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 Wars

Senate Democrats have yet to introduce their budget version of FY 2012 spending limits.  This did not stop Senate Majority Leader Harry Reid from forcing a vote to bring H.Con.Res. 34, the House-passed Ryan budget, to the Senate floor.  The maneuver failed on a 40-57 vote with Republican Senators Brown, Collins, Murkowski, Paul and Snowe joining 52 Democrats in rejecting the House changes to Medicare and other FY 2012 spending cuts.  Republicans countered with their own maneuver in an attempt to bring up a vote on President Obama’s FY 2012 budget proposal.  However, Democrats joined all Republicans in a 97-0 vote to reject the maneuver with Democrats stating the Obama spending blueprint now being used by Vice President Biden in his budget negotiations preempts the earlier proposal.  Senate Minority Leader Mitch McConnell said he still intends to insist that spending caps be placed on appropriations for FY 2012-2013 and on major reforms to Medicare and other health programs in order for him to support an increase in the $14.294 trillion federal debt ceiling.  House Speaker John Boehner also said he stands firm in his position that spending cuts should exceed the amount of any increase in the debt limit.  The office of Senator Reid commented that “Republicans are holding the United States’ credit hostage to ram through their plan to end Medicare.  They are now saying they won’t accept any plan to reduce the deficit unless it also cuts Medicare.  Voters have resoundingly rejected this ideological agenda.  Republicans should drop it and move on.”  Taking up this cudgel, the House has scheduled a vote this week to increase the debt ceiling limit, H.R. 1954, but without any spending caps or changes to Medicare and other federal health programs.  The move is designed to fail, thus showing the need in the House for stern measures to rail in Medicare spending and the growing federal debt.  The burden to reach a negotiated settlement on federal spending levels for the next few years thus falls on the budget summiteers led by Vice President Joe Biden.  The bipartisan leadership group is expected to continue their talks in an effort to reach agreement in time to meet the August 2nd deadline for a debt ceiling vote demanded by Treasury Secretary Timothy Geithner.  However, Senator McConnell and 16 other Republican senators sent a letter to the Treasury Secretary dressing him down for statements that could “sow the seeds of doubt in the market regarding the full faith and credit of the United States.”  Other Republicans are urging Secretary Geithner to prepare for a realignment of federal payment and spending priorities in the event the August deadline is breached.

Appropriations Matters
The House was able to proceed on the FY 2012 appropriations front given this body’s earlier adoption of the Ryan budget.  This week the Military Construction, Veterans Affairs and Related Agencies Appropriations Act of 2012 is expected to be called up in the House for a final vote.  Committee action on the Agriculture/FDA appropriations bill is also expected to be completed.  In other House action, the Defense authorization bill, H.R. 1540, was passed with numerous provisions affecting military-related health care and health research programs.  The House also passed H.R. 1216 on a 234-85 vote, PPACA-related legislation that would subject the mandatory funding for training at health centers to annual appropriations.  The PPACA provided $230 million to health centers to establish or expand primary care training programs for medical residents in FY 2011-2015.  The House also adopted an amendment that would prohibit health center funding from being used to provide abortions (with some exceptions) as well as training to doctors on how to provide abortions.

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