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.


Budget Issues: House Passes Resolution of Disapproval on Extending Debt Ceiling

An element of the Continuing Appropriations Act for fiscal year (FY) 2014 allowed for Congress to take up a resolution disapproving of the debt limit extension until February 7, 2014 as enacted in the CR. Last week the House passed the resolution of disapproval, H.J.Res. 99, on a vote of 222 to 191. The vote is of no legislative consequence because the Senate is not expected to pass a similar measure (the President would veto the resolution, even if it were to pass). Conferees on the budget bill also met this week to scope out their priorities. If an agreement is to be reached on a short-term spending cap for the remainder of this fiscal year, the House would have to agree to a cap exceeding the FY 2013 $986 billion level extended until January 15th and the Senate would have to come down from that chamber’s $1.058 billion demand. The hope for an amelioration of sequestration, expressed by House Appropriations Chairman Hal Rogers (R-KY) and Senate budget conferees, particularly for the Department of Defense (DOD), may help drive a conference agreement before the December 13th deadline. However, in their opening statements the conferees expressed their desires for longer-term deficit reduction goals. Rep. Tom Cole (R-OK) expressed Republican leadership views that the conferees could shift sequester savings from the discretionary side of the budget to the non-discretionary side (with House Budget Committee Chairman Paul Ryan (R-WI) previously outlining Medicare reforms as a centerpiece of entitlement reform). However, Senator Jeff Sessions (R-AL) said he opposes using savings from Social Security and Medicare reform to finance new federal spending. Also, Rep. Ryan has ruled out tax rate increases, thus setting up a confrontation with Senate Budget Committee Chair, Patty Murray (D-WA), who said revenue increases would have to be part of any agreement. Although Senate Finance Committee Chairman Max Baucus (D-MT) said there will not be a markup of tax reform in his committee this year, Senator Rob Portman (R-OH) expressed support for including instructions for tax reform framework in the agreement. To expedite the agreement, Rep. Hal Rogers expressed hope that all twelve appropriations bills for FY 2014 would be wrapped up into an omnibus measure. Budget negotiations may continue this week, although the House recessed until November 12th.

Senate HELP Committee Approves GME Funding and Older Americans Act

The Senate Health, Education, Labor and Pensions (HELP) Committee unanimously approved S. 1557, the Children’s Hospital GME Support Reauthorization Act of 2013, which would reauthorize graduate medical education (GME) funding up to $300 million annually over five years. The Committee also reported out a reauthorization of the Older Americans Act, bipartisan legislation first passed more than 40 years ago in 1965 for the delivery of nutrition and social services for seniors.

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