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.


Appropriations Issues

It is anticipated that the House/Senate conference on H.R. 2112, the “minibus” FY 2012 appropriations bills for Agriculture/FDA, Commerce/Justice/Transportation and Housing/Urban Development, will be finalized in time for passage this week.  The bill appears to be the most likely vehicle for another CR to extend federal agency funding from November 18 into December.  The Senate also voted 81-14 to limit debate on H.R. 2354, the FY 2012 Energy/Water appropriations bill, which could serve as the vehicle for a second appropriations minibus if the Financial Services (H.R. 1573) and State/Foreign Operations (H.R. 1601) measures are added.  Debate on the Financial Services bill could become contentious given that it contains IRS funding for the implementation of the PPACA.  The Homeland Security and the Legislative Branch appropriations are possible additions to the second minibus in conference.

Super Committee Agreement in Doubt

As of this Monday the Joint Select Committee on Deficit Reduction has only 10 days to agree on a 10-year deficit reduction plan of at least $1.2 trillion, draft legislative language and obtain a CBO cost analysis to confirm the minimum target (to avoid across the board cuts of $600 billion from defense and non-defense spending accounts).  Proposed offers by Democrats and Republicans on the panel were rejected by each party last week.  The $2.3 trillion Democrat plan would raise about $1 trillion in taxes ($350 billion specified and $650 to be obtained from another special tax committee before 2013) and reduce the size of federal health programs: by cutting about $350 billion from Medicare, including $250 billion from providers and $100 billion by requiring beneficiaries to contribute more to the program and by cutting about $50 billion from Medicaid and the PPACA, including about $8 billion from preventive health programs.  The plan would seek to achieve about $5 billion in savings from durable medical equipment spending; $4 billion from DSH hospitals; $13 billion through a Medicaid “provider tax”; and $20 billion by increasing federal rebates from drug companies.  In addition, the plan would seek to fix the Medicare physician payment SGR problem and pay for the fix by means of savings from the overseas contingency operations (OCO) budget.  The $1.5 trillion Republican plan would raise about $300 billion in revenue and cut spending by about $1.2 trillion, including raising the Medicare eligibility age from 65 to 67.  In addition, Senator Pat Toomey said the Super Committee should consider a 10-year $1.2 trillion deficit reduction plan which would decrease spending by $700 billion and increase revenues by about $500 billion (by decreasing tax rates and eliminating certain deductions).  Adding to the pressure for an agreement among committee members, the President said he would veto any effort to mitigate the effect of the $1.2 trillion in mandated cuts to defense and non-defense accounts through sequestration.

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