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.


House Passes CR to Fund Government Through Dec. 11

The House of Representatives has passed, by a voice vote of 359-57, H.R. 8337, which would extend current levels of federal funding through December 11. Lawmakers were able to reach an agreement on the inclusion of nutrition assistance and trade relief payments for farmers in the final deal. The bill extends the Medicare geographic practice cost index (GPCI) floor and a number of health care programs, including community health centers, the National Health Services Corps, Teaching Health Centers, and the Special Diabetes Program, that were set to expire on November 30, and averts a $50 increase in 2021 Medicare Part B premiums. It would instead limit any increase in Medicare premiums to around $4 a month. It would also extend the time in which Medicare health care providers must repay accelerated and advanced payments, and reduce the interest rate of those loans to 4 percent until the current public health emergency end. The Senate has scheduled a procedural vote on Tuesday for the continuing resolution (CR) with a final vote expected on Wednesday, September 30 – just before the end of the fiscal year.

President Unveils Executive Order on Preexisting Conditions, Surprise Billing

The President issued a new executive order (EO) regarding protections for Americans with preexisting conditions and surprise medical billing. The EO, which includes the two directives, forms the “America First Health Plan” unveiled by President Trump during an event in North Carolina on Thursday, which the President had previewed as his replacement plan for the Affordable Care Act (ACA). The first directive calls on Congress to pass a legislative fix to hold patients harmless from surprise medical bills and states that the administration will take regulatory action to ban surprise medical bills if lawmakers are not successful by the end of the year. Policymakers are still at odds over how to resolve payment disputes that arise between providers and payers in the case of surprise insurance gaps. The second directive would declare it national policy to protect coverage of people with preexisting health conditions, without any additional specifics. The order comes as the White House supports a Supreme Court challenge to the ACA that could result in the law’s consumer protections being struck down. The high court is scheduled to hear the challenge just a week following the November elections. Should the 2010 health care law be declared unconstitutional, the administration would have to work with Congress to pass legislation to make the EO policy enforceable. During the event on Thursday, the President also promised to send $200 drug discount cards to the nation’s 33 million Medicare beneficiaries before the election. The cards would be paid for using projected savings from the administration’s recently announced “most-favored nation” drug pricing demonstration.

Trump Nominates Amy Coney Barrett to the Supreme Court

President Trump has nominated Judge Amy Coney Barrett to the Supreme Court of the United States (SCOTUS). Barret is a judge on the U.S. Court of Appeals for the Seventh Circuit, a position that required confirmation by the Senate in 2017, who clerked for the late Justice Antonin Scalia. If confirmed, she would fill the vacancy created by the late Justice Ruth Bader Ginsburg and strengthen the conservative majority on the court.

Supreme Court nominees require the support of a simple majority of the Senate. While Senate Majority Leader Mitch McConnell (R-Ky.) has said that he will hold a vote on Barrett’s confirmation before the end of the year, it would be possible for the chamber to confirm Barret in the time before the November 3 election if lawmakers move her nomination quickly. The confirmation process involves one-on-one meetings between the nominee and senators followed by a week of hearings before the Senate Judiciary Committee and a vote two weeks later on the Senate floor. Senate Judiciary Committee Chairman Lindsey Graham (R-S.C.) has stated that the confirmation hearings on Amy Coney Barrett’s nomination to the Supreme Court will start October 12 and he expects to report out the nomination by October 22 for consideration by the full Senate.

Senate Democrats are unified in their opposition to any SCOTUS nominee considered before the election.

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