Hatch-Brady Proposal Introduced as Alternative Market Stabilization Plan
On October 24, Senate Finance chairman Orrin Hatch (R-UT) and House Ways and Means chair Kevin Brady (R-TX) proposed a bicameral agreement for ACA market stabilization. Similar to the Senate HELP Committee proposal released last week, Hatch-Brady includes two years of funding for the ACA’s cost-sharing subsidies. The Hatch-Brady plan would also waive the ACA’s individual mandate for five years. Further, employers would not be penalized through the employer mandate if coverage was not provided for the previous two years.
Both Senate proposals were introduced shortly after the White House announced that it will no longer make the ACA’s cost-sharing reduction payments. Eighteen Democratic state attorneys general sued to force the administration to keep making the payments until the courts can decide whether it is legal for the funds to be cut unilaterally. However, U.S. District Court Judge Vince Chhabria ruled this week that the administration does not have to continue making the payments.
For Republicans to pass one of these market stabilization bills, they would need to secure 60 votes in the Senate. As it stands, the Alexander-Murray bill appears to have 60 votes in the Senate, but the vote count on Hatch-Brady is unclear. The sticking point for Hatch-Brady would be that Democrats are expected to oppose any waiver of the individual mandate. Thus, it is likely that Republicans will either have to pass Alexander-Murray, with some minor modifications, or not pass anything at all.
Opioid Crisis Declared National Public Health Emergency
On October 26, President Trump officially declared the opioid epidemic a national public health emergency under federal law. The administration took action because drug overdoses are now the leading cause of death by injury in the United States, topping both traffic crashes and gun-related violence. The directive included action items, such as opioid training for prescribers and lifting a restriction in some states on inpatient treatment. However, there was no new funding announced to address the emergency.
The administration established the President’s Commission on Combating Drug Addiction and the Opioid Crisis in March of 2017. The Commission noted the fastest way to increase treatment would be to waive the prohibition on using Medicaid funds to pay for inpatient substance abuse treatment. The administration’s directive indicates it will follow the Committee’s recommendation by allowing many states to waive this prohibition. Additionally, the White House said it will extend the use of telemedicine to address the opioid epidemic by allowing for the remote prescribing of medicine used for the treatment of substance abuse and mental health.
Bipartisan Deal to Repeal Medicare Therapy Caps Announced
Republican and Democratic leadership on the House Ways and Means and the Energy and Commerce committees announced an agreement to permanently repeal the annual limit on per-patient therapy expenditures set by Medicare. According to information posted on the Ways and Means website, the policy intends to repeal the current therapy caps, continue to require an appropriate modifier on claims submitted over the new threshold and continue targeted medical review of claims established by the Medicare Access and CHIP Reauthorization Act.
Health-Related Legislation Introduced This Week
Rep. Pete Sessions (R-TX) introduced a bill (H.R. 4133) that would amend Title XVIII of the Social Security Act to establish a Medicare payment option for patients and eligible professionals to freely contract, without penalty, for Medicare fee-for-service, while allowing Medicare beneficiaries to use their Medicare benefits.
Rep. Gregg Harper (R-MS) introduced a bill that seeks to extend the additional temporary exception from the Medicare site-neutral inpatient payment rate to additional DRG codes for severe wound discharges from long-term care hospitals.
Rep. Jason Smith introduced a bill (H.R. 4136) to amend Title XVIII of the Social Security Act to strengthen intensive cardiac rehabilitation programs under the Medicare program.
Next Week in Washington
The House and Senate return Monday for a full legislative week. The House will take up legislation to extend federal funding for the Children’s Health Insurance Program (“CHIP”), which expired at the end of September. Earlier this month, the House Energy and Commerce Committee advanced H.R. 3921 to fund CHIP for five years, as well as continue funding for community health centers for two years.
The House will also vote on legislation (H.R. 849) to repeal the ACA’s Independent Payment Advisory Board.
This Week in Washington in History
79 years ago this week, 1938: The Fair Labor Standards Act becomes law, establishing the 40-hour work week. Sen. Hugo Black (D-AL) had originally pushed a 30-hour work week bill, but it met stiff resistance in the House.
63 years ago this week, 1954: President Dwight Eisenhower conducts the first televised Cabinet meeting. Secretary of State John Foster Dulles would brief the cabinet on his recent travels to Europe.
16 years ago this week, 2001: The USA PATRIOT Act is signed into law by President George W. Bush, greatly expanding intelligence and legal agencies’ ability to utilize wiretaps, records searches and surveillance.
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