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.


Senate Continues Budget Caps/Debt Ceiling Negotiations; House Makes Progress on Appropriations

Senate Republican leadership are still working with White House officials to reach a government budget and debt limit deal that could be presented to House Democrats in the hope of avoiding a government shutdown. Majority Leader Mitch McConnell (R-Ky.) and Senate Appropriations Chairman Richard Shelby (R-Ala.) met with Treasury Secretary Steven Mnuchin and Acting White House Chief of Staff Mick Mulvaney last week and stated that progress is being made on an agreement to include the debt ceiling fix with government funding legislation. The two-year agreement to lift the budget caps and avoid sequestration would also extend the nation’s $22 trillion borrowing limit. Democrats are adhering to a principle of parity that any deal to raise defense spending caps be coupled with an increase in non-defense domestic discretionary spending.

The House of Representatives began consideration of its first package of spending measures last week. The chamber adjourned before voting on final passage, which is expected to take place early this week. The nearly $1 trillion minibus (H.R. 2740) covers fiscal year (FY) 2020 appropriations for Defense, Labor-Health and Human Services-Education, State and Foreign Operations, and Energy and Water. The House Rules Committee approved 77 amendments to the Labor-HHS portion of the bill for consideration on the floor, most of which would result in relatively small changes to funding levels. Among the amendments added to the package are changes that would require that Affordable Care Act (ACA) open enrollment data be disaggregated by race, ethnicity, preferred language, age, and sex; strike a 20-year-old rider barring the U.S. Department of Health and Human Services (HHS) from creating a national patient identifier; prevent implementation of a White House rule to expand the availability of short-term health insurance plans;

increase funding for food allergy research, and overturn a recent administration ban on using federal funds to conduct medical research that relies on fetal tissue from elective abortions. The White House has threatened to veto the House bill in its current form because of increases to domestic spending and because of the inclusion of Democratic priorities that undermine the President’s agenda.

The House plans to begin consideration of a second package of spending bills this week. Beginning June 19, the chamber will take up H.R. 3055, which contains FY 2020 appropriations for Commerce-Justice-Science, Agriculture-Food and Drug Administration, Interior-Environment, Military Construction-Veterans Affairs, and Transportation-Housing and Urban Development. House leadership hopes to complete consideration of all 12 appropriations bills before the end of the month. The Senate has yet to begin debate on any of the 12 annual spending bills which must be passed before the end of the current fiscal year on Sept. 30. Senate appropriators are waiting for a deal to be reached on budget caps to set overall spending limits.

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