House Passes Bill to Suspend Debt Ceiling
On January 23, the House passed a bill that would suspend the debt ceiling and allow the federal government to keep borrowing money until May 17. Both the Senate and the White House have indicated they will not block the House-passed measure. Notably, the bill (H.R. 325) requires the House and Senate to pass a budget for fiscal year 2014 by April 15 or risk having their pay withheld.
Assuming the bill is signed into law, the debt limit is off the table until mid-May. The next pressure point for Congress then becomes the sequester, which is scheduled to begin March 1. With over a month to go, it is unlikely both sides can find the offsets necessary to supplant the issue by March 1. Republicans are unlikely to agree on further tax increases that Democrats are currently demanding.
After March 1, the next choke point becomes March 27, which is when the continuing resolution that funds the government expires. If the two sides are unable to reach an agreement on a continuing resolution, a government shutdown becomes a possibility.
Despite the temporary suspension of the debt ceiling, many House and Senate Republicans are still pushing for deep cuts to health programs as a way to reduce the deficit and hope that the temporary suspension of the debt limit will set the stage to come up with a broader deficit reduction plan that tackles entitlement spending.
Following the House suspension of the debt ceiling, Senate Finance Committee ranking member Hatch (R-UT) outlined five structural reforms to Medicare and Medicaid. As the ranking member on the committee with jurisdiction over Medicare, the outline represents a realistic wish list for Senate Republicans to have structural reforms included in a deficit reduction package.
The list includes transforming Medicare into a “per capita cap” system, raising the Medicare eligibility age to 67, changing Medicare into a premium support-type system where plans bid against traditional Medicare, combining Part A and B deductibles and reforming “Medigap” coverage. All reforms have been introduced in the past and gained some measure of bipartisan support.
House Committee Approves Pediatric Bills
On January 22, the House Energy and Commerce Committee advanced a new reauthorization bill for the Children’s Hospital Graduate Medication Education program (H.R. 297). Last Congress, almost identical legislation passed the House but lacked the votes to pass the Senate. It is expected to pass and be ready to go before the full House as early as February.
The Energy and Commerce Committee also passed legislation creating a National Pediatric Research Network (H.R. 225). The bill would award grant funding to public or private nonprofit entities for planning, establishing or strengthening pediatric research.
IPAB Repeal Bill Introduced in the House
On January 23, Rep. Roe (R-TN) reintroduced a bill to repeal the Independent Payment Advisory Board (“IPAB”) – a panel of 15 health care experts with the power to cut Medicare payments to doctors if spending grows faster than a prescribed rate.
The IPAB was one of the more controversial provisions of the Affordable Care Act. It would give an unelected board the power to make Medicare cuts now reserved for Congress. The AMA and other health providers have endorsed the repeal legislation.
In 2012, Roe’s bill passed the House with the backing of seven House Democrats. The bill failed to get through the Senate due in large part to budget concerns. The Congressional Budget Office estimated the measure would have increased spending by $3.1 billion over 10 years.
For more information, please contact John F. Williams, III at 317.977.1462 or jwilliams@hallrender.com.
