GOP prepares to battle itself over defense spending

Less than two weeks after cementing another major increase to the Pentagon budget, lawmakers are now talking about going the opposite direction — and are even raising the specter of across-the-board cuts that rocked the establishment just over a decade ago.

An emerging deal between Speaker Kevin McCarthy and conservatives who initially opposed his bid for the gavel looks to exact deep spending cuts. This comes amid a looming partisan fight over the debt limit, compounding fears that overall spending is poised for a return to automatic reductions known as sequestration.

Among the concessions McCarthy made to secure the speakership was a vote on a budget framework that caps discretionary spending at fiscal 2022 levels and aims to balance the federal budget in a decade.

The nascent pact does not make a specific commitment on defense spending. Many Republicans have sought to quash chatter of Pentagon cuts, noting they could instead look to make reductions from the non-military side of the ledger. But if the Pentagon is not spared, reverting to last year’s budget levels would amount to a roughly 10 percent cut, wiping out a $75 billion increase enacted last month.

“Seems like we could be backing ourselves into sequestration,” warned Rep. Mike Waltz (R-Fla.), an Army veteran and Armed Services Committee member, on a Friday conference call with McCarthy and allies, POLITICO reported.

Incoming Armed Services Chair Mike Rogers (R-Ala.), who harshly criticized the party’s conservative wing during the chaos over the speaker’s gavel, said he’s “not worried” about the deal affecting defense. Incoming Appropriations Chair Kay Granger (R-Texas) and Rep. Ken Calvert (R-Calif.), who is set to chair the top defense spending panel, also support additional Pentagon funding.

Arnold Punaro, a former top staffer on the Senate Armed Services Committee, said he is "not nearly as sanguine" that the Pentagon will end the year unscathed as some who’ve downplayed it.

"I remind people the last time we had a Republican House and Democratic president and a debt ceiling and spending confrontation we got the [Budget Control Act] and the sequester," Punaro said.

A deal to vote on spending cuts isn’t part of a rules package governing the House that lawmakers will vote on when they return Monday. Yet defense spending will be part of the calculus for some Republicans.

Texas Republican Tony Gonzales plans to oppose the rules package in part because of his concerns about national security spending.

"This has a proposed billions of dollar cut to defense, which I think is a horrible idea when you have [an] aggressive Russia in Ukraine, you have a growing threat of China in the Pacific," Gonzales said Sunday on CBS's "Face the Nation." "How am I going to look at our allies in the eye and say, 'I need you to increase your defense budget,' but yet America is going to decrease ours?"

Defense hawks are eyeing another real increase this year of up to 5 percent to meet threats posed by Russia and China and to mitigate high inflation. And supporters of increased defense spending are now warning up front that they outnumber the budget hardliners in the GOP conference.

“There's a ton of defense hawks that are necessary to get to the math of 218,” Rep. Mike Gallagher (R-Wis.), a member of the Armed Services Committee, told POLITICO.

Fellow Armed Services Republican Don Bacon of Nebraska piled on, cautioning, "Most of us won't vote for cuts to defense.”

Another Republican, Rep. Nancy Mace of South Carolina, told CBS she was “on the fence” on the rules package, citing concerns about the handshake agreements struck with conservatives and the potential for shrinking military spending.

"I don't want to see defense cuts," Mace said. “We don't know what deals were made, and that's something that we should be transparent about."

Some conservatives who pressed for a pact on reducing spending attempted to tamp down talk of Pentagon cuts in the wake of the negotiations over the speaker’s gavel.

The office of Rep. Chip Roy (R-Texas), one of the conservative holdouts who cut a deal to support McCarthy and is a military spending skeptic, downplayed the possibility of defense cuts as spin by "big spending neocons & the military industrial complex."

"[D]uring negotiations, cuts to defense were NEVER DISCUSSED," Roy's office wrote on Twitter. "In fact, there was broad agreement spending cuts should focus on NON-DEFENSE discretionary spending. This means cutting funding for the woke & weaponized bureaucrats that received massive increases under the $1.7 trillion omnibus."

Even if defense becomes a target for fiscal hardliners, McCarthy can't guarantee cuts. Gutting the domestic funding for this fiscal year that House Democrats enacted on their way out of power will almost certainly be rejected by the Senate, which remains in Democratic hands, and President Joe Biden.

"I think it would pass the House. I doubt it would pass the Senate,” Gallagher said of bills that reduce domestic spending. “But therein lies the rub of everything we do when it comes to government spending."

If Republicans’ fiscal hard line doesn’t result in reduced spending, the gridlock will likely force Congress to put spending on autopilot. Funding programs through temporary continuing resolutions, which carry over the previous year’s levels and block new programs from getting started, is a long-running complaint of Pentagon brass.

"This backroom deal not only contradicts Republican calls for transparency, but it also kills the 2024 government funding process before it has even started, all but guaranteeing a shutdown," chided Rep. Rosa DeLauro, the top Democrat on the House Appropriations Committee.

Roman Schweizer, an analyst with investment firm Cowen, is skeptical cuts will come to fruition but said in a Friday note to investors that spending debates in the divided Congress will still be "a mess."

"Everyone expects gridlock between Republicans and Democrats for the next two years. Some may prefer it," Schweizer wrote. "What we're seeing now is gridlock between GOPers."

There’s still a faction of conservatives that’s unconvinced the Pentagon should get a pass.

“Everything has to be on the table,” said GOP Rep. Jim Jordan of Ohio, a co-founder of the House Freedom Caucus, on “Fox News Sunday.”

"Frankly, we'd better look at that money we send to Ukraine as well and say how can we best best spend the money to protect America,” he added. “I think that's what the people elected us to do. That's what we're going to do."

Fiscal hardliners may even find common ground with progressives who’ve long sought to restrain defense spending, though they’ve had little success because most Democrats and Republicans still back a larger Pentagon budget. And progressives would almost certainly reject cuts to domestic spending or holding the federal borrowing limit hostage.

"There are places I may actually agree with Republicans on defense cuts. I think it is absurd we are going to have almost a trillion dollar defense budget,” progressive Rep. Ro Khanna (D-Calif.) told “Fox New Sunday.” “And if they're going to look at that and make certain cuts, then let's have that conversation."

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Colorado governor pledges to end chartered migrant buses bound for Chicago, New York

NEW YORK — Colorado Governor Jared Polis announced over the weekend his state would no longer charter buses of migrants to New York City and Chicago, a process that had irked the mayors of both cities and led to a public war of words among the three Democrats last week.

On Saturday, Polis told Chicago Mayor Lori Lightfoot there were no more buses for migrants scheduled to arrive in her city from Denver, and informed New York City Mayor Eric Adams that the last bus of asylum seekers would arrive Sunday, according to a statement released by his office.

“People fleeing violence and oppression in search of a better life for themselves and their families deserve our respect not political games and we are grateful we have been able to assist migrants to reach their final destination,” Polis said in the statement. “We refuse to keep people against their will if they desire to travel elsewhere.”

In an interview with POLITICO last week, Polis said that Denver had seen a backlog of asylum seekers who had arrived from the southern border and became stranded in the Mile High City during last month’s historic winter storm. While he said that Colorado had been assisting migrants with travel to their final destinations for weeks prior, the flow of asylum seekers spiked as the backlog was being cleared. Saturday’s statement suggests the state began to charter entire buses of asylum seekers bound for Chicago and New York to alleviate the pressure.

The conversation between Polis and the two mayors came on the same day that Lightfoot and Adams sent a letter demanding the Colorado Democrat halt the flow of travelers out of Denver.

“You must stop busing migrants to Chicago and New York City,” the mayors wrote. “In the case of family reunification, let us work together to ensure that people are reconnected with their loved ones, however sending migrants to our cities whose systems are over capacity, where they may struggle to find shelter and other services is wrong and further victimizes these most vulnerable individuals.”

Both mayors have said that social safety nets in their cities are at capacity, and spent last week criticizing Polis' actions. New York City, for example, has seen an influx of more than 36,000 migrants.

While Polis pledged to stop the chartered buses, his spokesperson said they would continue to help asylum seekers on an individual basis should they want to reach cities beyond Denver.

"We will not prevent anyone who wants to leave from going to their preferred destination," spokesperson Conor Cahill said in a statement Monday. "The travel backlog from the holiday season and winter storms have cleared, and Denver and the state will now resume normal assistance for migrants."

While representatives for Lightfoot did not immediately comment, a spokesperson for Adams said that the end of the charter buses was welcome news.

“While we are pleased that Colorado has stopped the chartering of buses to New York City, we are hopeful that any city or state feeling the impacts of this humanitarian crisis will partner with us and others to advocate for the federal government to come up with a national solution to the challenge surrounding asylum seekers,” Fabien Levy said in a statement.

All three Democrats have called for more resources from the federal government to help them deal with the influx.

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The fight over how to deliver bad news to patients

Congress was full of good intentions when it directed the Department of Health and Human Services to make sure patients get their test results as soon as they’re available.

But the implementation of that directive has set off a battle between doctors on one side and HHS and patient advocates on the other, and raised a fundamental question: How should patients get bad news? The debate underscores how medicine's digital transformation is changing the doctor-patient relationship and upending ingrained practices.

Doctors say that patients are now receiving news about potentially terminal disease, or other, less catastrophic but confusing, test results from patient portals before they have a chance to explain them. The American Medical Association is pressing the department to revise its rules, and the trade group for physicians is finding allies in state legislatures. But patient advocates, and HHS, say patients should, and can, decide when they want their results.

The doctors say they know how their patients feel. Patients “are extremely angry and have had harms they're reporting from getting instant access,” AMA President Jack Resneck said. “We're seeing a parent who finds out at nine o'clock on a Friday night when they can't reach anybody that their child's leukemia has recurred.”

The AMA and other groups representing physicians want HHS to allow them to delay the release of test results so they can talk patients through them. Concerned doctors have convinced legislatures in at least two states to weigh in on their behalf.

But patient advocates and HHS’s Office of the National Coordinator for Health IT, or ONC — which wrote the regulations — think such exceptions could do more harm than good.

“That test result may be what someone needs in order to search for a clinical trial, an emergency second opinion, for a Social Security disability application or to connect with necessary community supports,” said Grace Cordovano, a board-certified patient advocate.

Elise Sweeney Anthony, executive director of policy at ONC, wrote in a post to the agency’s web site that finding out she had breast cancer before talking with her doctor better prepared her for follow-up care. The early access allowed her to learn more about the specific cancer and talk to a friend who had also had breast cancer to prepare for a more productive doctor's appointment, she wrote.

“My journey was eased by a care team that embraced health information technology and shared decision making,” she wrote. “The fact that my care team supported my choice to receive my lab results in that way was invaluable.”

A mandate from Congress

Congress ordered HHS to bar health care organizations from hoarding patient data in a 2016 law, the 21st Century Cures Act.

Congress directed HHS to prevent providers, health IT developers and health information exchanges and networks from blocking the flow of health data to consumers. Congress was motivated to act by concerns that electronic health records vendors and providers were making it more difficult to release patient health information to stifle competition.

The goal of the regulations was to promote health data-sharing and patient access.

HHS first proposed the rule in 2019, but then put it on hold when the coronavirus arrived in 2020. The regulation went into effect in a more limited scope that included test results in April 2021 and expanded to include the full definition of electronic health information in October.

Just before, the AMA, the American Hospital Association, the College of Healthcare Information Management Executives and other groups asked unsuccessfully for a further delay, arguing that providers’ technical systems weren't yet ready, and that vendor and provider deadlines weren't aligned.

HHS did provide an exception that allows doctors to withhold patient information if divulging it could harm the patient.

But the exception is too narrow, according to the AMA, which wants HHS to make clear that doctors may hold back information if releasing it immediately would cause “mental or emotional harm.”

“We're just asking for a little flexibility for a few hours or a few days when there's bad news to be able to deliver it by phone or in person and to be able to more personally deliver that bad news,” Resneck said. “What we're talking about is very rare, less than 1 percent of cases.”

The AMA points to survey data it commissioned showing close to two-thirds of patients want their doctor to talk them through “life-changing” results.

Other physician groups are raising concerns. Brian Outland, director of regulatory affairs at the American College of Physicians, which represents internists, argues that while patient access to timely information has its benefits, the rule is creating more work for doctors and can cause problems for patients.

“Patients often will get anxious about the results. It creates more phone calls and … can add to the physician burden,” Outland said, adding that it can also erode patient trust in the medical system.

The doctors are finding allies in state legislatures.

California passed a California Medical Association-backed law that would allow doctors more time to review results before releasing them. And Kentucky passed a Kentucky Medical Association-backed bill last spring that allowed providers to delay releasing test results for up to three days if they believe the results could inflict emotional damage.

Trusting patients

The debate over the rule has split doctors from patient advocates.

The advocates say that the rule already gives patients a choice about whether they want their results immediately or not, and that their decision should be respected.

“Ultimately, the result is the patient's to have and they should decide the timing of it,” said Deven McGraw, a member of ONC’s Health IT Advisory Committee, former high-ranking HHS Office for Civil Rights official and lead of data stewardship and sharing at biotech firm Invitae.

“The regulations do not prevent a physician from having a conversation with their patients when they are ordering particular tests, telling them about the fact that they might get their results in advance of the doctor seeing them,” said Genevieve Morris, a former top ONC official and now senior director of interoperability strategy at health IT firm Change Healthcare.

The AMA’s Resneck said that technology issues prevent many providers from separating patients who want their results immediately from those who don’t.

HHS National Coordinator for Health IT Micky Tripathi expects that’s a problem the market can solve.

“'It’s absolutely the case that the electronic health record vendors don't uniformly have the ability to [let patients decide if they want results delayed],” Tripathi said. “But that's what demand and supply is all about. Right now, the demand is there. We would expect now the response from the supply side.”

Leigh Burchell, vice president of government affairs at health IT firm Altera Digital Health, said on behalf of the Electronic Health Record Association that “many EHR technologies can or will soon support both immediate transmission of clinical data or a delay.”

Although some people have good relationships with their doctors, many patients don’t, added Morris.

That “impacts whether a patient wants to hear bad news from them or from a computer screen,” she said.

For example, Morris said she had a test result that came back showing she had hypothyroidism and meant she'd have to be on medication for the rest of her life. When a nurse called her to inform her, the nurse had “zero sympathy,” she said.

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Kyiv thinks Russian cyberattacks could be war crimes

Ukrainian cyber officials are gathering digital evidence for The Hague to prosecute, their top chief says.

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Newsom asks Biden for emergency declaration after extreme storms batter California

SACRAMENTO, Calif. — Gov. Gavin Newsom will ask President Joe Biden to declare a state of emergency after a series of storms battered the state in the first week of the year, causing deadly flooding, downed trees and widespread power outages.

“We have all the confidence we’ll receive [the declaration] based on the conversations we’ve had with the White House,” Newsom said at a Sunday news conference.

Across the state, more than 424,000 people are without power and more than 20,000 have been evacuated from their homes, said Nancy Ward, director of the governor’s Office of Emergency Services. She emphasized that floods are more deadly than any other natural disaster and that they've killed 12 Californians since Dec. 31 — more deaths than from the last two wildfire seasons combined.

The governor had already declared his own state of emergency this month in response to the extreme weather. But a decree from the president can provide even more resources through the Federal Emergency Management Agency.

The news came just hours after rain and gusty winds swept across Northern California Saturday night, including Sacramento, knocking out power and sending trees toppling into houses.

State officials emphasized that more storms are on the way — with wet and windy conditions expected to worsen Monday night into Tuesday morning.

“The worst is still in front of us,” Newsom said. “Don’t test fate.”

State officials have high-water vehicles, rescue helicopters and shelters ready to deploy. They encouraged residents to prepare for severe weather and power outages, and to stay off the roads during storms, especially those that are flooded.

The governor also said he plans to ask the Legislature for an additional $200 million to shore up the state’s aging levees in his 2023 budget proposal, which he will release on Tuesday.

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Biden administration condemns storming of government buildings in Brazil's capital

The Biden administration on Sunday condemned the attacks by supporters of former President Jair Bolsonaro of Brazil on the country’s congress, supreme court and presidential palace.

“Using violence to attack democratic institutions is always unacceptable. We join @LulaOficial in urging an immediate end to these actions,” Secretary of State Antony Blinken said Sunday on Twitter, tagging President Luiz Inácio Lula da Silva, Bolsonaro’s newly inaugurated successor.

The storming of government buildings on Sunday in Brasilia drew immediate parallels to the Jan. 6, 2021, attacks on the U.S. Capitol — almost exactly two years ago. Supporters of Bolsonaro have protested against Lula’s electoral win since last year.

“President Biden is following the situation closely and our support for Brazil’s democratic institutions is unwavering,” national security adviser Jake Sullivan wrote on Twitter. “Brazil’s democracy will not be shaken by violence.”

Democratic members of Congress, including Rep. Joaquin Castro (D-Texas) and members of the Senate Foreign Relations Committee, drew a direct line to former President Donald Trump, who has faced criminal referrals related to his actions on and around Jan. 6.

“Domestic terrorists and fascists cannot be allowed to use Trump’s playbook to undermine democracy,” Castro tweeted.

Video of the attack in Brazil was “deeply disturbing,” having been in the Capitol on Jan. 6, Rep. Jimmy Gomez (D-Calif.) said.

Bolsonaro has been a supporter of Trump, often with a similar strongman style. The former Brazilian president is reported to have been spending significant time in Florida, Trump’s state of residence, in recent weeks.

Speaking on CNN following the attacks, Castro called for the Biden administration or Florida authorities to extradite Bolsonaro to Brazil.

“The United States should not be a refuge for this authoritarian who has inspired domestic terrorism in Brazil,” Castro said.

Brazilian Foreign Ministry officials did not immediately offer comment on Sunday. Protesters remained in Brazil’s National Congress and on its roof on Sunday evening, local time.

The tumult in Brazil, which has a population of about 215 million, is the latest in a series of political crises in Latin America and the Caribbean in recent years. Since Joe Biden took office, there have been an assassination of a Haitian president, unusual protests in Cuba, an attempted coup by a president facing impeachment in Peru and now the turbulence in Brazil. An anti-incumbent mood has also led to the election of some leftist leaders in the region.

Privately, and sometimes publicly, Latin American officials say the Biden administration needs to pay more attention to its own hemisphere, and not simply see it through the lens of migration.

The Associated Press contributed to this report. 

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Biden tours El Paso border sites

President Joe Biden on Sunday toured the busiest port in El Paso, Texas, met Border Patrol agents and was expected to head to a federally funded migrant services center in his first visit to the southern border since becoming president.

Biden was greeted by the state’s Republican governor, Greg Abbott, who has sparred with the administration over immigration policies, shortly after landing in El Paso on Sunday afternoon.

“The president caused the chaos at the border, needed to be here. It just so happens he’s two years and about $20 billion too late,” Abbott said to reporters.

The governor, for his part, has also faced accusations of using migrants as pawns, for facilitating the drop-offs of thousands from the border to Northern cities.

Border Patrol officers in El Paso showed Biden methods used for detecting smuggled goods, according to reporters on-site.

The president also planned to meet with local business leaders, White House press secretary Karine Jean-Pierre said on Sunday. Asked specifically by reporters, Jean-Pierre did not say whether Biden would speak to migrants on the trip.

The White House unveiled a new policy last week to grant humanitarian “parole” to 30,000 migrants a month from Cuba, Haiti, Nicaragua and Venezuela, as well as crack down on those who don’t go through legal routes.

“What we’re trying to have is to incentivize them to come to the ports of entry instead of in between the points of entry,” Secretary of Homeland Security Alejandro Mayorkas said of migrants on Sunday, speaking to reporters on the way to El Paso.

Mayorkas on Sunday looked to draw a distinction between a new regulation proposed by the Department of Justice last week and a similar, Trump-era rule known as a “transit ban.”

“It’s not a ban at all,” Mayorkas said of the proposal, which — similar to the Trump-era policy — would require migrants to first be turned away from safe harbor in another country before applying for asylum in the United States.

Biden’s visit to El Paso comes amid criticism from Republicans for his administration’s immigration policies, particularly in the face of the possibly imminent end of Title 42, an enforcement mechanism used by both the Biden and Trump administrations to quickly expel millions of people.

“El Paso is a place where, of course, we’ve seen an acute challenge,” Mayorkas said. The administration has surged 100 border agents to the city, and plans to open a new soft-sided migrant processing facility there on Tuesday, he said.

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