Illustration: Annelise Capossela/Axios
Health policy changes are expected to be less of a focus in Senate reconciliation discussions as the chamber moves forward with its own budget resolution next week.
Why it matters: The Senate's two-bill approach will put the immediate focus on immigration, energy and defense and likely push discussion of health offsets to the second bill.
The latest: Although the scope of the offsets is not entirely clear, lobbyists and aides don't expect using major — or possibly any — health policy changes as payfors.
- One possibility is finding savings from repealing Biden administration policies on matters like student loans, sources said. Energy policy can also provide offsets.
What they're saying: Senate Budget Chair Lindsey Graham told reporters Wednesday that he was planning to mark up his own budget resolution as soon as next week, in part because of the urgency of addressing needs at the border.
- This first measure is much smaller than the House reconciliation bill would be, containing roughly $150 billion for the border and $150 billion for the military.
- "It's going to be paid for. So we will instruct authorizing committees to go find payfors that are reconciliation-compliant," Graham said.
- Graham added that there were "a lot of good payfors out there" and that "it's got to be mandatory spending" but didn't specify which programs might be targeted.
He also said that the budget resolution could instruct the HELP and Finance committees to find savings in the mandatory space.
Between the lines: Even as the Senate moves forward on the two-bill track, the House continues to focus on a single-bill strategy.
- That is much likelier to include significant health care measures, particularly around Medicaid cuts, as lawmakers look to offset the trillions of dollars it will take to extend tax cuts.
- Asked about the Senate's plans, Energy and Commerce Chair Brett Guthrie told Axios that he was still focused on the single-bill approach but that he has "told leadership we're going to make health care work in whatever bill we choose."
Friction point: Adding to the congressional dysfunction is President Trump's apparent desire to spare Medicaid beneficiaries from any changes to the program while rooting out abuse or waste.
- Republicans continue to suss out what that means for their reconciliation plans, but Guthrie said that in his view it could still mean implementing Medicaid work requirements.
- "I've talked to the administration that we need to get it clarified what exactly that is, and then we can go from there," Guthrie said.
