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.


2% Sequester Set for July 1

Without action from Congress, Medicare sequester cuts are scheduled to go into effect on July 1. The 2% cuts to Medicare payments triggered by federal budget sequestration were previously stalled in response to the COVID-19 pandemic. A 1% Medicare sequester cut took effect on April 1 of this year, and the cut is slated to increase to 2% on Friday

President Signs Gun Safety Bill into Law

The Senate voted 65-33 to pass bipartisan gun safety legislation (S. 2938) last week. The bill aims to improve the national background check system, provides incentives for states to better review gun purchases by individuals aged 18 to 21, and closes the boyfriend loophole. It will also provide funding to enhance school security, strengthen mental health resources, and provide grants to states for establishing crisis intervention programs, regardless of whether they implement red-flag laws. It also includes new criminal penalties for straw purchases and gun trafficking. The House of Representatives passed the Bipartisan Safer Communities Act on Friday in a 234-193 vote, with 14 Republicans joining all Democrats voting in support of the measure. The legislation was signed into law by President Joe Biden on Saturday.

House Passes ARPA-H, Mental Health Legislation

The House of Representatives passed legislation (H.R. 5585) to formally authorize the Advanced Research Projects Agency for Health (ARPA-H) last week in a 336-85 vote. The bill would establish ARPA-H as an independent agency within the U.S. Department of Health and Human Services (HHS). It would also limit the number of program offices within ARPA-H and cap its administrative costs at 15%. Congress already provided $1 billion in funding to jumpstart the new biomedical research agency in the fiscal year (FY) 2022 omnibus appropriations package. While the White House has endorsed the bill, it has opposed provisions to make ARPA-H an independent operating division outside of the National Institutes of Health. It is unclear when the Senate will vote on the authorizing legislation. Earlier this year, the Senate Health, Education, Labor, and Pensions (HELP) Committee included ARPA-A authorizing language in its pandemic preparedness legislation. Congressional delegations from across the nation have already begun to press HHS to headquarter ARPA-H in their states, with Texas, Georgia, Massachusetts, and California making their case for housing the new agency.

The House also passed a sweeping mental health care bill (H.R. 7666) in a 402-20 vote last week. The Restoring Hope for Mental Health and Well-Being Act would reauthorize and expand federal mental health care and substance abuse programs through 2027 and increase access to opioid use disorder treatment by allowing doctors to prescribe buprenorphine without a waiver from the Drug Enforcement Administration. The legislation would also require nongovernmental health plans to comply with mental health parity laws. The bill’s future is unclear, as the Senate Finance Committee is working to draft its own bipartisan mental health and addiction package.

Supreme Court Overturns Roe v. Wade and other Rulings

The U.S. Supreme Court has overturned Roe v. Wade, ending the constitutional right to abortion after almost 50 years of legal precedent. Justices Samuel Alito, Clarence Thomas, Neil Gorsuch, Brett Kavanaugh, John Roberts, and Amy Coney Barrett ruled in favor of overturning Roe. The decision upholding a Mississippi law criminalizing abortion after 15 weeks returns the issue of abortion to the states. As many as 26 states are expected to end the right to abortion, with 13 of those states having already-established trigger laws in place. While congressional Republicans praised the decision, Democratic leadership criticized the ruling, with Senate Majority Leader Chuck Schumer (D-N.Y.) stating the decision marked “one of the darkest days our country has ever seen,” and House Speaker Nancy Pelosi (D-Calif.) characterizing it as “cruel” and “outrageous.” Other lawmakers questioned the consistency of the ruling with prior statements made by the Supreme Court justices, with Sen. Susan Collins (R-Maine) and Joe Manchin (D-W.Va.) pointing to testimony under oath made by Justices Gorsuch and Kavanaugh that Roe was legal precedent.

In a split 5-4 decision, the Supreme Court upheld a 2005 rule from the U.S. Department of Health and Human Services (HHS) that decreased the amount of disproportionate share hospital adjustments hospitals receive for serving a larger share of poor patients. The ruling will allow HHS to continue using its preferred method of calculating payments for hospitals that take on a disproportionate number of low-income patients.

In a split 6-3 ruling, the US Supreme Court struck down a New York law that barred most people from carrying handguns in public, ruling for the first time that the Second Amendment protects gun rights outside the home. The ruling could mean more guns in public places in some of the most populous American cities. New York was one of at least six states -- along with California, Massachusetts, New Jersey, Maryland, and Hawaii -- with laws that prevented most people from legally carrying a handgun in public.

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