WASHINGTON - The federal government was barreling toward a shutdown Friday evening as a last-ditch meeting between President Donald Trump and the Senate's top Democrat produced no resolution and Trump redoubled his support for the Republican plan.
Facing a midnight deadline, Senate Minority Leader Charles Schumer, D-N.Y., said he and Trump made "some progress" in a private meeting about keeping the government open but did not strike a final deal.
"We still have a good number of disagreements," Schumer told reporters at the Capitol upon returning from the White House. "The discussions will continue."
Opposition to the bill among Senate Democrats appeared to be hardening as Friday evening began. Michigan Sens. Gary Peters and Debbie Stabenow, who is up for reelection in a state that voted for Trump, both announced that they would vote against it. Sen. Heidi Heitkamp, D-N.D., who faces an even tougher path to reelection in a red state, said she would support the bill.
On Twitter, Trump wrote that a four-week extension of government funding "would be best" and that leaders were "making progress."
"Excellent preliminary meeting in Oval with @SenSchumer - working on solutions for Security and our great Military together with @SenateMajLdr (Mitch) McConnell and @SpeakerRyan," wrote Trump, who spoke to House Speaker Paul Ryan, R-Wis., on the phone late Friday afternoon.
The timing of further votes in the Senate was unclear with less than seven hours before the deadline. Senate Majority Whip John Cornyn, R-Texas, said there would be a vote to end debate on the House-passed spending bill in the late afternoon or early evening, but did not offer more detail.
With time running out, one possible approach under discussion on Capitol Hill would be a two- or three-week extension of government funding, according to senior Republican aides. Several Republican senators had rejected the idea.
Speaking to reporters, Office of Management and Budget director Mick Mulvaney predicted that the conflict has a "really good chance" of being resolved before government offices open Monday, implying that the weekend would mitigate the impact of a shutdown.
"I think there's a deal in the next 24 hours," he said.
House members were advised to remain in Washington on Friday in case of "additional procedural votes."
Republicans are insisting on a four-week funding extension that includes a six-year authorization for the Children's Health Insurance Program and delays several health-care taxes. Democrats have called for a funding extension for several days that would allow more time for negotiations over the legal status of immigrants brought to the United States illegally as children, known as "dreamers."
Cornyn dismissed the notion of a days-long funding bill as "an absurd idea." He said if Schumer met with Republican leaders to work on an agreement, there was a chance a shutdown could be avoided.
Not all Senate Democrats opposed the one-month bill. Indiana Sen. Joe Donnelly, who faces reelection in a state that supported Trump in 2016, announced his support in a Senate floor speech.
"It's the most basic duty of Congress to keep our government running," he said.
Trump and the Republicans, who control all levers of government, faced the possibility of a shutdown on the first anniversary of his inauguration. According to a new Washington Post-ABC News poll, Americans by a 20-point margin blame Trump and the GOP over Democrats if the government closes.
The Schumer-Trump meeting had set off alarms among congressional Republicans. Neither Senate Majority Leader McConnell, R-Ky., nor Ryan, who resolved Friday morning to stand firm in their support of the House bill, attended the White House meeting.
Schumer returned to the Capitol and met with House Minority Leader Nancy Pelosi, D-Calif., and Senate Minority Whip Richard Durbin, D-Ill., for over an hour.
Republicans on Capitol Hill said White House aides assured them that no private deal will be struck between Trump and Schumer.
As Senate Republicans remained short of the 60 votes needed to advance the bill to fund the government through Feb. 16, McConnell delivered a political salvo on the Senate floor, saying Democrats had been led into a "box canyon" by Schumer.
By late Thursday, at least nine Senate Democrats who had voted for a short-term spending bill in December said they would not support the latest proposed extension. They joined 30 other Democrats and a handful of Republicans in opposing the bill.
Sen. Jeff Flake, R-Ariz., said late Thursday that he was "not inclined" to vote for a short-term spending measure because leaders did not keep their promise to hold a vote by the end of January on legal protections for young undocumented immigrants.On Friday morning, he said he preferred Democrats' proposal of a mini funding extension to allow more time for negotiations, an idea GOP leaders rejected Thursday. He was "still looking" at the House bill late Friday afternoon.
Marc Short, Trump's director of legislative affairs, said that the effort by Democrats to put an immigration fix in the bill was unreasonable, given that legislative text has not been drafted and the program doesn't expire until March.
"There's no DACA bill to vote on, and there's no emergency on the timing," Short said.
A government shutdown causing employee furloughs has never occurred under unified party control of Congress and the White House.
The Trump administration is drawing up plans to keep national parks and monuments open despite a shutdown as a way to blunt public anger, and while the military would not cease to operate, troops would not be paid unless Congress specifically authorizes it.
The last shutdown, in 2013, lasted for 16 days as Republicans tried unsuccessfully to force changes to the Affordable Care Act. On Jan. 30, Trump is scheduled to deliver his State of the Union address.
In a sign of the preparations on Capitol Hill, congressional staffers received formal notice Friday morning that they may be furloughed starting at midnight. Individual lawmakers will have to determine which aides have to report for work during the impasse.
As senators awaited news about possible votes, the White House prepared to delay Trump's departure for his Mar-a-Lago resort in Florida until after a short-term spending bill is passed. The president had intended to leave Washington late Friday afternoon ahead of a lavish celebration of his first year in office that is planned for Saturday night.
With the House scheduled to be out of session next week, several leaders have planned trips abroad. Vice President Pence will travel to Israel and Egypt, Ryan will visit Iraq, and House Majority Leader Kevin McCarthy, R-Calif., and House Freedom Caucus Chairman Mark Meadows, R-N.C., will accompany Trump to the World Economic Forum in the Swiss resort village of Davos.
McCarthy spokesman Matt Sparks said the Davos trip would be canceled in the event of a government shutdown, but that did not stop Pelosi from criticizing the trip.
"Every year the Republicans plan the January schedule so that they can go to Davos. They want to spend next week hobnobbing with their elitist friends instead of honoring their responsibilities to the American people," she said.
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The Washington Post's Sean Sullivan and John Wagner contributed to this story.
FRANKFORT, Ky. - Gov. Matt Bevin is exultant as his administration sets out to transform Medicaid. Only a week ago, he won federal permission to pursue a goal that has animated his two years in office: Making hundreds of thousands of poor Kentuckians hold jobs or engage in their communities in other ways to keep their health insurance. It is an approach never tried by any state, and it will also transform lives.
The unorthodox plan, Bevin has faith, will lift people into economic self-reliance, ease Kentucky's stubbornly high rates of addiction and ill health and propel the needy to "derive a sense of dignity by your own power." From this capital city in the state's Bluegrass country, he is buoyed by a sense of mission. "It's a . . . joy that we are doing right by people," Bevin says.
More than a two-hour drive to the southeast in rural Floyd County, where one person in three lives in poverty, word of these coming changes has reached 20-year-old Lakin Branham. She relied on Medicaid last summer when she entered a residential drug-treatment program after wrecking her grandmother's car and serving a brief jail stint for a DUI. Five months clean, she needs the program to pay for medicine to fight depression and two hours of drug counseling every other week.
She hopes to go back to community college part-time - too few hours to keep her insurance once Medicaid's new rules phase in later this year. The changes sound "crazy and stupid," says Branham, who for the moment is adjusting to sobriety while helping her grandmother care for her grandfather with pancreatic cancer. "People need their Medicaid. . . . If they could work their way out of poverty, they would have already been there."
This conservative Republican governor and this young woman struggling into adulthood reflect the chasm of perspectives across Kentucky as the state moves to impose work requirements as a condition of eligibility in the half-century-old safety-net insurance program.
Which perspective is right - or whether both contain shards of truth - will become evident as the five years of this novel experiment play out, and as researchers and state officials scrutinize the effects.
Whatever they learn will have broad relevance because other states are waiting in line. Nine more - almost all led by Republicans - have applied to the federal Centers for Medicare and Medicaid Services for permission to adopt similar "community engagement" requirements, and others are considering them. There is little doubt that more approvals lie ahead. Before becoming CMS administrator, Seema Verma was a consultant who helped design Kentucky's plan, traveling to Frankfort at least every other week to coach the governor's aides.
For now, those aides are speeding to convert the plan into action. They are starting to strengthen coordination with local job-training offices. They are drafting letters and text messages to try to notify notoriously hard-to-reach people about to become part of Kentucky HEALTH (Helping to Engage and Achieve Long Term Health), as the plan is called.
Meanwhile, consumer-health advocates in Kentucky and Washington are finalizing a lawsuit to try to block the state, contending its action undermines Medicaid's purposes and is illegal.
In the middle are an estimated 394,000 Kentuckians. That is state officials' most recent snapshot of how many of 1.4 million Medicaid recipients are able-bodied people ages 19 to 64 who will not be exempt because of circumstances such as pregnancy, schooling, medical frailty or disability. Officials expect that perhaps 264,000 will not be in compliance when the rules begin between July and November.
The experiment unfolding here is a dramatic about-face from the early years of the Affordable Care Act, when a Democratic governor, Steve Beshear, employed the 2010 law to spread insurance more widely than in nearly any other state.
Then Bevin, an investor-businessman who had run a family bell-making company, took office. Reversing Kentucky's Medicaid expansion under the ACA had been a central campaign promise. But after his election, he assigned staff to design the work requirements and premiums that many on Medicaid soon will be charged - from $1 to $15 a month, depending on their income. The plan also includes a "My Rewards" account for people to earn extra benefits, including dental and vision care that until now has been part of basic coverage, in exchange for healthy behaviors.
In an interview last weekend, the governor said the large drop in uninsured Kentuckians under the ACA "doesn't mean squat" because it has not translated into less obesity, diabetes, opioid abuse or any of the other measures that make the state among the nation's least healthy places.
"Guess what?" Bevin said. "As people engage in their own health outcomes, engage in doing for themselves, they will remove themselves [from the program]. I don't need to do it."
State officials expect that 95,000 fewer Kentuckians may be on Medicaid by the end of the five years as a result of the new rules. They cannot yet predict how many will wean themselves through jobs and rising incomes and how many will be locked out for failing to comply.
Bevin projects confidence that the plan will endure. But if it was blocked in court, he said, he would eliminate the Medicaid expansion, "no question, 100 percent."
During two years of preparation, his aides have defined many details. People covered by the new rules will need to log 80 hours monthly of work, school, job-training, volunteering or caregiving - or any combination. Every month, they must send the state proof of compliance. If they fail to do either, they will have a month to begin following the rules, then one more month before they lose eligibility.
Other important aspects remain in flux. The approved plan says Kentucky will assess whether any areas of the state have too few jobs, training opportunities or public transportation. Adam Meier, deputy chief of staff for policy and the governor's right hand on the Medicaid changes, said that assessment has not yet begun. "If we see huge issues once we roll out, we could back off" requirements in certain counties.
The fiscal effects - a linchpin of Bevin's rationale while campaigning - are still blurry. Meier said savings should come from fewer enrollees, a reduction in benefits such as dental and vision care and transportation for non-emergency services, the new premiums and people's improved health. "It's all such a guess at this point," he acknowledged, "because it's never been done before."
Cara Stewart, a leading critic and lawyer at the Kentucky Equal Justice Center, says there are too many unknowns. She is not even sure which parents fall outside the work requirements. Although state officials say the plan's reference to "minors" means children up to age 18, Stewart says the plan documents also refer to a section of federal Medicaid rules that includes only children 6 and younger.
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Caught in limbo are people such as Teresa Loman, who lives in working-class Erlanger in northern Kentucky and juggles two part-time bartending jobs while raising Leona, 6 1/2, and Vivian, 4. Loman is good at her work - friendly with customers and a three-time winner of the Guinness Perfect Pour competition at Molly Malone's Irish Pub in nearby Covington.
The girls have health coverage through her partner, Steve Hunter, and his job as a wine and beer distributor. But Loman, 35, has Medicaid and worries she will be cut off when Vivian is a little older because her bartending hours do not add up to 80 every month.
Loman knows the importance of Medicaid. It paid thousands of dollars in hospital bills a couple of years ago after a pain in her side turned out to be an inflamed appendix that was about to burst.
When she started at her second job, at Braxton Brewing Co., she was full time for several months. Working opposite shifts to avoid day-care expenses, she and Hunter didn't see each other much, Leona and Vivian did not see them together, and she had little time for healthy cooking. Loman does not think the new rules should force her to choose between her insurance and being a good mother. "I want to be there to teach [the girls] to read and sled and make homemade playdough," she said. "It's not fair to ask someone to give that up."
The Medicaid changes have proponents. Goodwill Industries of Kentucky endorsed them because they are in sync with its mission of helping people overcome barriers and enter the workforce, said Amy Lutrell, the group's president. Still, Lutrell said, "Kentucky will need to step up" and make sure supports are available. And state officials must be realistic about how long changing lives takes, she added.
Wrinkles are common in the lives of people scraping by. Since she graduated from a special-education program in Covington, Pauline Creech's only job was cleaning at a gas station long ago, and her only volunteering was at her now-grown son's elementary school. For more than two decades, Creech got Social Security disability payments, which meant that she also was on Medicare, the federal insurance for older and disabled Americans. Medicare covered her chemotherapy when she first got leukemia.
Two years ago, she got a letter from the Kentucky Lottery, saying she had won $50,000 in a second-chance drawing she entered with tickets from friends. She thought it was a fake, but it was true. The next surprise was that she suddenly had too much money to keep getting disability payments. Her Medicare vanished, too.
Creech, 48, now gets Medicaid, which is the insurance she used for an appointment just before Christmas with her cancer doctor, who told her that blood tests show the leukemia has returned after seven years of remission. On Monday, after another appointment to decide on her new treatment, she stood in a scuffed Covington bar called Mr. T's Tavern on Main and wept as she thought about the possibility of losing her insurance. "I don't want to miss appointments," she said.
Over in Dwale, her speck of a town in Floyd County, Lakin Branham also is unsure whether she can keep her insurance. She is heeding her drug counselor's advice not to heap stress onto her newly won sobriety. She doesn't have much of a history of doing what the state will require: She dropped out of community college after a few months and was fired from the only job she has ever held - cleaning rooms at a Super 8 hotel.
Her new goal is to be a counselor, but she knows her path will not be quick and will be even harder if she loses health coverage.
Losing Medicaid, she says, is "not the way to get out of poverty at all."