Politics This Week: Health Care Legislation

House Speaker Paul Ryan says Congress will be focused on keeping the government funded this week, not health care as President Trump proposed. Trump, meantime, also wants to introduce a tax overhaul.

STEVE INSKEEP, HOST:

In this country, this was supposed to be a businesslike week for the United States Congress. Lawmakers were quietly working on a spending bill that they must pass this week to keep the government running. And then, President Trump's administration insisted that the measure must include money for a Mexican border wall. Homeland Security Secretary John Kelly affirmed that demand on Fox News.

(SOUNDBITE OF TV SHOW, "FOX NEWS")

JOHN KELLY: It goes without saying that the president has been pretty straightforward about his desire and the need for a border wall. So I would suspect - he'll do the right thing for sure - but I will suspect he will be insistent on the funding.

INSKEEP: In addition to that spending bill, the president also spoke of another vote in Congress on health care legislation. And he promised to drop a massive tax reform plan. What's going on? Well, it's the final week before the president hits the 100 day mark, a common point to measure how presidents are doing. NPR's Scott Detrow has covered just about every one of those days. And he's in our studios.

Good morning, Scott.

SCOTT DETROW, BYLINE: Morning, Steve.

INSKEEP: How much is the president likely to get out of Congress this week?

DETROW: Well, probably just that spending bill. The White House, you know, as you said, is desperate to get a lot of big things moving ahead of this hundred-day mark. But the thing is, congressional leaders are very focused on that spending bill. They do not want to go down the road of a possible government shutdown and brinksmanship.

INSKEEP: Oh, because that's what would happen if there's no spending bill passed. You shut down the government, and it's all on Republicans in that case.

DETROW: Right. And you're talking about funding the government. You're talking about a massive health care system. You're talking about massive tax reform. These are all really big things that take a long time to do, and you have to do them one at a time. These are not things to get done in a three-day span.

INSKEEP: And yet, Republicans are talking again about reviving a replacement for Obamacare after they failed to even bring one to a vote some weeks ago. What stands in the way of doing that?

DETROW: Well, the same dynamics that stood in the way of the vote being passed before, which is why it never came to a vote because the votes weren't there. No Democrat is going to vote for this at all, so the Republicans have to make the far-right Freedom Caucus part of their caucus happy who want to see as much of a repeal of the entire thing as possible, and also, a big chunk of moderates who are very uncomfortable with scaling away previously doled out entitlements and scaling back this Medicaid expansion, especially, that so many states have taken out.

INSKEEP: Is tax reform looking any easier?

DETROW: Well, our colleague Susan Davis said when the health care bill failed that if that's a 5K or a 10K, tax reform is a marathon.

INSKEEP: (Laughter).

DETROW: And you need to run the first before the second. It's really tough. And even the biggest advocates of tax reform say that's going to take a year or more. So that's not something that you can just roll out, say here's what I want to do and get it passed in a matter of weeks.

INSKEEP: So whatever the president has accomplished in the first hundred days - maybe we would say he's most likely already accomplished. There are some things on that list - Mick Mulvaney, the budget director, talked about them also on Fox News Sunday over the weekend - the administration spending a lot of its first hundred days talking to the base, talking to the home team, his political base. And Mulvaney was promoting what has been accomplished. Let's listen.

(SOUNDBITE OF TV SHOW, "FOX NEWS SUNDAY")

MICK MULVANEY: We've put out more executive orders than any previous administration in the last 50 years. And importantly, these are not creating new laws. Most of these are laws getting rid of other laws, regulations getting rid of other regulations. We're reducing the role of government in your life during the first 100 days and we're doing so on truly historic basis.

INSKEEP: OK, that's Mick Mulvaney. Scott Horsley, our colleague, noted the other day that a lot of those executive orders signed by the president just tell the government to do what it's already doing. There is a huge change in personality in the White House. But has there really been that big a change in the substance of government, Scott?

DETROW: In terms of the seismic shift that Trump promised and campaigned on and you saw President Obama start to put in place in his first hundred days, we haven't really seen that.

INSKEEP: Although there are many, many hundreds of days to go. Scott, thanks very much.

DETROW: Sure thing.

INSKEEP: That's NPR's Scott Detrow.

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