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.


House Speaker Boehner Says Time for "Large" Talks on Debt Limit Deal

Demonstrating House Republican resolve that spending reductions must accompany any increase in the federal debt limit ceiling, last week the House voted 97-318  to reject a straightforward debt increase bill without cuts to spending and entitlements.  After meetings with the White House, Speaker John Boehner said it is time, in the next few weeks, for the President and top House and Senate leaders to forge an agreement to raise the debt ceiling with commensurate spending reductions.  He said the “small ball” Biden talks are moving too slowly. 

Apparently the Speaker and the President agree that the world markets could be disrupted if a vote is delayed until the August 2nd deadline pronounced by Treasury Secretary Geithner.  The urgency of a vote was underlined when Moody’s Investors Service issued a warning that it would downgrade its rating of United States debt if the nation defaults and still might downgrade the “outlook” for the nation’s credit rating absent a credible long-term deficit reduction plan. 

It is estimated that a target of $2 trillion in spending cuts and a debt ceiling increase of equal magnitude could move the next required vote on the debt ceiling until after the 2012 elections.  At this level, a complete overhaul of Medicare, along the lines of the Ryan “premium support” plan, may not be necessary which could let House Republicans off the hook on having to explain in 2012 a difficult vote on Medicare.  However, many new House Republicans may still insist that a longer-term deficit reduction plan be scheduled which would include Medicare and other major entitlement spending reforms but with no increase in income tax rates.

House Move Appropriations Bills Forward
Before recessing for this week, the House Appropriations Committee approved the FY 2012 Agriculture spending bill with $2.1 billion for the FDA (an 11.5% cut from FY 2011) and the Defense Subcommittee approved the Defense bill which includes $74 billion in health related spending.  A Rehberg amendment adopted by the full committee requiring the Secretary of Agriculture to justify FDA rulemaking was criticized by Democrats as weakening FDA’s authority to keep drugs safe. The House also began debate on the Military Construction/Veterans appropriations measure, H.R. 2055, which would give the VA $39.6 billion to carry out its health program duties.  The most contentious cuts are left for the LHHS appropriations bill, to be taken up just before the Labor Day recess, with spending allocations of $139.2 billion (12% less than for FY 2011 and 23% less than requested by the President).

CLASS Act Regulations

Rebutting earlier concerns that the PPACA long-term care CLASS Act program might be in jeopardy or curtailed, HHS testified at a Senate hearing that the agency will propose regulations in October to implement the program.  To make the program more viable, HHS is considering whether to increase the minimum earning requirement for beneficiaries, index premiums for inflation and strengthen anti-fraud protections.  HHS also supported an update of the Older Americans Act to include evidence-based interventions to improve the health of beneficiaries with chronic illnesses; give the Administration on Agency control of the Senior Community Service Employment Program; and provide permanent legal authority for the anti-fraud Senior Medicare Patrol Program.

Update on PPACA Constitutional Challenge

The Department of Justice has filed a motion to dismiss the Thomas More Law Center suit challenging the PPACA individual mandate in the U.S. Court of Appeals for the Sixth Circuit.  DOJ argued that the case is moot, given that one of the individual plaintiffs already has health insurance and cannot, therefore, show economic injury resulting from the mandate.  Plaintiffs argued otherwise, stating that they would still be harmed from the anticipated increase in premiums required under the PPACA.

June 6, 2011: | Page 1 Page 2



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