Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


Talks Begin This Week on FY 2014-2023 Spending/Taxes

In an effort to file a conference report by December 13th, this week the House and Senate conferees on the fiscal years 2014-2023 Budget Resolution, H.Con.Res 25, are scheduled to begin their discussions over the level of federal spending and taxes needed to help contain and, perhaps, reduce federal deficits over ten years. Senate conferees, led by Senate Budget Committee Chairman Patty Murray (D-WA), are expected to push for a scale-back of spending cuts mandated under the Budget Control Act (BCA) and obtaining a deficit-neutral effect by closing tax “loopholes”. House conferees, led by House Budget Committee Chairman Paul Ryan (R-WI), are expected to push for entitlement reforms (e.g. modifying Social Security cost-of-living-adjustments (COLAs); means-testing parts of Medicare and raising the eligibility age, etc.) and to resist tax increases. The opposing agendas of Democrats and Republicans may again lead to a last-minute deal which accomplishes little of either agenda. Changes to the Patient Protection and Affordable Care Act (PPACA) being pushed by Republicans, and a growing number of Democrats, that have a potential chance of being included in a conference agreement include a repeal of the medical device tax and a delay in the individual mandate or the related penalty for non-compliance. Although the House and Senate resolutions both contain deficit-neutral reserve funds for reforming the Medicare physician payment system that relies on the much-criticized sustainable growth rate (SGR), to include such long-term reforms the conferees will have to agree on spending cuts/revenue-increases to offset the $175.5 billion ten-year cost contained in the latest Congressional Budget Office (CBO) projections. The conferees could expedite their agreement by pursuing the reconciliation route which would require only a majority vote in each chamber for passage.

HHS Secretary Under Fire for ACA Glitches

Flanked by individuals who will benefit from Obamacare, the President said in a White House Rose Garden ceremony that the PPACA website glitches will be fixed, that the “product is working. It’s really good….”, and that there is massive demand for it. Nonetheless, Rep. John Fleming (R-LA) and 31 other House Republicans sent a letter to the President that asks for the resignation of Department of Health and Human Services (HHS) Secretary Kathleen Sebelius due to the many failures of the HealthCare.gov website to operate successfully in enrolling potential individuals and small businesses. The Secretary will have her “day in court” this Wednesday when she is scheduled to testify before the House Energy and Commerce Committee. Despite the problems disclosed in the hearings held last week by the same committee, the Centers for Medicare and Medicaid Services (CMS) said that about 700,000 individuals have completed the application process for enrollment under the federal and state-run health insurance exchanges. The technical problems with the exchanges, including the inability of the entities to properly transfer personal and coverage information to health insurers, led senior Administration officials to meet with insurer CEOs at the White House to hash out the situation and discuss the efforts underway to address the problems. In this connection, the White House announced that Jeffrey Zients, a former acting director of the Office of Management and Budget (OMB), will take charge of the efforts to fix the exchange problems. He said that a contractor has been assigned to make the necessary changes and that the website is expected to be fully functional by the end of November. The House Speaker, John Boehner (R-OH), got into the fray in stating that the website glitches are only part of the problem with the health law and that hundreds of thousands of individuals have been notified that their current health coverage is being dropped by their insurer (defying the President’s earlier promise that people will not lose the coverage in which they are currently enrolled).

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