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.


House Actions on CLASS Act Repeal and Doc Fix

sday to take up the vote on H.R. 1173, legislation that would repeal the PPACA Community Living Assistance Services and Supports program.  Because HHS has suspended the program’s implementation, the $2 billion in CBO projected savings under Medicaid will not be realized and the supposed budget neutrality of the PPACA has already been breached.  Nonetheless, the Democrat leadership in the House, who said a replacement should be substituted for the current law, is expected to oppose the legislation.  Rep. Charles Boustany, who introduced the legislation, said he is developing legislation to replace the CLASS Act.  While the Senate is unlikely to act on this repeal bill, both the Senate and the House are focusing on how to extend the doc fix, payroll tax cut and unemployment benefits beyond the end of February when the current law expires.  The conference committee on H.R. 3630, the Middle Class Tax Cut Act of 2011, met last week for opening statements only.  The next meeting is scheduled for this Wednesday.  Conference Chairman Rep. Dave Camp said that the committee should consider an extension of the Medicare physician payment fix for one, two or more years.  Rep. Chris Van Hollen said the fix should be for not less than to the end of the year.  The trick is for the committee to find the funding for the extension with some members suggesting that savings from the drawdown of the Iraq and Afghanistan wars be used to come up with a permanent solution.  This course may not be the one taken given the President’s statement in his SOTU address that war savings be used instead to pay down the debt and fund road and construction projects.

President's SOTUA Falls Short on FY 2013 Health Issues

The President gave little hint in his State of the Union address as to how his FY 2013 budget will address rising federal health costs other than to say that he is “prepared to make more reforms that rein in the long-term costs of Medicare and Medicaid, and strengthen Social Security, so long as those programs remain a guarantee of security for seniors.  But in return, we need to change our tax code so that people like me, and an awful lot of members of Congress, pay our fair share of taxes.”  He appeared to support federal medical funding by calling for continued investment in medical research that “could lead to new treatments that kill cancer cells but leave healthy ones untouched” and questioning whether tax cuts for high-income earners should be extended “Or do we want to keep investments in everything else -- like education and medical research; a strong military and care for our veterans?”
The PPACA was only alluded to indirectly in the President’s demand for increased economic “fairness” and his statement that he will not go back to the days when health insurance companies had unchecked power to cancel policies, deny coverage and charge different premiums for men and women.  House Speaker John Boehner, however, said that the PPACA is “driving up premiums and jeopardizing coverage for millions of Americans.  President Obama promised he would make our economy stronger, but policies like ObamaCare have made it worse….”
Whatever the President’s budget, to be released February 13th, does to address Medicare and other health spending, House Republican Budget Committee Chairman Paul Ryan said his conference will not back away from proposing long-term Medicare reforms in his committee’s FY 2013 budget which will be fashioned in early March after the CBO provides the committee with their ten-year baseline.  House Republicans are also going on the offensive by pushing budget legislation that would: turn annual budget resolutions into legislation that could be signed into law (H.R. 3575); keep CBO from incorporating inflation increases into its projected spending baselines (H.R. 3578); change budget accounting to include some liabilities that are currently off budget (H.R. 3581); and require CBO to take into account the effect that bills might have on economic growth through so-called “dynamic scoring” (H.R. 3582).  Such measures have little chance in the Senate which has limited the discussion of budget reform to steps to achieve two-year budgeting and changes to the Senate’s rules in considering budget-related legislation.  The budget is likely to include provision for the reauthorization of the FDA’s review of drug and medical devices, given House Energy and Commerce Health Subcommittee Chairman Joe Pitt’s comments that he hopes to mark up the reauthorization bills in April to enable quick House consideration and enactment by the end of June.

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