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Archive | Legislation

Tick Tock – Has Time Run Out for Health Reform?

During his State of the Union address, the President did not give any insight into the best path forward for moving comprehensive health care reform. Congress continues to mull over how to pass legislation, and reform advocates are holding out hope that Members can refocus and revive the debate. Meanwhile, it has become clear that creation of new jobs will be the President’s number one priority in 2010.

The New York Times reports that Democrats are considering splitting up the bill and moving smaller pieces separately but Politicoconfirms that option may not be a simple and expeditious process.

The Washington Post reports that Democrats are still contemplating on how to proceed but lawmakers remain steadfast in their commitment to passing legislation and maintain that reconciliation is still on the table.  We anticipate that Democratic leaders will continue to caucus over the next couple of weeks to work on developing a sustainable path forward.

In other health news, while the Democrats still maintain a filibuster proof majority before Republican Senator-elect Scott Brown is seated, the Senate managed to pass a resolution that increases the debt ceiling to $14.3 trillion, which greases the wheels for a potential five-year Medicare physician payment fix that would be exempt from the pay-as-you-go rules.  Congress is still required to pass legislation to stop the 21 percent cuts from going through on March 1, 2010.

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Capital Thinking Radio Show

CT_radio1 Join us this week on Capital Thinking this week as host Kevin O’Neill examines the political impact of the recent House approval of the most sweeping piece of social legislation in decades. John Jonas and Martha Kendrick provide strategic analysis of the bill and what to expect next.

Tune in every Thursday at NOON EST and 9:00 am PST on VoiceAmerica Business

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Still Going for Gold

In hopes of moving health care reform, President Obama has taken a more active role in the debate. Earlier this week, the President released his proposal for reform, which is mostly additive to or revisionist of the Senate bill. The President included several fraud and abuse provisions that were included in H.R. 3970, the “Medical Rights and Reform Act,” or H.R. 3400, the “Empowering Patients First Act.”

On Thursday, President Obama is convening a bipartisan summit with a goal of identifying compromises that will help to move health care reform legislation forward. Senate Republican Leadership has expressed disappointment in the President’s unwillingness to scrap the current health care reform bills and have suggested that an incremental approach to reform is more appropriate than comprehensive reform. The summit does not change the procedural options for moving reform legislation. Congress has two options: either move incremental reform bills or use reconciliation to pass comprehensive reform. President Obama will use the summit to build support for passage of health care reform, even if by reconciliation.

At this point, we expect Congress to move several health care provisions separate from health care reform, including a physician fee fix, repeal of the insurance antitrust exemption, and a package of health extenders and use reconciliation to pass comprehensive reform.

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At Last – Long-awaited Health Reform Reconciliation Bill Released

Today House Democratic Leadership released the legislative text of the Reconciliation Act of 2010, sponsored by House Budget Chairman John Spratt.  The bill amends a number of provisions in the Senate-passed “Patient Protection and Affordable Care Act,” including:

  • Provides additional subsidies to improve the affordability of coverage for individuals with incomes up to 400 percent of the federal poverty level;
  • Imposes additional requirements for coverage of non-dependent children up to age 26;
  • Closes the Medicare Part D donut hole by 2020 by offering seniors an immediate $250 rebate and subsequently increasing discounts on brand-name drugs;
  • Strikes the controversial 100-percent federal Medicaid matching rate for Nebraska (known as the “Cornhusker kickback”);
  • Delays the annual cap on contributions to health flexible spending accounts (FSAs) by two years until 2013;
  • Delays the excise tax on high-cost health plans to 2018, increases the dollar thresholds and indexes them to inflation;
  • Delays the industry fee on sales of brand name pharmaceuticals by one year to 2011 but increases revenues raised by $4.8 billion;
  • Delays the medical device tax on manufacturers by two years until 2013 and switches the industry fee to an excise tax on the first sale for use of medical devices at 2.9 percent rate; and
  • Delays the health insurance industry fee by three years to 2014.

House Majority Leader Steny Hoyer announced that the House would convene at 1:00 pm on Sunday, but the final vote on the reconciliation bill would likely not begin until later in the day to comply with the Democratic Leaders’ promise to give Members 72 hours to review the final bill text.  The House is expected to approve the Senate-passed health reform bill using a “deem-and-pass” procedure that Republicans protest as unconstitutional.

Since the bill’s release, several House members have switched their previous ‘no’ vote to a ‘yes’ – including Reps. Bart Gordon (D-TN), Luis Gutierrez (D-IL), Betsy Markey (D-CO), and Mike Arcuri (D-NY).  Additionally, Rep. Dennis Kucinich (D-OH) announced yesterday that he will now vote in favor of the bill.

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Politico Explains Impact of Sequestration

Today, Politico published an article by Jonathan Allen that sets out exactly how the cuts will impact nondefense and defense spending.

The Office of Management and Budget (OMB) will write a sequestration order that details the exact amount of the cuts to federal programs.  The report is expected in January.

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Rep. Allyson Schwartz Proposal to Repeal SGR

Rep. Allyson Schwartz (D-PA) has proposed to repeal the SGR and freeze the current Medicare physician payment rates through 2012. She proposes to provide primary care physicians with a 2.5 percent annual rate increase and specialists with a 0.5 percent increase from 2013-2016. Her proposal calls on CMS to test and evaluate physician payment models and identify at least four models from which physicians could select to be paid beginning in 2016. If physicians elected to remain in the fee-for-service system, reimbursement rates would decrease annually to encourage providers to move away from the FFS system.

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President to Nominate Marilyn Tavenner as CMS Administrator

Later today, the President is expected to nominate Marilyn Tavenner to succeed CMS Administrator Donald Berwick when his recess appointment expires on December 31, 2011. Marilyn Tavenner currently serves as the Principal Deputy Administrator and Chief Operating Officer of CMS. She will serve as Acting Administrator of CMS during her confirmation process.

Marilyn Tavenner was Secretary of the Virginia Health and Human Resources Department during Governor Tim Kaine’s (D) administration from 2006-2010. Previously, she was a nurse and an executive at the Hospital Corporation of America. She was Chairwoman of the Virginia Hospital Association and a trustee at the American Hospital Association.

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OMB Director Provides Guidance on FY 2013 Budget Requests

The Director of the Office of Management and Budget circulated a memorandum to the heads of Departments and Agencies with the following directions regarding their Fiscal Year 2013 budget requests:

1. Overall agency requests should be at least 5% below the FY 2011 enacted appropriations;

2. The budget submission should outline options in line with the President’s efforts to cut waste and reorganize priorities to reduce the deficit and invest in areas that will generate jobs and economic growth; and

3. Departments and agencies should identify in their budget requests additional discretionary funding reductions that would amount a level at least 10 percent below the FY 2011 enacted appropriations.

The memorandum specifies that departments and agencies should not simply propose across the board spending cuts and that the reductions that are identified in the budget requests will be used as guidance for the President as he makes decisions about funding cuts.

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Membership of Joint Committee on Deficit Reduction

The House and Senate Republican and Democratic Leaders were each required to select three Members of Congress to sit on the Joint Committee.

Senate Majority Leader Harry Reid (D-NV) appointed Sen. Patty Murray (D-WA) as a Joint Committee co-chair, Senate Finance Committee Chairman Max Baucus (D-MT), and Sen. John Kerry (D-MA).

Senate Minority Leader Mitch McConnell (R-KY) selected Sen. Jon Kyl (R-AZ), Sen. Pat Toomey (R-PA), and Sen. Rob Portman (R-OH), a former Director of the Office of Management and Budget (OMB), to serve.

House Speaker John Boehner (R-OH) appointed House Ways and Means Committee Chairman Dave Camp (R-MI), Rep. Jeb Hensarling (R-TX) to be co-chair of the Committee, and House Energy and Commerce Committee Chairman Fred Upton (R-MI).

House Minority Leader Nancy Pelosi (D-CA) announced her selection of Rep. Jim Clyburn (D-SC), Rep. Chris Van Hollen (D-MD), and Rep. Xavier Becerra (D-CA) to the Committee.

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Key Dates for Joint Committee on Deficit Reduction

On August 2, President Obama signed into law the Budget Control Act of 2011, which authorizes an increase in the debt ceiling, caps spending, and provides a process by which an additional $1.2 trillion in cuts will be made.

The law authorizes a Joint Committee of Congress that is required to draft legislation to reduce the deficit by at least $1.2 trillion.  If Congress does not enact such legislation before December 23, 2011, across the board spending cuts would be triggered.  The timeframe by which Congress is required to pass this deficit reduction legislation is short:

  • August 16, 2011 – Members of the Joint Committee on Deficit Reduction Appointed
  • September 16, 2011 – The Joint Committee Meetings Begin
  • October 14, 2011 – House and Senate Committees may submit recommendations for deficit reduction to the Joint Committee
  • November 23, 2011 – The Joint Committee votes on recommendations
  • December 23, 2011 – The House and Senate must vote up or down without amendment on the deficit reduction legislation

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