The first few years of health reform could be very, very messy

July 2, 2012

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Top story: The health care aftermath

Most coverage of the Affordable Care Act focuses on what I'd call the "survival uncertainty" around the law: Will it pass? Will the Supreme Court overturn it? Will Mitt Romney win the election and repeal it?

But if you talk to the people involved in setting health care policy at either the state or federal level, their concern is the "implementation uncertainty": Will the states have their insurance markets up-and-running in time? If not, will the federal government really be able to swoop in and do it for them? Will any states actually opt-out of Medicaid?

The survival uncertainty has clearly driven the implementation uncertainty: Many governors said they were waiting on implementation until they knew whether the Supreme Court would rule for the law. Now some say they're waiting on implementation until they know who wins the election. Asked on Meet the Press whether Louisiana would be going forward with setting up their health insurance exchanges, Gov. Bobby Jindal said, "I think it makes more sense to do everything we can to elect Mitt Romney to repeal Obamacare."

If President Obama wins reelection and the survival uncertainty dissolves, then the end result of all this will be that many states are far behind schedule in implementation, and the first year or two of the full Affordable Care Act is much messier than it otherwise would have been. Exactly how messy depends on how much states are able to do between now and then, and arguably between now and the election. And that's what many of the top stories in today's Wonkbook are about.

Next up for health care: implementation. "A new front opened Friday in efforts to reshape how the federal government implements President Barack Obama's health-care overhaul now that the Supreme Court has ruled to keep the law in place. Employers, insurers, hospitals, drug makers and others are angling for an advantage as the government writes the regulations and sets the policies that will bring the law to life. Hospital owners want the government to reduce the $155 billion in health-care payment cuts they agreed to during negotiations over the law. Makers of medical devices hope to roll back a 2.3% tax on their sales contained in the measure. Insurance companies want more leeway to charge older people higher rates than younger ones. Drug makers are aiming at a provision that could squeeze how much Medicare pays for medicine...The White House gave lobbyists fresh hope that they can win changes to the law after President Obama said Thursday he wanted to improve the overhaul." Louise Radnofsky and Christopher Weaver in The Wall Street Journal.

States may not be able to meet key deadlines. "With Thursday’s Supreme Court ruling upholding President Obama’s landmark health-care law, debate has shifted to whether deadlines key to the law’s goal of expanding coverage to tens of millions of Americans will be pushed back. Some say states and the federal government are facing such complex technical and political realities that some deadlines need to be relaxed, including the Jan. 1, 2014, opening of online marketplaces where individuals and small businesses will be able to shop for coverage. And there may be pressure in Congress to delay some spending on the law to help reduce the federal budget deficit...For its part, the federal government says the marketplaces and other elements of the law will move forward on time...More than $850 million in grants has gone to states to plan their exchanges, with most accepting the money...Still, only 14 states and the District of Columbia have passed legislation authorizing the exchanges." Julie Appleby, Mary Agnes Carey, and Marilyn Werber Serafini in The Washington Post.

Some states may opt out of Medicaid expansion. "Millions of poor people could still be left without medical insurance under the national health care law if states take an option granted by the Supreme Court and decide not to expand their Medicaid programs, state officials and health policy experts said Friday. Republican officials in more than a half-dozen states said they opposed expanding Medicaid or had serious doubts about it, even though the federal government would pick up all the costs in the first few years and at least 90 percent of the expenses after that." Robert Pear and Michael Cooper in The New York Times.

The choice for states: Lots of Medicaid money now vs. more exposure to Medicaid costs later. "If anyone can claim the title of 'most surprised' by Thursday’s Affordable Care Act ruling, it might be Matt Salo. He directs the National Association of Medicaid Directors here in Washington and had no inkling that the Supreme Court would make the law’s expansion of Medicaid to 17 million Americans an option, rather than a requirement. 'We did not see that coming,' Salo says...Those calculations pretty much boil down to two incentives, pulling in opposite directions. On the one hand, there’s a deep pot of federal money for states to expand their Medicaid programs. On the other, there’s the fear of getting even more saddled with bills from an increasingly expensive entitlement program." Sarah Kliff in The Washington Post.

States may use the ability to opt out to win concessions. "Supreme Court ruling left the Democratic health care law intact -- but it also left Republicans in a stronger bargaining position when it comes to Medicaid. The ruling gives them the right to opt out of the Medicaid expansion envisioned under the law. But they know one thing: President Barack Obama wants them to stay in, and so many might just go along and take the money -- after they’ve squeezed out as many other concessions as they can get from the feds. One of the most health care-savvy governors, Louisiana’s Bobby Jindal, is already wondering whether this creates a backdoor way to achieve the Holy Grail for Republican governors -- turning his federal Medicaid dollars into a block grant. 'I believe [the feds] can go to the states and negotiate' to convert their Medicaid dollars into unrestricted lump payments 'for states that want to do this,' Jindal said Friday in a call with reporters." J. Lester Feder and Jason Millman in Politico.

Hospitals are pushing states to opt in. "Hospitals are urging states to expand Medicaid under the new health-care law, bringing a potent political force to bear on governors who face pressure from Republican leaders to opt out of the beefed-up program. States won a reprieve from the requirement this week when the Supreme Court ruled they could decline to expand Medicaid to a broader swath of the poor in 2014 without losing their existing federal funding for the program...'You're going to see a major intensification of lobbying at the state level by the hospitals and the doctors,' said John Gorman, a health-care consultant and former lobbyist...Governors who might opt out of Medicaid are likely to face pressure from hospitals. That's because the law also has provisions forcing steep federal cuts to supplemental Medicaid payments received by hospitals that serve large numbers of poor and uninsured patients." Thomas Burton, Jennifer Corbett Dooren, and Daniel Lippman in The Wall Street Journal.

The road to repeal looks hard for Republicans. "Minutes after the Supreme Court ruled to uphold most of the health care law, Congressional Republicans vowed to use every ounce of their legislative muscle to repeal it on their own...Should they win the White House and gain even a narrow majority in the Senate, Republicans would be able to use the same procedural approach Democrats took to get the health care law over the finish line two years ago to undo the taxes and federal subsidies that are at the core of the law. But attacking the law by stripping away its layers of taxes, fees and subsidies is not the same as dismantling it. Undoing the major benefits and policies of the law -- which include medical coverage for children up to age 26, protections for people with pre-existing conditions and the end of annual and lifetime caps on certain forms of coverage -- would require the acquiescence of Senate Democrats, which is highly unlikely." Jennifer Steinhauer in The New York Times.

For the record, I think Republicans could repeal Obamacare if they win the election, for reasons I explain here.

Mitch McConnell has no plan to cover the uninsured. "Pressed by Chris Wallace to say what he would do to insure the 30 million people who will get insurance under Obamacare, McConnell at first dodged the question, instead launching into a litany of complaints about the law...Asked the question again by Wallace, McConnell actually laughed, and said he’d “get to it in a minute,” before claiming the best thing we can do for the health system overall is to get rid of the law and all of its 'cuts' to health providers. He labeled Obamacare a 'monstrosity' and vowed that there would not be a “2,700 page” Republican reform bill. Asked a third time how Republicans would insure those 30 million people, McConnell said: 'That is not the issue. The question is how you can go step by step to improve the American health care system.'" Greg Sargent in The Washington Post.

@DLeonhardt: Round #1 of Obamacare fight was the Hill. #2 was Scotus. #3 is election. If Obama loses #3, #4 is Hill again.

Anna Wilde Mathews profiles four people who will decide the fate of Obamacare:"The fate of the health-care overhaul may hinge largely on people like Matt Lea. Now that the Supreme Court has affirmed that the law will survive, the insurance industry will focus on consumers such as Mr. Lea--a healthy, 27-year-old entrepreneur in Madison, Wis., who doesn't have health insurance...Starting in 2014, the law will offer both carrots and sticks to get him insured. Mr. Lea might have to pay around $2,916 a year, or $243 a month, for a plan at the law's lowest tier of coverage, according to a projection by Larry Levitt, a senior vice president at the nonpartisan Kaiser Family Foundation. If he makes $30,000 that year, he would get an annual federal subsidy worth around $882 to help. If he makes $40,000, there is no federal aid...And in 2014 the health overhaul's main stick--a tax penalty for not buying insurance--would be just $95 for Mr. Lea, or 1% of his income, whichever is greater. It will ramp up to $695 or more in 2016."

FRANK: The healthcare system now has a chance to evolve into something better. "What’s important now is how the health care sector will evolve under the new framework. And here, there are grounds for optimism. While the effects of the court’s Medicaid restrictions aren’t entirely clear, the law will certainly extend coverage to tens of millions who now lack it. In addition, new insurance exchanges will provide a broader array of care options. Increased competition tends to hold costs in check, even while enhancing service quality, and there’s no reason to expect the situation in health care to be different. Many scholars have argued that private, nonprofit institutions like the Mayo Clinic are the most effective model of providing care, and not only because they can better coordinate across many specialties. They are also less likely than traditional fee-for-service practices to prescribe unnecessary tests and procedures...But no matter which model proves most effective, it is likely to spread faster in the competitive environment established by the insurance exchanges." Robert Frank in The New York Times.

John Roberts might have initially voted to strike down the mandate. "Chief Justice John Roberts initially sided with the Supreme Court's four conservative justices to strike down the heart of President Obama's health care reform law, the Affordable Care Act, but later changed his position and formed an alliance with liberals to uphold the bulk of the law, according to two sources with specific knowledge of the deliberations. Roberts then withstood a month-long, desperate campaign to bring him back to his original position, the sources said. Ironically, Justice Anthony Kennedy - believed by many conservatives to be the justice most likely to defect and vote for the law - led the effort to try to bring Roberts back to the fold...The conservatives refused to join any aspect of his opinion, including sections with which they agreed, such as his analysis imposing limits on Congress' power under the Commerce Clause, the sources said. Instead, the four joined forces and crafted a highly unusual, unsigned joint dissent." Jan Crawford in CBS News.

@mattyglesias: When John Roberts was appointed, the constitutionality of an individual healthcare mandate was the mainstream Republican view.

BARNETT: The Constitution won even as healthcare lost. "The legal challenge to the Affordable Care Act, which I advocated as a law professor before representing the National Federation of Independent Business as a lawyer, was about two huge things: saving the country from Obamacare and saving the Constitution for the country. On Thursday, to my great disappointment, we lost the first point in the Supreme Court’s 5 to 4 ruling to uphold the health-care law. But to my enormous relief, we won the second. Before the decision, I figured it was all or nothing. But if I had been made to choose one over the other, I would have picked the Constitution...The Supreme Court has definitively ruled that the commerce, necessary and proper clause, and spending power have limits; that the mandate to purchase private health insurance, as well as the threat to withhold Medicaid funding unless states agree to expand their coverage, exceeded these limits; and the court will enforce these limits." Randy Barnett in The Washington Post.

@CitizenCohn: Btw, still amazed Randy Barnett got justices to buy activity/inactivity. Not happy about it; strongly disagree. But it's an impressive feat.

YOO: Roberts' ruling was no win for conservatives. "Conservatives are scrambling to salvage something from the decision of their once-great judicial hero. Some hope Sebelius covertly represents a 'substantial victory,' in the words of conservative columnist George Will...All this is a hollow hope. The outer limit on the Commerce Clause in Sebelius does not put any other federal law in jeopardy and is undermined by its ruling on the tax power (discussed below). The limits on congressional coercion in the case of Medicaid may apply only because the amount of federal funds at risk in that program's expansion--more than 20% of most state budgets--was so great. If Congress threatens to cut off 5%-10% to force states to obey future federal mandates, will the court strike that down too? Doubtful. Worse still, Justice Roberts's opinion provides a constitutional road map for architects of the next great expansion of the welfare state." John Yoo in The Wall Street Journal.

COHN: Medicaid expansion is likely to win, but it may take a while. "Yes, the Supreme Court upheld the individual mandate and its associated reforms of private insurance. But it also ruled that the law’s expansion of Medicaid was unconstitutional. Does that mean the Medicaid expansion might not go forward? Does it mean that a significant number of low-income Americans will remain uninsured because they can't get into the program? In the long run, probably not. In the short run, quite possibly yes...An instructive example may be the history of Medicaid itself. It became law in 1965, as part of the same act that created Medicare. By 1972, every state but one had opted into the program, according to Sara Rosenbaum, a professor at George Washington University...Eventually, all the states will probably choose to participate in the Medicaid expansion, just as they did with the original Medicaid initiative. But it may take a little time, and a lot of pressure, for that to happen." Jonathan Cohn in The New Republic.

@sarahkliff: So, uh, what do we do now?

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Top op-eds

1) BILMES AND CHODOS: Sending cash to the states would be the best stimulus. "Twenty-five years ago, President Ronald Reagan angered many Democrats with a broad effort to eliminate red tape and allow states discretion over federal grants. He called it the New Federalism. A half-century earlier, President Franklin Roosevelt angered many Republicans by using federal dollars to put millions back to work through a variety of programs that became known as the New Deal. Although we think of these two presidents and their initiatives as ideological opposites, there is no law of nature (or of economics) that prevents us from combining their ideas to help address the faltering economy today. A Reagan-Roosevelt approach -- a sort of decentralized recovery that sends money directly to the states -- has the best chance of putting people back to work and making America stronger...President Obama should appeal directly to the nation’s 50 governors by proposing a direct grant to each state to spend as it sees fit." Linda Bilmes and Shelby Chodos in The Washington Post.

2) KRUGMAN: It's hard to see a case for optimism for Europe. "Over the past few months I’ve read a number of optimistic assessments of the prospects for Europe. Oddly, however, none of these assessments argue that Europe’s German-dictated formula of redemption through suffering has any chance of working...What would it really take to save Europe’s single currency? The answer, almost surely, would have to involve both large purchases of government bonds by the central bank, and a declared willingness by that central bank to accept a somewhat higher rate of inflation. Even with these policies, much of Europe would face the prospect of years of very high unemployment. But at least there would be a visible route to recovery. Yet it’s really, really hard to see how such a policy shift could come about...So will Europe save itself? The stakes are very high, and Europe’s leaders are, by and large, neither evil nor stupid. But the same could be said, believe it or not, about Europe’s leaders in 1914. We can only hope that this time is different." Paul Krugman in The New York Times.

3) PEARLSTEIN: Outsourcing has hidden benefits. "In thinking about the full economic impact of offshoring, however, this exercise of counting jobs gained and jobs lost in particular companies, or particular industries, only gets you so far. Few would dispute that, by raising profits, offshoring has been a boon to shareholders in the companies that do it, including investors and executives at private-equity firms. And the bigger benefit has gone to the customers of these firms, businesses as well as consumers, who now enjoy a wider variety of goods at a savings of tens of billions of dollars every year. Those savings and those extra profits aren’t put under the mattress. Most of it is spent or invested in the United States in ways that are hard to track but have surely created hundreds of thousands of jobs in other companies and other industries. Those who hold those jobs would have no reason to know that they are beneficiaries of the process of outsourcing and globalization. But in a very real sense, they are." Steven Pearlstein in The Washington Post.

4) KARLAN: This Court term may come to haunt liberals. "Anton Chekhov once remarked that 'one must not put a loaded rifle on the stage if no one is thinking of firing it.' In the term that ended last week, the Supreme Court reached a liberal outcome in cases involving President Obama’s health care law, Arizona’s draconian immigration statute and mandatory life sentences for juveniles. But the conservative majority also laid down a cache of weapons that future courts can use to attack many of the legislative achievements of the New Deal and the Great Society -- including labor, environmental, civil rights and consumer protection laws -- and to prevent new progressive legislation. Far from being a source of jubilation, the term may come back to haunt liberals...A Congress that can advance national priorities only through its taxing power is a Congress with little power at all. That is the real legacy of the last term...The court’s guns have been loaded; it only remains to be seen whether it fires them." Pamela Karlan in The New York Times.

5) IRWIN: Protectionism is returning. "President Obama has provided no leadership in trying to keep world markets open for trade. Out of fear of offending labor unions and other domestic constituencies, his administration long delayed submitting free trade agreements with Korea, Colombia and Panama for congressional approval. Instead of seeking to reinvigorate the languishing Doha round of trade negotiations at the WTO, it has been almost completely passive and allowed world-trade policies to drift. Congress has also done little to help. Senate Republicans and Democrats teamed up late last month to maintain import restrictions for the sugar industry, defeating an amendment from Sen. Jeanne Shaheen (D., N.H.) that would have gradually eliminated them. Keeping domestic sugar prices at twice the world level helps a few sugar-cane and beet farmers at the expense of consumers and taxpayers, while leading to job losses in sugar-using industries, such as candy and confectionary manufacturing." Douglas Irwin in The Wall Street Journal.

Top long reads

Steven Mufson on tar sands in Alberta:"Every day, fleets of these Brobdingnagian trucks are digging up countless tons of Alberta’s oil sands -- a black, gooey mixture of sand, oil and water that lies just below the Canadian province’s boreal forest, an immense region thick with jack pines, spruce, aspen and tamarack trees and fed by wetlands that cover most of the area. The viscous petroleum, or bitumen, is so common that, in some places, it oozes out along the banks of the Athabasca River and was used by Native Americans to seal canoes. Canada’s economically recoverable oil sands are estimated to be about 170 billion barrels, reserves second in size only to Saudi Arabia. The Canadian Association of Petroleum Producers estimates that production, now 1.7 million barrels a day, could nearly double by 2020, enough to supply nearly 20 percent of U.S. oil consumption. With that, the oil sands would be producing more than Venezuela, Nigeria, Iraq or Kuwait."

Leslie Wayne on America's corporate tax haven -- Delaware:"Business -- the legal kind -- has been the business of Delaware since 1792, when the state established its Court of Chancery to handle business affairs. By the early 20th century, the state was writing friendly corporate and tax laws to lure companies from New York, New Jersey and elsewhere...President Obama has criticized outposts like the Caymans, complaining that they harbor giant tax schemes. But here in Wilmington, just over 100 miles from Washington, is in some ways the biggest corporate haven of all. It takes less than an hour to incorporate a company in Delaware, and the state is so eager to attract businesses that the office of its secretary of state stays open until midnight Monday through Thursday -- and until 10:30 p.m. on Friday. Nearly half of all public corporations in the United States are incorporated in Delaware. Last year, 133,297 businesses set up here. And, at last count, Delaware had more corporate entities, public and private, than people -- 945,326 to 897,934."

Cover interlude: Colin Hay plays The Beatles' "Norwegian Wood" at Rolling Stone.

Got tips, additions, or comments? E-mail me.

Still to come: Consumers won't drive the recovery; Connecticut wants to tighten Medicaid eligibility; more states get NCLB waivers; the NRC has a new chair; and a great deal of guitar riffs.

Economy

Consumer spending was flat for the first time in six months. "Consumer spending held flat for the first time in six months in May, even as incomes grew, suggesting sluggish job growth and concerns over Europe are causing shoppers to pull back. Personal spending was unchanged from the prior month in May for the first time since November 2011, the Commerce Department said Friday. And April consumer expenditures were revised down to a 0.1% gain from a previously reported 0.3% increase." Eric Morath and Sarah Portlock in The Wall Street Journal.

Consumers are unlikely to rescue the recovery. "When job growth picked up late last year, many experts saw the seeds of a consumer-driven economic rebound. As Americans returned to work, the theory went, they would have more money to spend on everything from clothes to vacations to houses...The consumer recovery was never as robust as it first appeared. In May, the Commerce Department revised down its estimate of first-quarter spending growth to 2.7% from 2.9%. Last week, the figure was revised down yet again, to 2.5%. That still represents the fastest growth since late 2010, but it isn't enough to shift the recovery into a higher gear." Ben Casselman in The Wall Street Journal.

States are planning new regulations to slow foreclosures. "States across the country are proposing a range of new rules that would make it more difficult for banks to foreclose on troubled homeowners. The moves have been prompted by concerns that lenders have been inefficient in restructuring mortgages, which results in unnecessary foreclosures, while using shoddy paperwork to repossess homes. Lenders are strongly resisting the measures, arguing that they will introduce new bottlenecks in the foreclosure process that could obstruct the incipient housing recovery...Nationwide, 25 states have bills contemplating changes to various laws governing the foreclosure process, according to the National Conference of State Legislatures. In Oregon, the state's outgoing attorney general proposed new rules covering how banks handle loan modifications. New York's assembly is considering a measure that would criminalize foreclosure paperwork forgeries." Nick Timiraos in The Wall Street Journal.

Plans for a eurozone bank regulator are facing doubts. "Facing a bank crisis in Spain and the prospect of outbreaks in other major countries, European leaders have pledged to establish a new agency aimed at curbing problems afflicting lenders in the euro zone. Yet for now the proposal amounts to little more than a vague statement of intent, one that has prompted more questions than answers. Will the new regulator have the power to rein in risky practices and hold offending banks accountable, for example, and will it be willing to exercise that power? Or will it be weak and overly beholden to national political factors that have too often gotten in the way of making bank supervision effective in Europe? It is not a moot point, given that two rounds of stress tests by another Pan-European agency gave passing grades to most banks in countries that use the euro currency, including some that turned out to be deeply troubled and in need of bailouts, contributing to a crisis of confidence in Europe’s financial system." James Kanter in The New York Times.

@ryanavent: Give me control of the Fed's twitter feeds, and I'll demonstrate how to raise inflation expectations.

Artist profile interlude: Submarine Channel profile's typographer Karel Martens.

Health Care

Connecticut wants federal approval to tighten eligibility rules for its Medicaid program. "Connecticut officials believe some parents of college-aid children are taking advantage of the state's Medicaid health-insurance program for low-income adults, seeking government subsidies for their children's health care so they don't have to pay for private insurance. But advocates for the disadvantaged question the claim, voicing concern that people who need Medicaid could be unfairly harmed. The state Department of Social Services is moving toward seeking federal approval to change its eligibility rules for the two-year-old program, known as LIA. The agency wants to count parental income and assets for applicants under 26 years old who live with their parents or are claimed as a dependent on their parents' tax returns...Besides counting parental income for younger applicants, the department is proposing an asset test for current and new applicants...The state also wants to limit nursing home care coverage to 90 days per admission." Susan Haigh in The Wall Street Journal.

Domestic Policy

Five more states got NCLB waivers. "The Obama administration granted waivers to five more states seeking relief from key conditions of the No Child Left Behind education law on Friday. In exchange, the states agreed to enact new standards and evaluate schools and teachers based on students’ academic progress...The No Child Left Behind law has been up for renewal since 2007, but Congress has not authorized revisions. Friday’s action by the administration brings to a total of 24 the number of states that have received waivers, and applications from an additional 13 states are under review. The department’s approval of requests from Arkansas, Missouri, South Dakota, Utah and Virginia on Friday came the week after the federal Education Department declined to approve an application from Iowa, on the grounds that the state had not demonstrated that it would adequately measure teacher performance." Motoko Rich in The New York Times.

The Senate will vote soon on cybersecurity legislation. "Senators are set to tackle legislation to protect the nation’s computer system when the upper chamber returns from its July 4th recess, but the efforts are being hampered by disagreements over the government’s role in overseeing cybersecurity standards. Senate Majority Leader Harry (D-Nev.) has repeatedly said he believes cybersecurity legislation is critical, and he is expected to push for a vote in July...Both CISPA and Lieberman-Collins would encourage companies to share information about cyberthreats with each other and with the government. But Lieberman-Collins is seen as having stronger safeguards to protect people's private information...Senate Republicans, led by John McCain (Ariz.), Kay Bailey Hutchison (Texas) and Saxby Chambliss (Ga.), are pushing their own cybersecurity bill, the Secure IT Act. The GOP bill is similar to CISPA in that it authorizes only voluntary information-sharing and would not set any cybersecurity mandates." Brendan Sasso in The Hill.

A judge overturned part of the DOE's for-profit college rules. "A federal judge in Washington has overturned a main component of the federal Department of Education’s 'gainful employment' rules, which were applied to career-training programs and were hotly contested by for-profit colleges, saying that regulation was arbitrary. The ruling by Judge Rudolph Contreras of Federal District Court was released on Saturday...Under the regulations, programs had to meet one of three tests or lose their eligibility for federal student aid: at least 35 percent of graduates must be repaying their loans, the typical graduate’s estimated annual loan payments must not exceed 12 percent of earnings, or they must not exceed 30 percent of discretionary income. But Judge Contreras ruled that the 35 percent debt-repayment standard had no basis...The judge left standing the disclosure portion of the regulations, under which career-college programs must disclose to students their graduation rate, their placement rate and their students’ median debt load." Tamar Lewin in The New York Times.

Congress passed transportation funding and a student loan extension. "Lawmakers approved a broad measure Friday that freezes federally subsidized student loan rates for another year, reauthorizes the government flood insurance program and extends federal transportation funding for two more years. The deal resolved months of acrimonious debate on key legislative concerns on the eve of a Fourth of July recess, and offered President Obama an opportunity to claim victory after a high-profile campaign to pressure Congress into action on both the student loan and transportation issues. But it also provided an opening to Republicans to challenge the president’s long-running argument that he is hamstrung by a do-nothing Congress..The agreement includes the first long-term transportation spending plan agreed to since 2005, replacing a series of short-term extensions. It passed the House 373 to 52 and the Senate by a vote of 74 to 19." Ed O'Keefe and Rosalind Helderman in The Washington Post.

Rock history interlude: 100 famous guitar riffs in one take.

Energy

The Senate confirmed Allison Macfarlane as the new chair of the NRC. "The Senate confirmed President Barack Obama's choice as chairman of the Nuclear Regulatory Commission, George Mason University geology professor Allison Macfarlane, and extended the term of a Republican commissioner, Kristine Svinicki. Ms. Macfarlane, a Democrat, will succeed Gregory Jaczko, who stepped down as chairman following conflicts with fellow commissioners." Ryan Tracy and Corey Boles in The Wall Street Journal.

The House passed the transportation appropriations bill for 2013. "The House approved a bill funding the Department of Transportation and the Department of Housing and Urban Development (HUD) for 2013, the sixth of 12 spending bills the House is hoping to finish before the end of the fiscal year. Members approved the bill, H.R. 5972, in a 261-163 vote. The bill, H.R. 5972, was supported by 76 Democrats, and 54 Republicans voted against it. The legislation would spend $51.6 billion in 2013, a cut of about $4 billion from 2012 levels. But as has been the case with other spending bills, several House Republicans tried unsuccessfully to cut spending further along the way...On Friday, the House also voice-voted an amendment from Rep. Jeff Landry (R-La.) to prohibit any funds from being used to implement any rule requiring GPS tracking or other devices to be installed in passenger or commercial vehicles." Pete Kasperowicz in The Hill.

@damianpaletta: In other news...White House reiterates it will veto any spending bill until House GOP agrees to FY '13 spending level set last year

Wonkbook is compiled and produced with help from Karl Singer and Michelle Williams.

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Sarah Kliff · July 1, 2012