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4 big tests facing the Republican-led Senate

The Senate returned to Washington this week with a busy agenda, facing major legislative action on Medicare, Iran, education policy, and President Obama's attorney general nominee. On some issues, lawmakers are up against an imminent deadline - doctors will face a 21 percent cut in government reimbursements for treating Medicare patients unless the Senate can pass a so-called "doc fix" before Wednesday, for example.

Other measures are on a more relaxed timetable, but they may build to a head soon because of mounting political pressure. Lawmakers wary of a nuclear deal with Iran will have the first chance to act on their reservations Tuesday, when the Senate Foreign Relations Committee votes on a bill allowing the Senate to review any final deal that emerges from the framework announced last week. Also on Tuesday, the Senate's Health, Education, Labor, and Pensions Committee will mark up an education proposal to succeed No Child Left Behind.

Looming over it all is the nomination of U.S. Attorney Loretta Lynch, which has been pending for more than 150 days, caught up in an unrelated fight over abortion provisions in a human trafficking bill.

It all adds up to quite a juggling act for the Senate's GOP leaders, who came into power in January promising a more open, functional chamber and now must deliver on that promise. Here's a progress report on four of the most consequential items on the Senate's to-do list.

Preventing a doctors' pay cut

The most pressing issue facing the Senate is a bill, passed by a broad bipartisan basis in the House last week, that would permanently rescind the so-called "sustainable growth rate" (SGR), a payment formula imposed in 1997 that annually slashes government payments to doctors who treat Medicare patients.

The cuts have been scheduled 17 times since 2003, but because they're politically problematic, lawmakers have averted them all 17 times by passing what's called the "doc fix." A $200 billion House bill that passed last month would have tabled the issue for good, repealing the SGR and offsetting roughly a third of the cost by modestly trimming provider payments and increasing premiums on wealthy Medicare beneficiaries.

GOP passes bipartisan Medicare reform, still wants to repeal Obamacare 02:51

The Senate was expected to act on the measure before lawmakers left at the end of March, but a small core of conservative opposition forced GOP leaders to postpone a vote. The cuts to doctor payments technically went into effect on April 1, but the agency said it was permitted to withhold those payments for two weeks to allow Congress time to address the issue. Come Wednesday, though, Doctors will begin seeing a 21 percent reduction in their Medicare reimbursement checks, and the onus is on the Senate to prevent that.

Senate conservatives are pushing GOP leaders to fully offset the cost of the legislation, with some lawmakers demanding the removal of a "pay as you go" provision from the House version of the bill. That would require them to fully fund the measure, but it would allow them the remainder of the year to do so, and it would avert the looming pay cut for doctors in the meantime.

It's also possible senators could add do more to offset the cost of the package before voting on it, or they could pass another short-term "doc fix" and punt the fight over a comprehensive solution yet again.

GOP leaders have avoided tipping their hand on the way forward. They're expected to talk with their caucus about it at a policy lunch on Tuesday, and they could announce a timeline after that.

Debating the Iranian nuclear deal

On Tuesday, the Senate Foreign Relations Committee will vote on a bill inserting Congress into the delicate negotiations over Iran's nuclear program, which produced an interim agreement last week and face an end-of-June deadline for a final deal.

The bill would prevent Mr. Obama from lifting any sanctions on Iran, which the Iranians have demanded as a condition of limiting their nuclear energy program, until lawmakers have had 60 days to review the deal. They could vote to approve or disapprove of lifting the sanctions, and the president could veto any potential expression of disapproval.

Lawmakers want Congress to review any final Iran agreement 03:55

The White House has warned that any congressional action could jeopardize a deal, which they've framed as the best way to prevent Iran from acquiring a nuclear weapon. White House press secretary Josh Earnest said again Monday that the president would "absolutely" veto the bill in its current form. But given the likelihood that enough Democrats could sign onto a bill to override a veto - nine Democratic senators are currently listed as co-sponsors - supporters of a deal have also begun an effort to contain the bill's diplomatic damage by limiting its scope.

White House allies hope to use the amendment process to water down provisions limiting the president's ability to dissolve sanctions. And Democratic Sens. Chris Coons and Christopher Murphy are proposing to strip language linking the deal's approval to a determination that the Iranian government has ceased its sponsorship of terrorist activities.

Republicans, though, are hoping to give the bill more teeth, not fewer. Florida Sen. Marco Rubio, who declared his 2016 presidential bid Monday, is pushing an amendment tying approval of the deal to Iran's recognition of Israel's right to exist. And Georgia Sen. Johnny Isakson would like Iran to reimburse the victims of the 1979 hostage crisis at the U.S. Embassy in Tehran.

Given the uncertainty about the shape of a final bill - and how it might affect the ongoing negotiations - the White House has pushed lawmakers to wait and see the text of the agreement before voting on final passage of an oversight bill. Some Democrats who believe Congress should have a voice in the matter seem prepared to countenance a delay.

"I'm coming back firmly committed to a congressional role in this process," Connecticut Sen. Richard Blumenthal told the New York Times, "but feeling strongly about talking to colleagues about improvements and when in the next three months we really need to consider this."

Replacing "No Child Left Behind"

In stark contrast to the intense political fight over Iran in the Foreign Relations committee, a separate Senate panel - the Health, Education, Labor, and Pension Committee - is making steady, relatively quiet progress on a comprehensive update to the Elementary and Secondary Education Act.

The previous reauthorization, the No Child Left Behind Act, passed in 2001 but expired in 2007. That bill dramatically increased the federal government's role in education policy -- from student standards and testing, to teacher evaluations, to guidelines for turning around poorly-performing schools. Opponents - mostly Republicans but some Democratic groups as well - have cast it as a counterproductive federal overreach into education policy.

Parents debate Common Core in schools 02:38

A bill getting marked up on Tuesday, the product of negotiations between Sens. Patty Murray, D-Washington, and Lamar Alexander, D-Tennessee, would greatly scale back the federal government's ability to affect states' policies. It would allow states to decide whether to evaluate teacher performance and how it should be measured. It would require states to improve failing schools but provide them with more flexibility to do so than they enjoy under the current system, which spells out four prospective turnaround methods. It would extend the requirement for states to include student testing results in their accountability systems but allow each state to determine how much weight that testing should carry (other pertinent factors include graduation rates, workforce readiness, and English proficiency of non-native speakers.)

Perhaps most politically important is the bill's clarification that the federal government cannot interfere with each state's ability to set academic standards. That measure is intended to placate critics who say current law allows the federal government to promote "common core" standards by tying federal grant money to a state's adoption of those standards. The new law would urge states to develop "challenging" curriculum but forbid the federal government from making the adoption of federal-backed standards a precondition of financial support.

"Basically, our agreement continues important measurements of the academic progress of students but restores to states, local school districts, teachers, and parents the responsibility for deciding what to do about improving student achievement," Alexander, the committee's chairman, said in a statement.

Murray, the ranking Democrat on the panel and a member of her party's Senate leadership, added, "This agreement is a strong step in the right direction that helps students, educators, and schools, [and] gives states and districts more flexibility while maintaining strong federal guardrails."

Voting on Loretta Lynch's confirmation

Complicating all of the Senate's ongoing business is the poisonous partisanship surrounding the nomination of Loretta Lynch, currently the U.S. Attorney for the Eastern District of New York, as Attorney General. Mr. Obama put forth her nomination last November, and more than five months have passed since then, making Lynch the longest-stalled attorney general nominee since 1985.

Democrats are furious with Republicans over the delay, accusing them of stalling a qualified nominee for the sake of an unrelated effort to tighten restrictions on abortion funding. At issue is a bill to prevent human trafficking into which Republican leaders inserted language mirroring the "Hyde Amendment," which prevents federally appropriated funds from being used to finance abortion. Republicans have said the language is similar to language included in funding bills that regularly clear Congress, but Democrats say including it in the trafficking bill would further its influence because that bill does not require annual reauthorization.

Loretta Lynch's AG appointment blocked by politics 03:51

Republicans leaders have insisted the human trafficking bill be passed before Lynch's nomination comes up for a vote. They say it's the Democrats' obstinacy on abortion, while Democrats say it's the GOP's decision to shoehorn a divisive social fight into an unrelated, relatively anodyne bill - that's to blame for Lynch's long delay.

"I don't know why they've all of a sudden decided to draw the line in the sand on [abortion] and kind of make this the holy grail for Democrats," South Dakota Sen. John Thune, the third-in-command Senate Republican, told Politico. "Because it just doesn't seem to be, in the end, a position they can prevail on."

If and when senators can resolve their differences over abortion and the human trafficking bill, it appears they'll have just enough votes to approve Lynch's nomination. The chamber's 46 Democrats are expected to support her, and last week, Illinois Sen. Mark Kirk became the fifth Republican to say he'd vote to confirm Lynch. The others are Maine Sen. Susan Collins, South Carolina Sen. Lindsey Graham, Utah Sen. Orrin Hatch, and Arizona Sen. Jeff Flake.

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