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.


Appropriators to Congress: "Take it or Leave it"

The House of Representatives returns this Tuesday and the Senate on Monday with appropriations committee chairs and their ranking members expected to hash out final decisions on how to allocate $1.012 trillion in fiscal year (FY) 2014 spending among the 12 subcommittee discretionary spending programs. To date, the preliminary spending decisions have been held close to the vest and budget hawks are wary that the House will take the lead in rushing an omnibus bill to the House floor without giving members on either side a chance to amend the legislation. Congressional leaders are hoping to have the House clear the omnibus by Friday, January 10th with the Senate following suit by Monday, January 13th in order to meet the January 15th deadline when the current continuing resolution (CR) expires. Also, on Wednesday the House will bring up under “suspension of the rules” the bill H.R. 3527, the Poison Center Network Act, and on Thursday the “Health Exchange Security and Transparency Act of 2014” which Majority Leader Eric Cantor (R-VA) says is designed to help address the security problems connected with the ObamaCare website and alert individuals when their personal information is compromised. House Minority Leader Nancy Pelosi’s (D-CA) office said that Republicans remain intent on undermining the Patient Protection and Affordable Care Act (PPACA) and that the latest effort is an attempt to scare constituents away from accessing the website. Nonetheless, the Majority Leader’s office indicated that the House will soon take up additional legislation to elicit the disclosure of reliable and complete enrollment data.rm.

HealthCare.gov Double Enrollment or Double Trouble?

The Centers for Medicare and Medicaid Services (CMS) said that private health coverage enrollment under ObamaCare doubled to 2.1 million and that another 3.9 million were declared eligible for Medicaid or the Children’s Health Insurance Program (CHIP) through November, thus equaling or exceeding the number of individuals who lost coverage through health insurance policy cancellations. Nonetheless, CMS has yet to disclose the distribution of enrollees among the “old and sick” and “the young and healthy” which will determine the success or failure of the law to make health insurance “more affordable” as promised. Also, it was reported that health insurers continue to have problems with the enrollment information forwarded through the website. Individuals accessing the website who were determined to be eligible for Medicaid were reported to also be having trouble actually obtaining coverage, thus the federal government has begun making “robocalls” to such individuals asking them to reapply. Republicans continue their efforts to point out the flaws with the law and promote legislation (see above House schedule) and to even challenge the law in court. As to the latter, Senator Ron Johnson (R-WI) is apparently going the court route in an attempt to overturn the regulation finalized by the Office of Personnel Management (OPM) which would allow congressional staff to continue receiving federal contributions toward their health insurance, despite the rule which would require designated staff to obtain their coverage under the District of Columbia’s or other ObamaCare exchanges. The Republican state attorneys general in eleven states also sent a letter to the U.S. Department of Health and Human Servicces (HHS) objecting to the proposed PPACA rule that allows health insurers to continue offering health plans that the companies had previously cancelled. They said that they are concerned that the Administration is consistently rewriting rules and basing them on illegal executive actions. They also questioned the security of personal information and urged HHS to require navigators and other with such access to be trained and licensed in a manner similar to that required of state-licensed agents and brokers. Key HHS individuals responsible for the implementation of the HealthCare.gov website continue to exit the Administration, the latest being the CMS Chief Operating Officer Michelle Snyder.

January 6, 2014: | Page 1 Page 2



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