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.


Congress Passes Bill to Address Debt Limit, Medicare Cuts

Congress successfully passed the Protecting Medicare & American Farmers from Sequester Cuts Act (S. 610) last week. The bill, which was signed into law by President Joe Biden on Friday, partially staves off a 3.75% decrease in physician payments by providing a 3.0% increase for calendar year 2022 to the Medicare conversion factor for providers and would temporarily block sequestration cuts to Medicare and other mandatory spending programs. It suspends for three months, through March 31, 2022, the 2% automatic sequestration cut to Medicare payments, followed by a reduction to 1% for three months, through June 30, 2022. The legislation would also excuse for 2022 the 4% statutory pay-as-you-go (PAYGO) reduction to Medicare physician reimbursements. The bill preventing billions of dollars in Medicare pay cuts also includes a provision providing for a simple majority, expedited process through which Democrats can raise the debt ceiling by a specific dollar amount without any Republican support. Congress previously faced a partisan impasse on the debt ceiling, with Republicans vowing to not cooperate in raising the debt limit, and Democrats wishing to avoid the use of the cumbersome budget reconciliation process. Lawmakers reached a deal to raise the debt limit after a series of negotiations between Senate Majority Leader Chuck Schumer (D-N.Y.) and Minority Leader Mitch McConnell (R-Ky.). The one-time agreement creates a pathway for Democrats to raise the debt ceiling with a simple majority threshold that avoids a Senate filibuster. Democrats are discussing a plan to cover borrowing through 2022, which would require a $2 trillion increase to the debt limit. Timing for a Senate vote to raise the federal debt limit has not been set; the House of Representatives is on notice to vote on Tuesday should the Senate act by then, according to Majority Leader Steny Hoyer (D-Md.). December 15 is viewed as the effective deadline to raise or suspend the debt limit.

Senate May Turn to Consideration of BBB This Week

Senate committees of jurisdiction have begun releasing their draft portions of the Build Back Better reconciliation package, including the Senate Health, Education, Labor, and Pensions Committee and the Senate Finance Committee. The updated text remains subject to a review by the Senate parliamentarian. Senate Majority Leader Chuck Schumer (D-N.Y.) stated in a letter to colleagues last week that he still aims to pass the Build Back Better legislation before Christmas. It remains unclear, however, whether this is a realistic timetable, given that Sens. Kyrsten Sinema (D-Ariz.) and Joe Manchin (D-W.Va.) continue to express reservations about the bill after months of negotiation. Beyond the $2 trillion tax and spending reconciliation package and raising the debt limit, lawmakers also hope to complete work on the annual National Defense Authorization Act (NDAA) between now and the Christmas holiday.

Lawmakers Ask GAO for Report on DTC Advertising

Reps. Angie Craig (D-Minn.) and John Joyce (R-Pa.) have sent a letter asking the Government Accountability Office (GAO) to review regulations on direct-to-consumer (DTC) advertising practices for prescription medical products. “The rise of internet marketing and the push toward a DTC model of health care delivery represents a major change within our health care system. We are concerned that with the rapid growth of DTC advertising, appropriate regulatory oversight may be falling behind,” the lawmakers state. The letter was signed by 17 other members of Congress.

Senate Republicans Attempt to Overturn Vaccine Mandate

The Senate passed a resolution of disapproval of the administration’s vaccine mandate for large, private sector employers by a vote of 52-48 last week. Sens. Joe Manchin (D-W.Va.) and Jon Tester (D-Mont.) were the only Democrats to join all 50 Republicans in support of the measure, which would block the vaccine order promulgated by the Occupational Safety and Health Administration (OSHA) through the use of the Congressional Review Act (CRA). The Democraticcontrolled House of Representatives is not expected to take up the resolution; however, House Republicans plan to circulate a discharge petition to try to force a vote. Should the resolution be advanced to the president for signature, President Biden is expected to veto it. A federal court has already acted to halt the rule, which covers workers at companies with 100 or more employees. In related news, General Electric Co., Union Pacific Corp., and BNSF Railway announced last week that they have suspended their employee vaccine mandates following the recent court ruling halting the Biden administration’s order requiring federal contractors to get vaccinated. The courts have also put a halt to the government contractor vaccine mandate as well as the health care mandate proposed by the Centers for Medicare and Medicaid Services.

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