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.


Biden Administration Releases FY 22 Budget Priorities

The White House released its fiscal year (FY) 2022 discretionary funding request on Friday. The $1.52 trillion preliminary budget proposal includes topline funding figures and sheds light on the administration’s prioritization of combating inequality, protecting public health, and addressing climate change for the upcoming fiscal year. The budget includes a 15.9% boost to nondefense discretionary spending, and a $1.7% increase for defense programs. Agencies within the Department of Health and Human Services would see a 23.5% budget increase.

While presidential budgets outline administration priorities, the top-line spending figures may guide the work of Democratic appropriators in Congress. The budget proposal involves only discretionary spending, and not entitlement programs like Medicare and Medicaid. In addition, it does not include details on economic assumptions, deficit or revenue projections, or spending contained in the President’s proposed infrastructure package. The FY 2022 budget is the first in a decade that will not be constrained by spending caps put in place by the Budget Control Act of 2011.

It is rumored that the full budget, which will include programmatic funding proposals, will be released next month. Congressional appropriators have already begun to schedule budget hearings, and could begin marking up spending bills as early as next month. Appropriations legislation will require the support of at least 10 GOP members in the Senate to pass, and the spending bills or a continuing resolution will need to be enacted prior to Oct. 1 to avoid a government shutdown. Republicans have criticized the budget proposal for the relatively small increase to defense spending.

Please see the addendum to this newsletter for Hart Health Strategies Inc.’s more detailed summary of the President’s budget proposal.

House to Consider Medicare Sequester, Workplace Violence this Week

The House of Representatives will consider the Senate amendment to H.R. 1868 under suspension of the rules on Tuesday. This legislation would extend for nine months the temporary moratorium on the 2% Medicare sequester in light of the ongoing public health emergency. The bill, as amended, would delay the automatic cuts from April 1 to Dec. 31. The House also plans to vote on a bill to address workplace violence in the health care and social service industries (H.R. 1195) this week.

Democrats Consider the Use of Reconciliation for Infrastructure Package

Senate Majority Leader Chuck Schumer (D-N.Y.) has confirmed that Democrats can use the budget reconciliation process for a second time during fiscal year 2021 to pass the President’s infrastructure and jobs proposal. The announcement follows a ruling from the Senate parliamentarian on the issue. According to Schumer’s office, the parliamentarian advised that Democrats could use the same process employed to pass the American Rescue Plan Act earlier this year, although “some parameters still need to be worked out.” Majority Leader Schumer had asked the parliamentarian whether the fiscal 2021 budget resolution used to pass the pandemic aid bill could be reused for a second reconciliation package in the same fiscal year. It remains unclear, however, which proposed infrastructure and jobs provisions could pass the Senate’s Byrd rule test, or whether Democrats even have enough support within their own caucus to use reconciliation again this fiscal year. The process would require the support of all 50 Democratic senators; moderates like Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.), however, have already raised concerns about using the process in a way that could set a new precedent, with Manchin also expressing opposition to the President’s proposed corporate tax rate hike. Without this special ruling, Democrats would still have been able to perform a separate reconciliation for fiscal year 2022.

The administration has already released the first of two long-term infrastructure proposal - the American Jobs Plan, totaling $2.7 trillion. The White House has said that a forthcoming package, the American Families Plan, could be released as soon as this month. It is expected to total around $1 trillion and include child care and health measures as well as tax hikes for individuals to help fund the administration’s proposed spending increases. House Speaker Nancy Pelosi (D-Calif.) has said that she expects that the proposals will be packaged into two separate bills by Congress.

The Congressional Progressive Caucus (CPC) has released their top five priorities for the American Jobs Plan after surveying its 95 members. Health care-related provisions supported by the caucus include mandating that Medicare negotiate drug prices, restricting drug price increases that rise faster than the rate of inflation, and capping drug prices at the average price charged in other Organization for Economic Cooperation and Development (OECD) member countries. The caucus also supports requiring that the government use the savings generated by these provisions to pay for lowering the Medicare eligibility age and expanding Medicare program benefits to cover dental, vision, and hearing care. The CPC’s priorities also include investing $450 billion in Medicaid home and community-based services (HCBS).

The President will meet with both Democratic and Republican members of Congress today to discuss his infrastructure plan and gauge support for the proposal.

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