes just roads and bridges or includes a bigger agenda around airports, water and sewers and other forms of infrastructure. The key impact as far as human services is how it gets paid for. Some conservatives are opposed to a $1 trillion proposal talked about by candidate Trump. This would be the one area where Democrats may be open to supporting the new President. To this point transportation reauthorization bills have struggled to get adopted by recent congresses dating back for more than a decade. Policymakers have been unwilling to increase the gasoline tax (last increased in 1993 by 4.3 cents).
Child care in early childhood education. There seemed to be some broad agreement between the two presidential campaigns on the need for expanded support for child care. There were wide differences between what Secretary Hillary Clinton and candidate Donald Trump proposed here but there could be some opening for some family and medical leave and expanded tax credits for child care support. These ideas conflict with current Republican congressional priorities. Education could also be targeted for dramatic changes including the expanded use of vouchers and other increased state flexibility options.
To keep up to date on some of these developments the transition website can be reached at:
The Trump Tax Plan: Trump Tax Plan