Senate Minority Leader Tells Hall Render Some ACA Provisions Will Remain
At a small breakfast meeting in Washington, D.C. on Wednesday, Senate Minority Leader Mitch McConnell (R-KY) told Hall Render Shareholder John Williams that Senate Republicans will follow the lead of their House counterparts and prepare legislation to keep those provisions of the Affordable Care Act (“ACA”) that are popular with the American public should the health care law be struck down by the Supreme Court later this month. While Senator McConnell would not name the specific ACA provisions Senate Republicans would reintroduce, allowing children to remain covered by a parent’s health insurance plan until the age of 26 has polled very well with the public. Last month, word leaked from Capitol Hill that the House Republican Leadership was working with the Republican members of the House Physician Caucus to prepare bills for introduction should the Supreme Court rule the ACA is unconstitutional. The breakfast meeting included discussion of a wide range of health care related issues and was also attended by Sen. John Cornyn (R-TX) and Sen. Pat Toomey (R-PA). Mr. Williams was in Washington, D.C. to promote the creation of Hall Render’s new Federal Legislative and Regulatory Advocacy practice area.
House Passes Bill to Repeal Medical Device Tax
On Thursday, the United States House of Representatives passed a bill to repeal a 2.3% tax on medical device manufacturers that is part of the ACA. Although the Obama Administration has made clear the President will veto the bill, it still won the support of 37 Democrats. Regardless, most Democrats still believe the Republican House Leadership is trying to take a piece-by-piece approach to repeal of the ACA. To make up for the $29 billion in lost revenue the tax is expected to generate, House Republicans included a provision that requires all overpayments of health insurance subsidies provided in the ACA to be recaptured. As the law stands today, only some overpayments must be returned to the federal government. Interestingly, the bill’s passage comes just ahead of the Supreme Court’s ruling on the constitutionality of the ACA’s individual mandate provision, which requires all Americans to buy health insurance or pay a fine. In the end, it is unlikely President Obama will ever have to exercise his veto authority since the bill will almost certainly die in the Democrat-controlled Senate.
ACO Movement Likely to Continue After Supreme Court Ruling
At a conference of Accountable Care Organization (“ACO”) stakeholders held in Washington, D.C. this week, the prevailing belief was that using the concept of “accountable care” to reform health care delivery and coordinate patient care is a model that will continue to move forward regardless of how the Supreme Court rules on the constitutionality of the ACA. As reported by Inside Health Policy, many believe CMS could do some “administrative shuffling” to find a way for those ACOs already in place to continue. Doug Hastings, past president of the American Health Law Association, told the conference attendees, “Most of us believe in the promise of accountable care. If the law is struck in its entirety, take a deep breath. Move ahead on the commercial level. Work at the state level and work with the next Congress to pick up the pieces at the federal level.” Hastings noted that, while many believe actions taken that were legal under controlling law at the time can remain in place, there would still be a lot of questioning and litigation.
Administration Orders Health Agencies to Cut FY 2014 Budget Requests
In attempt to implement a broad deficit reduction plan, the Obama Administration has ordered all executive branch departments and agencies, except the Pentagon, to cut their budget requests for fiscal year 2014 to 5% below the level proposed in the President’s fiscal year 2013 budget. This includes health-related agencies like HHS, CMS and FDA. The order, which targets “lower-priority spending,” is set forth in a May 18 memo from the acting director of the Office of Management and Budget (“OMB”) to department and agency heads that was released by the Administration this week. OMB tells agencies that “hard choices” will be required in the 2014 budget process and instructs budget staff to avoid offering up new user fees to offset existing spending, propose at least three priority program reform proposals where legislative, budget or administrative changes could lead to long-term cost savings and include offsets for any programs that are not budget-neutral and emphasize use of information technology to achieve savings. “To achieve these goals, your 2014 budget submission to the Office of Management and Budget should reflect the President’s commitment to cut waste, set priorities among programs, and make targeted investments in critical priorities,” the acting director says in the memo. “Unless your agency has received different guidance from OMB, your overall agency request for 2014 should be 5 percent below the net discretionary total provided for your agency for 2014 in the 2013 Budget.”
Legislation
The following health care-related bills were introduced this week:
- S. 3271 – (bill text not yet published) Senator Kerry (D-MA) introduced a bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy. Currently, Medicare beneficiaries aged 65 and older can buy supplemental Medigap polices without being denied coverage or charged higher premiums because of their medical histories. S. 3271 would extend those policies to all Medicare beneficiaries, including disabled patients of any age and patients with end-stage renal disease.
- S. 3272 – Senator Sanders (D-VT) introduced a bill that would authorize dental care for Medicare, Medicaid and Veterans Administration beneficiaries, increase access to dental services and boost the number of dental providers serving the poor. An identical bill (H.R. 5909) was also introduced in the House this week.
Next Week
- The Senate is in session next week and will focus primarily on comprehensive Farm legislation and marking up appropriations bills at the committee level.
- The House is in a week long recess.
- The Supreme Court’s decision on the ACA is expected any day now.
For more information, please contact John F. Williams, III at 317.977.1462 or jwilliams@hallrender.com.
