ML Strategies Weekly Health Care Preview – Week of December 4th
Following weekend passage of the Senate tax bill, we return this week with Congress needing to pass a government-spending bill. While it’s widely expected that this will be a two-week continuing resolution (CR), giving lawmakers time to hash out a long-term deal, a short-term extension still requires Democratic votes (spending measures can be filibustered, e.g., October 2013). So after the acrimonious tax debate, the pressure is on Republicans to construct a two-week spending measure that does not provoke Democratic opposition.
Whether this week or by December 22nd, the path to final spending bill may need to address the Deferred Action for Childhood Arrivals program, which the Trump Administration ended in September. Since the program doesn’t sunset until March, Republicans argue it does not need to be addressed in a year-end deal. The Democrats want to use the leverage they have now to seek a solution. There will also be tense debate over raising spending caps for defense and non-defense spending, with Democrats insisting that non-defense spending caps be increased by the same amount.
With the Senate including the individual mandate repeal in its tax reform package, it may also complicate yearend negotiations. Senator Collins supported the legislation in part because Leader McConnell committed to support her insurance market fix, which provides $4.5 billion in federal reinsurance funding over 2018 and 2019, as well as Alexander-Murray, the market stabilization package introduced in September. Then there’s also the complicated PAYGO rules. Because the tax bill is projected to raise the deficit by $1.5 trillion over the next decade, it triggers spending cuts to federal programs, including a 2% cut to Medicare. Congress can waive paygo rules to avoid the cuts. It is far from clear Democrats will provide the votes to allow Republicans to solve these problems created by tax reform legislation in a year-end deal.
THIS WEEK IN THE HOUSE
No hearings announced in the House this week.
THIS WEEK IN THE SENATE
On Tuesday, the Senate Appropriations Labor, HHS, Education Subcommittee will hold a hearing titled,
“Addressing the Opioid Crisis in America: Prevention, Treatment, and Recovery.”
On Wednesday (12/6), the Senate Special Committee on Aging will hold a hearing titled, “America’s Aging Workforce: Opportunities and Challenges.”
On Thursday (12/7), the Senate HELP Committee will hold a hearing titled, Implementation of the 21st Century Cures Act: Progress and the Path Forward for Medical Innovation.
THEN THERE'S CHIP
According to reports, a two-week CR would lift certain restrictions to help some states that are close to exhausting their CHIP funds, while giving lawmakers time to make a final deal on CHIP. This could make it easier to pass a two-week spending deal. The final CHIP-minibus issues will seem as though this will get resolved once the bigger picture items get sorted out.