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.


Remaining FY 2012 Appropriations to Hitch Ride on Omnibus

The Senate approved and sent to the President for enactment the first FY 2012 appropriations minibus legislation, H.R. 2112, which provides appropriations for the Agriculture/FDA, Commerce/Justice/Transportation and Housing/Urban Development agencies.  The bill also extends federal agency funding under the current CR from November 18 to December 16, thus setting up a pre-Christmas struggle to finish appropriations for the remaining agencies.  Before leaving for the Thanksgiving week, Senate Majority Leader Harry Reid also abandoned efforts to move a second minibus bill, H.R. 2354, which was structured around the FY 2012 Energy/Water appropriations bill.  With only a few weeks left in the legislative year, the “minibus” approach will have to yield to an omnibus appropriations measure to be taken up first in the House.  The House Appropriations Chairman, Harold Rogers, said he is determined to package the remaining nine appropriations bills, including Labor-HHS-Education, into one omnibus measure and avoid having to pass a continuing resolution.  In attempting to pass an omnibus bill, the House majority faces a challenge from their own Republican base, given that 101 Republicans voted against the minibus bill because of objections to higher levels of funding than they would like.

Will the Super Committee Fail?

Democrats on the Joint Select Committee on Deficit Reduction rejected a last-ditch “Plan B” Republican offer late last week, thus extending their discussions into this week and setting up a late Monday target to get any agreed upon proposal to CBO in time to meet the November 23rd deadline.  In general, the $643 billion Republican proposal would raise $229 billion in revenues and reduce spending by $316 billion without touching Medicare, Medicaid or Social Security.  The plan would not meet the minimum $1.2 trillion in deficit reduction over ten years which is required under the Budget Control Act (BCA) to avoid automatic $600 billion ten-year cuts in defense and non-defense spending, and a 2% cut in Medicare provider payments, beginning in 2013.  House Democrats and a bipartisan group of senators continue to urge the Super Committee to come up with a “big deal” of $3-4 trillion in deficit reduction.  However, with Republicans resisting more than $300 billion in revenue increases, such a big deal looks unlikely.  If the Super Committee fails to come up with “real cuts,” the automatic cuts in 2013 could still be mitigated in a number of ways.  Congress could: amend the BCA to avoid or reduce the automatic cuts (Senator McCain has threatened to move legislation to avoid the $600 billion in defense cuts); use accounting gimmicks to come up with the $1.2 trillion in deficit reduction (e.g. using up to $1 trillion in Iraq war savings; assuming the Bush tax cuts are extended to neutralize the CBO baseline; or using “dynamic” scoring from pro-growth tax reform); or direct committees of jurisdiction to come up with legislation to meet various revenue targets.  Failure of the committee could also have other election year consequences if the economy continues to struggle, because under this scenario the $2.1 trillion increase in the federal debt limit under the BCA could prove insufficient to avoid another vote on the debt limit next year.  On another note, House Majority Leader Eric Cantor said the House would act independently on legislation to avoid the 30% cut in Medicare physician payments scheduled to begin January 1st in the event that the Super Committee deadlocks.

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