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.


Republicans Ante Up in Partisan Budget Wars

Last week the Senate voted down motions to proceed on five different Republican budget resolutions.  The Senate voted 41-58 to reject a budget proposal based on the House-passed Ryan plan; 0-99 to reject a likeness of the President’s budget plan and rejected 42-57 a proposal by Senator Pat Toomey that he said would bring the federal budget into balance over eight years through a combination of tax policy changes and reductions in both mandatory and non-defense discretionary spending.  

Also rejected were FY 2013 budget proposals by Senator Rand Paul that would allow $3.084 trillion in new budget authority and Senator Mike Lee that would allow $2.225 trillion in BA for the year.  

Senate Budget Chairman Kent Conrad signaled that his committee has already proceeded to set FY 2013 budget priorities within the confines of the Budget Control Act and that Senate appropriators will abide with the committee allocations accordingly.  

House Speaker John Boehner also raised the stakes for FY 2013 spending, January BCA sequestration and ending the so-called Bush tax cuts by saying he will insist on increasing the debt limit above $16.7 trillion only to the extent of enacted spending cuts.  He indicated that, if the parties cannot begin negotiations soon, he would have to resort to a number of stop-gap measures to keep the government going.  

With Democrats and Republicans at a stalemate on budget matters, the Speaker’s comments may indicate that major budget and tax negotiations will proceed only after the election and, perhaps, be resolved only later in 2013 when the political landscape is clear.  In this regard, House Democrats, including Reps. James Clyburn and Chris Van Hollen, indicated they might support a one-year delay in BCA sequestration.

Guidance on PPACA Exchanges

HHS released a draft blueprint that states must submit by November 16th if they wish to operate their own health insurance exchanges beginning in 2014.  HHS also issued guidance stating that the agency will use an “open market model” to certify health plans that meet certain required standards in the first year they operate in exchange markets in states that do not set up their own health insurance exchanges.  If states do not intend to operate their own exchanges in 2014, HHS encouraged such states to enter into “partnership agreements” with HHS to provide assistance such as plan management and in-person consumer assistance.  To date, 49 states and DC have accepted PPACA grants to help plan for their health insurance exchanges.

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