Congress Returns for Fall Work Period
Congress returned to Washington this week after their longest break of the calendar year. The Senate reengaged on the issue of ACA repeal and began hearings on a legislative package to stabilize the ACA marketplace.
On September 6-7, the Senate HELP Committee held hearings with state insurance commissioners and five governors in an effort to develop an ACA stabilization package. HELP Chairman Lamar Alexander (R-TN) expressed the stabilization reform package could be the first bipartisan ACA legislation since the ACA was signed into law. Actions to help with stabilization include a combination of continuing cost sharing and changes to the ACA to increase flexibility for states through 1332 waivers.
Ranking Democrat Patty Murray applauded a separate plan from Gov. John Hickenlooper (D-CO) with Gov. John Kasich (R-OH) that gives greater state authority under 1332 waivers and includes cost-sharing reduction payments and $30 billion in state stability funding accompanied by light regulatory reform and policy fixes. While the governors’ plan has not received any official endorsement from either party, Murray said that she hopes their plan would serve to guide Congress’ action on health care.
The committee also discussed a health reform plan from Sens. Bill Cassidy (R-LA) and Lindsey Graham (R-SC). The Graham-Cassidy proposal would re-allocate all the ACA’s mandated spending through block grants that would not grow with enrollment numbers. The proposal represents the Senate’s last chance to repeal parts of the ACA through the reconciliation process.
Reconciliation of the competing health care proposals will have to happen in the next three weeks because the deadline to fast-track a repeal bill in the Senate is September 30.
Senate Committee Advances HHS Spending Bill
On September 7, the Senate Appropriations Committee voted to advance the FY 2018 Labor, HHS, Education (“Labor-HHS”) Appropriations Bill. The bill includes $79.4 billion in discretionary funding for HHS, a $1.7 billion increase above FY 2017.
The Senate committee increased funding for the Children’s Hospitals Graduate Medical Education (“CHGME”) program by $5 million above FY 2017. The CHGME program protects children’s access to care by providing freestanding children’s hospitals with funding to support the training of pediatric providers. The bill also provides a $4.5 million increase for rural health programs.
The bill provides a $10 million increase for the Office of Medicare Hearings and Appeals. The funding increase is intended to reduce the current backlog of over 600,000 cases. The Senate bill does not provide any new funding for the ACA and eliminates funding for the Independent Payment Advisory Board.
FY 2017 funding expires on October 1, 2017. With Congress and the White House agreeing to terms on a three-month continuing resolution (“CR”), FY 2017 funding will remain in effect until December 8, 2017. The CR provides the Senate roughly 40 legislative days to pass the Labor-HHS bill and reconcile any differences with the House-passed bill.
Health-Related Bills Introduced This Week
Sen. Susan Collins (R-ME) introduced a bill (S. 1782) to amend the Internal Revenue Code of 1986 to modify the definition of full-time employee for purposes of the employer mandate in the ACA.
Next Week in Washington
The House and Senate return Monday, September 11 for a full legislative week. The Senate HELP Committee will hold two hearings next week dealing with ACA market stabilization. The hearings will feature witnesses representing hospitals, health organizations and patient advocates from across the country. Also next week, the House Energy and Commerce Committee will hold an oversight hearing focused on health programs under the Public Health Service Act. On Tuesday of next week, former Acting Administrator at CMS Andy Slavitt will testify before the Senate Finance Committee on issues impacting cost and coverage in health care.
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