{"id":2533,"date":"2017-03-13T13:00:48","date_gmt":"2017-03-13T13:00:48","guid":{"rendered":"https:\/\/thornrun.com\/health-policy-report-81\/"},"modified":"2017-03-13T13:00:48","modified_gmt":"2017-03-13T13:00:48","slug":"health-policy-report-81","status":"publish","type":"post","link":"https:\/\/thornrun.com\/health-policy-report-81\/","title":{"rendered":"Health Policy Report"},"content":{"rendered":"

\nThe Week in Review<\/strong>\n<\/p>\n

\nIt was a monumental week in health policy as Republicans went to work advocating for their plan to repeal and replace the Affordable Care Act (ACA), dubbed the American Health Care Act (AHCA). The House Ways & Means and Energy & Commerce Committees held marathon markups for their respective portions of the bill last week over the objections of Democrats, who delayed the process as much as possible through parliamentary procedure. The details of the plan, the list of its supporters and detractors, and its path forward in both chambers is included in our roundup below. Expect the AHCA to control much of the legislative oxygen in the weeks to come.\n<\/p>\n

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\nOn the floor last week, the House moved on from its regulatory disapproval work to pass a defense appropriations bill and three tort reform measures. The defense bill (H.R. 1301<\/a>), which passed on a largely bipartisan 371-48 vote, would provide $583.7 billion in annualized funding for the fiscal 2017 year. The tort reform bills passed along more partisan lines and would specifically: (1) require federal courts to impose penalties on parties that file frivolous claims and repeal a safe-harbor provision that allows such parties to avoid penalties if they withdraw the suit (H.R. 720<\/a>); (2) allow class action lawsuits to move forward only if all potential members in a class action have suffered similar injuries (H.R. 985<\/a>); and (3) require additional in-state plaintiffs to show a plausible case in order to keep the matter in state courts (H.R. 725<\/a>).  \n<\/p>\n

\nMeanwhile, the Senate had a quiet week moving through House-passed disapproval resolutions including one (H.J. Res. 37<\/a>) that would rescind a joint rule published by the Department of Defense, General Services Administration, and National Aeronautics and Space Administration (NASA) requiring federal contractors to keep detailed information on their past labor violations. Two other resolutions cleared the way to roll back Education Department rules designed to increase teacher accountability (H.J. Res. 57<\/a>) and improve teacher training programs (H.J. Res. 58<\/a>).\n<\/p>\n

\nThe Week Ahead<\/strong>\n<\/p>\n

\nThe release of two separate documents – a Congressional Budget Office (CBO) score for the Republican health care plan and President Trump’s budget proposal for fiscal 2018 – will drive conversation in Congress this week far more than any of the measures on the chamber floors. The first document is sure to add a wrinkle to the debate over the Republican health care proposal after the House Committees with jurisdiction approved the bill last week before the non-partisan CBO could release its analysis.\n<\/p>\n

\nHealth and Human Services Secretary Tom Price appeared on talk shows Sunday morning to defend the AHCA, saying that “the plan that we've laid out here will not leave that number of individuals uncovered. In fact I believe, again, that we'll have more individuals covered.” Analysts are expecting the CBO score to project significant coverage losses – the Brookings Institution estimated<\/a> a projection of at least 15 million people losing insurance – in its consideration of the bill’s overall impacts on the federal budget and national economy. The White House has already downplayed the CBO estimate, but an unfavorable score will undoubtedly provide additional ammunition to the bill’s critics.\n<\/p>\n

\nThe FY18 budget could be released as soon as Wednesday as the White House finalizes its vision for a slimmer discretionary budget in all areas except for defense, which has been rumored to see a significant increase in funding. Among the offices facing the steepest cuts will be the State Department and the American foreign aid program, although Republicans in Congress have already expressed some skepticism of that plan. The President’s proposed budget kick-starts the appropriations process for the fiscal 2018 year, which will likely take considerable attention in both chambers of Congress later this spring and into the summer.  \n<\/p>\n

\nThe Senate will start its floor work today by finishing consideration of the nomination of health consulting executive Seema Verma to head the Centers for Medicare and Medicaid Services. A cloture vote on her nomination passed Thursday on a 54-44 vote, with vulnerable Democratic Sens. Joe Manchin (D-WV), Joe Donnelly (D-IN), and Heidi Heitkamp (D-ND) joining Republicans in approving the nomination. Watch for the upper chamber to also consider additional House-passed resolutions disapproving of Obama-era rules.\n<\/p>\n

\nIn the House, two veterans-related measures will hit the chamber floor. One measure (H.R. 1259<\/a>) would allow for the Department of Veterans’ Affairs (VA) to more easily fire or demote employees as part of Congress’ ongoing attention to the Department’s accountability. The other measure (H.R. 1367<\/a>) to be considered provides additional resources for the VA to attract, train, and retain qualified employees by establishing a healthcare and benefits fellowship program and creating a database of mission-critical vacant positions.\n<\/p>\n

\nHouse Republicans Release ACA Repeal Bill<\/strong>\n<\/p>\n

\nLast Monday, House Republicans released the text of the American Health Care Act (AHCA) – a 123-page bill to repeal and replace portions of the Affordable Care Act (ACA). The bill would replace the ACA's income-based premium tax credits with fixed, age-based tax credits that generally would be smaller. It would also reduce Medicaid spending by as much as $1 trillion over ten years according to initial projections by ending the enhanced federal funding for states to expand Medicaid to low-income adults and converting Medicaid from an open-ended entitlement to a program of capped, per-capita payments to the states. The bill would continue funding for the ACA’s Medicaid expansion until 2020, and also keep the law's premium subsidies through the insurance exchanges until 2020. The bill also omits a prior proposal to remove an existing tax exclusion for high-value employer health plans.\n<\/p>\n

\nAmong its key provisions, the bill would:\n<\/p>\n