Senators will look to clinch their first spending package of fiscal year (FY) 2020, voting on final passage of a four-bill minibus containing FY 2020 spending bills for Agriculture, Interior-Environment, Commerce-Science-Justice, and Transportation-HUD. Following passage of the first minibus, the upper chamber will take a procedural vote on a second spending package. The second minibus —which includes the Senate’s spending bills for Defense and Labor-HHS-Education — is unlikely to advance due to opposition by Senate Democrats over “poison pill” issues such as border security and family planning.
Senate Democrats are set to force a vote on a measure they contend is a referendum on GOP support for pre-existing conditions protections. The Congressional Review Act resolution would overturn the Trump administration’s guidance on “State Relief and Empowerment Waivers” under section 1332 of the Affordable Care Act (ACA) — a policy that Democrats argue undermines access to care for patients with pre-existing conditions. While the resolution only needs a simple majority to pass, it is unlikely to clear the upper chamber absent support from GOP Senators.
A recent article from Skilled Nursing News covered TRP’s Senior Vice President Andrea Maresca’s presentation on Medicaid issues at the American Health Care Association convention earlier this month. During the presentation, Maresca pointed out that the federal government is starting to take a closer look at supplemental programs that offset low reimbursement from Medicaid in skilled nursing facilities (SNF) – a concern that has come from the Center for Medicare & Medicaid Services (CMS) and several other governmental agencies. She astutely noted that these concerns are pushing the agency to develop regulations that boost transparency and provide clear rules of the road for the functionality of supplemental payment programs, saying that the agency can’t effectively evaluate SNFs under the current statutes. “All of this is driving work in the agency to come up with a regulation that will put more parameters about how supplemental payment programs would work in the future,” said Maresca. “The agency is also concerned about the lack of a clear link between how payments are made to providers, and whether these are made based on services delivered or somehow tied to quality and outcomes.”
Senators are continuing work on a four-bill minibus containing fiscal year (FY) 2020 spending bills for Agriculture, Interior-Environment, Commerce-Science-Justice, and Transportation-HUD. After adopting an amendment that would designate $5 million of the Agriculture Department's appropriated funds to be used for a loan program to help farmers resolve land ownership issues, Senate Majority Leader Mitch McConnell (R-KY) filed cloture to end debate on the spending package late yesterday. A final vote on the measure is expected on Wednesday or Thursday of this week.
In a recent article for Inside Health Policy, TRP’s Senior Vice President Shea McCarthy was quoted discussing the ideological split between lawmakers on fixes to the Affordable Care Act (ACA). As the article highlights the tensions over state reinsurance waivers, McCarthy noted that these these statewide debates are reflective of the “philosophical dissonance” between the Trump administration and Congressional Democrats on health care policy. “While Democrats have spent their energy talking about increasing coverage and consumer protections, CMS is hammering home a message about cost,” said McCarthy. “The debate over 1332 waivers may be reflective of this tension, but it’s also indicative of where they stand in the broader health policy discussion on everything from Medicare for All to reforming the Medicaid program.”
Thorn Run Partners’ Senior Vice President Shea McCarthy provided an overview of the Congress’s work to balance competing drug pricing priorities in a recent article for Inside Drug Pricing. As Congressional lawmakers walk this policy tightrope, McCarthy acutely pointed out that there’s an overarching desire among stakeholders to help consumers at the pharmacy counter while mitigating potential disruptions to research and development. “It makes sense that there appears to be growing interest in reforms that would remove some burden from patients without posing a threat to innovation,” McCarthy stated.
In today’s Politico Morning Money newsletter — the leading Financial Services beat in Washington, D.C. — TRP’s Jason Rosenstock was mentioned discussing Senator Elizabeth Warren’s (D-MA) rise in the race for the 2020 Democratic Presidential nomination. First published in TRP’s weekly Financial Services Report, Rosenstock’s quote astutely compares the anti-Wall Street sentiments that form the backbone of Sen. Warren’s campaign to the populist wave that elected President Donald Trump in 2016. “The rise of Warren shouldn’t surprise people as she is simply feeding on the same emotions that Trump tapped into to win four years ago,” said Rosenstock. “Whereas he used fear of immigrants and global supply chains, Warren focuses on corporate executives and lobbyists, who she claims have rigged the system in their favor."
House and Senate lawmakers will reconvene later today to close out the October legislative session. In the upper chamber, Senators will pick up debate on their first fiscal year (FY) 2020 appropriations package, starting with consideration of three amendments to the underlying bill. While the Senate had originally planned to take up a second minibus containing funding for Defense and the opioid crisis, partisan disagreements over President Donald Trump’s border security policies will likely sidetrack consideration of the measure until November. Barring any procedural or political hiccups, the first minibus is expected to pass later this week prior to the next district work period.
The Week in Review
Senators began full consideration of a four-bill spending package last week as the upper chamber looks to jumpstart its fiscal year (FY) 2020 appropriations process. The first Senate “minibus” includes spending measures for Agriculture, Commerce-Justice-Science, Interior-Environment, and Transportation-HUD, all of which were approved by the Appropriations Committee on a bipartisan basis. While Democrats plan to support the first package, Minority Leader Chuck Schumer (D-NY) noted that Democrats still hold reservations about other bills — specifically the spending measures for Defense, Military Construction-VA, Homeland Security, and Labor-HHS-Education — due to disagreements over “poison pill” issues such as border security and family planning.