Health Policy Update 1-9-17


What’s Ahead: This Week

Notable Policy Events

  • Monday, January 9
    • National Press Club, “Luncheon with Health and Human Services Secretary Sylvia Burwell.” Additional information: http://bit.ly/2iUF7oB
  • Tuesday, January 10
    • HHS Office of the National Coordinator of Health IT (ONC), “Privacy Policy Snapshot Challenge Webinar,” Additional information: http://bit.ly/2hY21wX
    • Center for Medicare & Medicaid Innovation (CMMI), “Webinar, Beneficiary Engagement and Incentives: Shared Decision Making (SDM) Model – Overview and Letter of Intent Process.” Additional information: http://bit.ly/2iVUmO7
  • Thursday, January 12
    • CMMI, “Webinar, Beneficiary Engagement and Incentives: Direct Decision Support (DDS) Model – Overview and Letter of Intent Process.” Additional information: http://bit.ly/2iVT99I
    • Cato Institute, “A New Agenda for the 115th” Additional information: http://bit.ly/2i5FVFE
  • Thursday, January 12 – Friday, January 13
    • Medicare Payment Advisory Commission (MedPAC), January Public Meeting. Additional information: http://bit.ly/2ewvVXE
  • Friday, January 13
    • American Enterprise Institute, “Fixing Health Care: Practice Lessons from Business Leaders.” Additional information: http://bit.ly/2iUTyZS

Weekly Wrap Up: Notable Health Care Developments From Last Week

Congressional Leadership

  • On January 3, Senate Majority Leader McConnell (R-KY) announced GOP committee assignments for the 115th Press release: http://bit.ly/2j071Qb
  • On January 5 and 6 respectively, House Energy & Commerce Committee Chairman Walden (R-OR) and House Ways and Means Committee Chairman Brady (R-TX) announced their committee’s GOP leadership assignments for the 115th Press releases from Chairman Walden and Chairman Brady: http://bit.ly/2i25yud and http://bit.ly/2j03nWB

ACA Repeal/Replace

  • On January 3, the House passed by a vote of 234-193 House Resolution 5, a rules package that includes a provision exempting any ACA repeal or reform measures from Congressional rules limiting how much legislation can increase direct spending. Press release: http://bit.ly/2hVN8Nh
  • Also on January 3, Reps. Kelly (R-PA) and Courtney (D-CT) introduced the Middle Class Health Benefits Tax Repeal Act of 2017 (H.R. 173), which would repeal the excise tax on high cost employer-sponsored health coverage, also known as the Cadillac Tax. Press release: http://bit.ly/2i5JuLX
  • Also on January 3, Rep. King (R-IA) and 23 GOP cosponsors introduced the Obamacare Repeal Act (H.R. 175), which repeals the ACA in its entirety. Press release: http://bit.ly/2i5vlOW
  • On January 4, the Senate passed a motion by a vote of 51-48 to begin 50 hours of debate on a the Fiscal 2017 Senate Budget Resolution (S. Con. Res. 3), which includes reconciliation instructions that directs the Senate HELP Committee, Senate Finance Committee, House Ways and Means Committee, and House Energy & Commerce Committee to produce legislation that achieves at least $1 billion each in deficit reduction over 10 years (FY 2017-2026). Legislation achieving these goals is due from each Committee by January 27. Resolution: http://bit.ly/2i6Ob9a
  • Also on January 4, the Republican Study Committee introduced the American Health Care Reform Act of 2017 (H.R. 277), which would repeal the ACA effective January 1, 2018 and replace it with a tax deduction for the purchase of health insurance, expand access to health saving s accounts, create high risk pools, allow the purchase of insurance across state lines, and reform medical liability law, among other provisions. Press release: http://bit.ly/2hY4Spq Summaries: http://bit.ly/2iW9Xx1 and http://bit.ly/2iVXAB7 Bill text: http://bit.ly/2iW0KVF
  • Also on January 4, Reps. Noem (R-SD) and Sinema (D-AZ) and 82 bipartisan cosponsors introduced the Jobs and Premium Protection Act (H.R. 246), which would repeal the ACA’s tax on health insurance providers. Press release: http://bit.ly/2i5HOlL
  • Also on January 4, Rep. Turner (R-OH) introduced three ACA-related bills: the Healthcare Tax Relief and Mandate repeal Act (H.R. 285), which would repeal the ACA’s individual and employer health insurance mandates; the First Responder Medical Device Tax Relief Act (H.R. 286), which would exempt certain emergency medical devices from the excise tax on medical devices; and the Student Job Protection Act of 2017 (H.R. 287), which would exempt student workers from the methodology for determining shared responsibility payments for higher education institutions. Press release: http://bit.ly/2i5EdUR
  • On January 5, Sens Rubio (R-FL) Cruz (R-TX) and Lee (R-UT) wrote a letter to GOP Senate leadership, urging them to repeal the ACA while paving the way for a balanced budget through the FY 2018 budget resolution. Press release: http://bit.ly/2iVZSQZ Letter: http://bit.ly/2iVZSQZ
  • Also on January 5, Sen. Kaine (D-VA) led a group of 13 Democrats in a letter to Majority Leader McConnell (R-KY), Senate HELP Committee Chairman Alexander (R-TN), and Senate Finance Committee Chairman Hatch (R-UT), urging them to discuss meaningful improvements to the ACA before moving forward with repeal. Press release: http://bit.ly/2hXDJ6e Letter: http://bit.ly/2hXDJ6e
  • Also on January 5, House Energy & Commerce Committee Ranking Member Pallone (D-NJ) and House Oversight and Government Reform Ranking Member Cummings (D-MD) released state-by-state fact sheets summarizing the impact of ACA repeal on individuals and families. Press release with link to state fact sheets: http://bit.ly/2iZTjg1 Summary: http://bit.ly/2iZUsV8
  • Also on January 5, HHS released a report finding that the uninsured rate for Americans with pre-existing conditions fell by 22% due to the ACA. Press release: http://bit.ly/2hY714x Report: http://bit.ly/2hY3NOp
  • Also on January 5, HHS Secretary Burwell released her HHS exit memo, outlining HHS’ work and accomplishments over the past eight years and urging against ACA repeal. Memo: http://bit.ly/2i1KBzA
  • On January 6, House Energy & Commerce Committee Chairman Walden (R-OR) released a chartpack describing the ACA’s impact on Americans. Press release: http://bit.ly/2i4qAKn Charts: http://bit.ly/2i1SHIp
  • Also on January 6, President Obama published an op-ed in the New England Journal of Medicine highlighting the risks to the American healthcare system if the ACA is repealed without a replacement in place. Op-ed: http://bit.ly/2iZVlwy

Legislative Update

  • On January 3, Rep. Paulsen (R-MN) and 223 bipartisan cosponsors introduced the Protect Medical Innovation Act of 2017 (H.R. 184), which would repeal the excise tax on medical devices. Press release: http://bit.ly/2iVXWHQ
  • On January 4, the House passed by a vote of 238-184 the Midnight Rules Relief Act of 2017 (H.R. 21), which allows Congress to consider a joint resolution to disapprove federal regulations released within the final 60 legislative days of a President’s term. The bill now moves to the Senate for consideration. Press release: http://bit.ly/2i1WLs1
  • On January 4, Rep. Brat (R-VA) and 7 GOP cosponsors introduced the Health Savings Account Expansion Act (H.R. 247), which would expand the use of health savings accounts to include health insurance payments and to increase the contribution limit. Sens. Flake (R-AZ) and Johnson (R-WI) introduced a companion bill in the Senate (S. 28). Rep. Brat and Sen. Flake press releases: http://bit.ly/2i5KHCW and http://bit.ly/2iZZl0f Bill text: http://bit.ly/2j02BbY
  • On January 4, Rep. Welch (D-VT) and 15 Democratic cosponsors introduced the Medicare Prescription Drug Price Negotiation Act (H.R. 242), which would require the Secretary of HHS to negotiate prices for Medicare part D covered drugs. Sen. Klobuchar (D-MN) and 9 Democratic cosponsors introduced a companion measure in the Senate. Rep. Welch and Sen. Klobuchar press releases: http://bit.ly/2i3itNX and http://bit.ly/2i5Fdbk
  • On January 5, the House passed by a vote of 237-187 the Regulations from the Executive in Need of Scrutiny (REINS) Act of 2017 (H.R. 26), which provides that major executive branch rules with an economic impact greater than $100 million must be approved by Congress before they can take effect. The bill now moves to the Senate for consideration. Press release: http://bit.ly/2iZP5oQ
  • On January 6, Rep. Rokita (R-IN) and 26 cosponsors introduced the State Health Flexibility Act, which would block-grant the federal share of Medicaid funding to states. The bill has been referred to the House Committee on Appropriations. Press release: http://bit.ly/2iaAcRZ
  • Also on January 6, Reps. Paulsen (R-MN) and Blumenauer (D-OR) introduced the Primary Care Enhancement Act, which would allow consumers to use their Health Savings Account dollars to pay for direct primary care services. The bill has been referred to the House Committee on Ways & Means. Press release: http://bit.ly/2jkU96F

Marketplaces

  • On January 4, CMS released an updated Open Enrollment Snapshot showing that 8.8 million consumers have signed up for Marketplace plans since Open Enrollment began on November 1, including over 2.2 million new consumers. Press release: http://go.cms.gov/2iUT5Ha
  • On January 5, CMS released its final specifications for issuers related to cost-sharing reduction reconciliation processes for the 2016 benefit year and prior year restatements. Specification documents: http://go.cms.gov/2hY6dwJ and http://go.cms.gov/2hY8pnR 

Medicare

On January 4, HHS Office of the Inspector General (OIG) released a report finding that federal payment for Part D catastrophic coverage exceeded $33 billion in 2015, more than triple the amount paid in 2010 and due largely to spending on high-price drugs. Summary with link to report: http://bit.ly/2i1NtMJ

Medicaid/CHIP

  • On January 3, CMS released Frequently Asked Questions (FAQs) outlining standards for Medicaid managed care organizations (MCOs) aimed at assisting Medicaid MCOs that may be interested in offering qualified health plans on the Marketplaces. FAQ: http://go.cms.gov/2iVPIzO
  • On January 5, CMS released guidance highlighting the benefits of the early and periodic screening, diagnostic and treatment (EPSDT) benefit for children and youth. Guidance: http://bit.ly/2iVVOzZ
  • On January 6, North Carolina Governor Cooper (D) released a proposal to expand Medicaid in the state, announcing plans to submit the proposal to CMS after a 10-day public comment period. On January 5, North Carolina State Senate President Pro Tempore Berger and State House of Representatives Speaker Moore sent CMS Acting Administrator Slavitt a letter requesting CMS reject North Carolina Governor Cooper’s expansion plan. Governor Cooper’s press release: http://bit.ly/2i1RwbW Senate President Berger’s press release: http://bit.ly/2i22HS1 Proposal: http://bit.ly/2i1V6D2

New Payment and Delivery System Models

On January 5, CMS released its third annual report to Congress on CMMI, highlighting the Center’s work in promoting delivery system reform efforts across the health care sector. Blog post: http://bit.ly/2hXW7Mm Report: http://bit.ly/2hY0M0K

Health IT

  • On January 5, HHS released a report finding that states have made efforts since 2010 to strengthen the connections between their health and human services programs through increased data and systems interoperability. Report: http://bit.ly/2iVY4qX
  • On January 4, House Energy & Commerce Committee’s Internet of Things (IoT) Working Group Co-Chairs Welch (D-VT) and Latta (R-OH) released a report detailing the workgroup’s findings from the last Congress, including how IoT is impacting the healthcare industry. Report: http://bit.ly/2i5J6wS

Misc.

  • On January 3, CMS outlined its strategy to address opioid abuse in Medicare and Medicaid, including action currently underway. Blog post: http://bit.ly/2hY5P1m Strategy: http://bit.ly/2hY5P1m
  • On January 4, Senate Judiciary Committee Chairman Grassley (R-IA) wrote a letter to CMS Acting Administrator Slavitt, requesting information about CMS’ classification of three drugs under the Medicaid Drug Rebate Program. Press release: http://bit.ly/2i4xlf8 Letter: http://bit.ly/2i1Jcci
  • Also on January 4, CDC released updated Zika data, indicating that there are now 4,835 and 35,152 cases of the virus in the states and territories, respectively. Data: http://bit.ly/2cddcRi
  • On January 5, HHS released a final rule on ceiling price and manufacturer civil monetary penalties under the 340B drug pricing program. Press release: http://bit.ly/2i4qJNE Final rule: http://bit.ly/2j00rsJ