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.


No Deal on Big Deal

President Obama’s proposal that congressional leaders focus on a long-term spending/revenue and debt ceiling increase agreement, including major Medicare/Medicaid/Social-Security entitlement and tax reform, collapsed over the weekend.  In opposing Democrat demands for major revenue increases during the current economic malaise, Republican leaders reflected the will of their members who could not be counted on to help pass such a revenue-induced $4+ trillion deficit reduction plan.  Also, it would have been nearly impossible logistically for Congress to draft such legislation before the July 22nd date which Speaker John Boehner says is the timetable required to meet the August 2nd enactment of legislation to raise the federal debt ceiling limit.  The fallback options are for the major parties to reach agreement on a $2+ trillion deficit reduction package to carry over until after next year’s elections or for the House to pass an even smaller debt ceiling increase with spending reductions of an equal amount.  This latter move would put the Senate in a position of “take it” or “let the market’s collapse.”  If a smaller package extends the debt limit only into 2012, it would leave both parties in the same position they are in today, but with election year politics making the next vote even more contentious.  In either case, it is inevitable that federal health spending programs will be targeted for significant reductions.  Senate Finance Committee Chairman Max Baucus said that one item “on the table” is an effort to save up to $100 billion over ten years by “blending” the separate federal matching rates provided to states under the Medicaid and SCHIP programs.  The spending/debt negotiations have also caused House Ways and Means Committee Chairman Dave Camp to back off an earlier agreement to include Trade Adjustment Assistance help to displaced workers as part of the trade legislation opening up markets in South Korea, Panama and Columbia.

Appropriations Matters
Last Friday the House passed H.R. 2219, the FY 2012 Defense Appropriations Act containing billions in health care and health research spending, on a 336 - 87 vote.  The legislation includes $32.3 billion for Defense Department health programs and medical research projects. With the President, House Speaker, House Minority Leader and Senate Majority and Minority Leaders attempting to regroup and fashion a more limited spending/revenue deal, the House Speaker has upped the ante by scheduling a vote in the House this week on a balanced-budget amendment to the Constitution.  A growing number of Senate and House Republicans are demanding that the constitutional amendment accompany any increase in the federal debt ceiling.  The Senate has yet to unveil a spending plan for FY 2012, although last week Senate Budget Committee Chairman Kent Conrad brought up his ten-year proposal for discussion with his Senate caucus.  Even in the absence of an FY 2012 plan, the Senate Appropriations Committee passed a $142 billion FY 2012 Military Construction/VA appropriations measure, including $52.5 billion in FY 2013 advance funding for veterans’ medical care.

Update on PPACA Constitutional Challenges

Last week the U.S. District Court for the Northern District of Ohio dismissed a second suit, U.S Citizens Association, challenging the constitutionality of the PPACA’s individual mandate, citing the earlier decision by the U.S. Court of Appeals for the Sixth Circuit which held that the mandate meets constitutional muster (Thomas More Law Center v. Obama 6th Cir., No. 10-2388, 6/29/11).  In another action attempting to show that Supreme Court Justice Elena Kagan should recuse herself from any future decision regarding the PPACA, the chairman of the House Judiciary Committee has requested documents from the Department of Justice showing the extent of her involvement in PPACA matters while she was solicitor general.

December 31, 1969: | Page 1 Page 2



 -  2019

 +  2018