Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


DOJ Decides Not to Defend the ACA, Reviving Congressional Replacement Discussions

The Department of Justice (DOJ) announced its decision last week to side with the district court’s December ruling declaring the entire Affordable Care Act (ACA) unconstitutional. This was a reversal of the Department’s previous position, which was that only a portion of the law should be struck down. The DOJ will file a brief supporting the decision with the U.S. Court of Appeals for the Fifth Circuit. The Fifth Circuit’s decision is likely to be appealed to the Supreme Court, regardless of the outcome.

Shortly after DOJ’s announcement, President Trump tweeted that Republicans should be the “party of health care,” and an aide to Vice President Pence promised that the administration would work to present a health care plan to Congress. But according to Rep. Mark Meadows (R-N.C.), White House officials told him that Congress should lead the effort to formulate a replacement for the ACA and that he is in discussions about a replacement plan with his Republican colleagues in both chambers. President Trump also stated that he has tapped John Barrasso (R-Wyo.), Bill Cassidy (R-La.), and Rick Scott (R-Fla.) to develop an ACA replacement plan that includes protections for preexisting conditions. The President’s acting chief of staff Mick Mulvaney announced over the weekend that the White House plans to send a short summary of its health care principles to Congress to guide any potential legislation.

Other lawmakers, like Ranking Member of the Energy and Commerce Committee Greg Walden (R-Ore.), instead expressed support for working on health care legislation for which there may be common ground with Democrats, like on drug-pricing or insurance improvements. Sen. Susan Collins (R-Maine) stated that she would be writing to Attorney General Barr to urge him to reconsider the administration’s approach to the ACA lawsuit.

House Speaker Nancy Pelosi(D-Calif.) announced that the House will vote this Tuesday on a resolution condemning the administration’s efforts to repeal the ACA. The resolution is led by Rep. Colin Allred (D-Texas). Senate Democrat leader Chuck Schumer (D-N.Y.) plans to offer an amendment to an unrelated disaster relief bill (H.R. 268) that would prevent the administration from spending money to litigate against the ACA in court. If Republican leadership allow the amendment to come up for a vote, it could force lawmakers to go on the record about the administration’s position on the law.

House Passes Medicaid Legislation

The House of Representatives passed by voice vote H.R. 1839, the Medicaid Services Investment and Accountability Act of 2019, last week. The legislation would extend the Excellence in Mental Health demonstration and the Money Follows the Person Program through September. It includes a provision establishing civil monetary penalties for the misclassification of covered outpatient drugs in the Medicaid drug rebate program. The bill also incorporates the provisions of the ACE Kids Act and would allow state Medicaid programs to establish health homes for children with medically complex conditions.

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