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.


Two-Month Doc Fix Enacted as Part of Extenders Legislation

With the threatened shutdown of the federal government avoided with the House and Senate sending H.R. 2055, the “Megabus” FY 2012 appropriations bill, to the President for his signature, the House created another showdown over the payroll tax-cut extenders legislation.  By a 229-193 vote, the House passed a resolution disapproving the Senate version of H.R. 3630 and requested a conference with the Senate to reconcile the House and Senate payroll tax cut provisions.  House Speaker John Boehner wrote the President urging him to tell the Senate to reconcile the House and Senate bills after Senate Majority Leader Harry Reid said he would not appoint conferees or call Senators back to negotiate a full year extender package (including a two-year “doc fix”).  Having the upper hand and public sentiment, the President rejected the Speaker’s overtures and urged the House to pass the two-month Senate bill.  With little leverage to force the Senate into backing the House stance, Speaker Boehner announced Thursday night that the House had reached agreement with the Senate on a new bill which adopts the Senate’s two-month extension together with a technical fix to the payroll tax cut which saves businesses from impossible changes to their payroll systems.  On Friday both the House and Senate passed H.R. 3765, the Temporary Payroll Tax Cut Continuation Act of 2011, by unanimous consent and the President signed the $33 billion extender into law.  As part of the agreement, the Senate agreed to appoint conferees on the House-passed bill, H.R. 3630, as amended in the Senate.  Speaker Boehner appointed the following conferees:

  • Kevin Brady of Texas,
  • Dave Camp of Michigan,
  • Renee Ellmers of North Carolina, tNan Hayworth of New York,
  • Tom Price of Georgia,
  • Tom Reed of New York,
  • Fred Upton of Michigan and
  • Greg Walden of Oregon.

In addition to extending unemployment benefits and the 2% payroll tax cut until February 29, the new law keeps Medicare physician payments at current levels for the first two months of the year and provides additional “extenders” for several other health-related programs as shown in the Appendix.

The extension of current Medicare payment levels for physicians in January and February avoids the scheduled 27.4% cut at the beginning of the year, but only delays a heated House and Senate debate over another extension for one or two years. The $202 billion House-passed version of H.R.3630, the Middle Class Tax Cut Act of 2011, would increase Medicare payments for physicians by 1% in 2012 and 2013 at a cost of about $39 billion, but result in a scheduled 37% cut in 2014. The resolution of the payroll tax cut package did not settle all disputes in the Senate, however. Senate Minority Leader Mitch McConnell objected to ending the first session of this Congress to thwart the President’s “recess appointment” of various agency officials. Thus, the Senate will not formally recess until the fourth Monday in January.

Supreme Court Sets Spring Schedule for Arguments on PPACA

The U.S. Supreme Court announced that it will hear five and one-half hours of arguments on the PPACA on March 26-28 as follows: one hour on March 26 to hear arguments on whether the anti-injunction act (AIA) effectively blocks a commerce clause challenge to the PPACA individual mandate (HHS v. Florida, U.S., No. 11-398, review granted 11/14/11) before the 2014 effective date;  two hours on March 27 to hear arguments only on the constitutionality of the individual mandate; and two and one-half hours on March 28 to hear arguments over the severability of the individual mandate from the rest of the PPACA (National Federation of Independent Business v. Sebelius, U.S., No. 11-393, review granted 11/14/11) and the constitutionality of the PPACA Medicaid expansion (Florida v. HHS, U.S., No. 11-400, review granted 11/14/11).

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