Fits and Starts on Infrastructure and Health Care Legislation

Congress continues to struggle with finding consensus on major legislation, and also still has a lot of work ahead in coming months to settle federal government spending levels for 2018.

Progress on President Trump’s concept for a big investment in infrastructure continues to be elusive. During the week of June 5th, the Trump administration promoted “infrastructure week,” with a series of speeches and events around the country to highlight the need for investments in infrastructure and faster permitting processes. While a detailed infrastructure proposal has still not been issued, the White House did release an infographic with a bit more detail on the ways in which the $200 billion in federal funds are intended to be used. They propose $25 billion for rural infrastructure projects, $15 billion for “transformative projects,” and $100 billion for “locally prioritized” infrastructure projects. It was left unspecified what the remaining $60 billion would be for.

Questions still remain about the infrastructure package as a detailed proposal has not yet been issued.

However, the fate of the infrastructure package in Congress remains a big question mark. A total of 253 House members – nearly half of which were Republicans – signed a letter to the House tax-writing committee asking them to fix the shortfall in the Highway Trust Fund through any tax reform efforts. While this does not preclude an infrastructure package from being passed, it does clearly indicate that, given limited funds, the majority of House members put a stronger priority on shoring up existing transportation funding streams. Congressman Graves (R-MO), who is the chair of the House Transportation Subcommittee on Highways and Transit, led the letter and said, “Instead of thinking a one-time, trillion-dollar investment would solve our long-term infrastructure problems, my focus is on making sure we're being responsible in how we plan for and fund projects in the future."

On the health care front, Congressional Republicans continue to try to repeal Obamacare. On June 22, Senate leadership released its health care bill, the Better Care Reconciliation Act. It would result in a significant decline in access to health insurance. Another key aspect of the legislation is that it would eliminate the Prevention and Public Health Fund starting in 2018—a year earlier than the House bill. The Prevention fund invests approximately $1 billion each year in health care and prevention programs, including state and local health department efforts to support healthy eating and active living. It currently makes up about 12 percent of the entire CDC’s budget.  These funds are an important part of many communities’ efforts to create healthier environments for people, and we are greatly concerned about efforts to eliminate the Prevention Fund.

The Senate was supposed to vote on the legislation this week, but the vote was postponed a few weeks due to a lack of votes. The fate of the health care bill also will influence progress on tax reform, as savings from the health care bill were intended to be used to further cut taxes. This could then affect timing or prospects for an infrastructure package. We will be watching closely as all of these dominoes fall into place in the coming weeks and months.