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.


Congress Returns

The House returns this Tuesday to take up the resolution of disapproval of the President’s exercise of authority under the CBA to increase the federal debt limit by $1.2 trillion.  Although House Republicans are expected to vote to disapprove the increase, the move is expected to be approved by the Democrat majority in the Senate, thus allowing for an increase in the debt limit to $16.4 trillion.  Although this limit is not expected to be breached until 2013, an earlier breach could throw a monkey-wrench into the legislative proceedings intended to ease Congress into the election season this November. 
The Senate will return on January 23rd to a joint session of Congress the next day to hear the President deliver his State of the Union Address.  With congressional Republicans, as well as all Republican presidential candidates, intent on repealing the health reform law, the President can be expected to give a vigorous defense of the PPACA during his address. 
The President will have a new Chief of Staff to defend the law and to negotiate a deal with Congress to extend the payroll tax cut and Medicare physician payment fix before the temporary extension ends on January 29th.  Jack Lew, who headed OMB, will take over the COS duties as the conferees on H.R.3630, the Middle Class Tax Cut Act of 2011, begin their discussions this week.

Additional Brief Filed with Supreme Court on PPACA

Florida and 25 other stated filed another brief in their suit challenging the constitutionality of various aspects of the PPACA.  The latest brief urged the Supreme Court to declare the Act unconstitutional with respect to the Act’s Medicaid expansions.  Saying that the PPACA Medicaid provisions are coercive, the brief stated that the Act “threatens States with the loss of every single penny of federal funding” under Medicaid.  They asked the court to define the outer limit of federal spending powers which would amount to coercive and unconstitutional action regarding the shared federal/state funded Medicaid program.  In related news, a report issued by the RWJ Foundation and the Urban Institute said that, if the Supreme Court rules the PPACA individual mandate unconstitutional, the number of uninsured individuals would rise from 26 million to 42 million.

HHS "Guidance" on PPACA Essential Benefits Challenged

The guidance bulletin issued by HHS on PPACA mandated “essential health benefits” has become a political football.  A letter sent to HHS Secretary Kathleen Sebelius by the chairs of the three House committees of jurisdiction and Senators Orrin Hatch and Mike Enzi charge that the bulletin does not comply with regulatory requirements that a proposed rule be issued along with a cost benefit analysis of the “unfunded mandate” impact of the provision.  The authors asked HHS to provide a legal basis for issuing only a “bulletin” and for an analysis of the economic impact of the requirement.  Various patient advocacy groups have also expressed their displeasure with the way essential health benefits are defined by giving states leeway to make the final decisions on coverage.

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