POLICY BRIEFINGS

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.


THIS WEEK'S BRIEFING - AUGUST 8, 2022

Senate Passes Inflation Reduction Act


The Senate passed the Inflation Reduction Act via the budget reconciliation process on Sunday in a party-line 51-50 vote, with Vice President Kamala Harris casting the tie-breaking vote. The $437 billion tax, climate, and health package is the product of careful negotiations between Senate Majority Leader Chuck Schumer (D-N.Y.), Sen. Joe Manchin (D-W.Va.), and most recently, Sen. Kyrsten Sinema (D-Ariz.). Sinema signaled her support for the bill late last week after a proposal to narrow the carried interest loophole was dropped and an exception to the minimum corporate tax was made for accelerated depreciation tax deductions used by many manufacturers. The legislation gives the Medicare program authority to set the price of certain high-expenditure prescription drugs, in both Part B and Part D. Sen. John Barrasso (R-Wyo.) had drafted an amendment that would remove providers who buy and bill Part B drugs from the middle of the new pricing mechanism and would instead enable Medicare to achieve the same savings via a direct rebate from drug companies, but the Congressional Budget Office was unable to score that amendment in time for consideration. The legislation would also cap out-of-pocket Part D spending at $2,000 per year and extend expanded Affordable Care Act premium subsidies for three years. The measure includes $374 billion for energy and climate programs. It would establish a 15% corporate minimum tax on large firms, a 1% excise tax on the value of stock buybacks, and an $80 billion increase to the Internal Revenue Service budget for tax enforcement. The chamber worked through the weekend to complete the vote-a-rama process, a marathon series of back- to-back amendment votes with no time limit. Most Democrats voted against all amendments to protect the underlying bill. Democrats did not have the 60 votes required to waive the procedural objection against a $35 cap on insulin for private insurance plans, which the Senate parliamentarian determined violated the chamber’s Byrd Rule. Seven Republicans - Sens. Bill Cassidy (R-La.), Susan Collins (R-Maine), Josh Hawley (R-Mo.), Cindy Hyde-Smith (R-Miss.), John Kennedy (R-La.), Lisa Murkowski (R-Alaska), and Dan Sullivan (R-Alaska) – voted with Democrats in the 57-43 vote. A $35 insulin cap for Medicare beneficiaries, however, remains in the package. The bill will need to be passed by The Senate passed the Inflation Reduction Act via the budget reconciliation process on Sunday in a party-line 51-50 vote, with Vice President Kamala Harris casting the tie-breaking vote. The $437 billion tax, climate, and health package is the product of careful negotiations between Senate Majority Leader Chuck Schumer (D-N.Y.), Sen. Joe Manchin (D-W.Va.), and most recently, Sen. Kyrsten Sinema (D-Ariz.). Sinema signaled her support for the bill late last week after a proposal to narrow the carried interest loophole was dropped and an exception to the minimum corporate tax was made for accelerated depreciation tax deductions used by many manufacturers. The legislation gives the Medicare program authority to set the price of certain high-expenditure prescription drugs, in both Part B and Part D. Sen. John Barrasso (R-Wyo.) had drafted an amendment that would remove providers who buy and bill Part B drugs from the middle of the new pricing mechanism and would instead enable Medicare to achieve the same savings via a direct rebate from drug companies, but the Congressional Budget Office was unable to score that amendment in time for consideration. The legislation would also cap out-of-pocket Part D spending at $2,000 per year and extend expanded Affordable Care Act premium subsidies for three years. The measure includes $374 billion for energy and climate programs. It would establish a 15% corporate minimum tax on large firms, a 1% excise tax on the value of stock buybacks, and an $80 billion increase to the Internal Revenue Service budget for tax enforcement. The chamber worked through the weekend to complete the vote-a-rama process, a marathon series of back- to-back amendment votes with no time limit. Most Democrats voted against all amendments to protect the underlying bill. Democrats did not have the 60 votes required to waive the procedural objection against a $35 cap on insulin for private insurance plans, which the Senate parliamentarian determined violated the chamber’s Byrd Rule. Seven Republicans - Sens. Bill Cassidy (R-La.), Susan Collins (R-Maine), Josh Hawley (R-Mo.), Cindy Hyde-Smith (R-Miss.), John Kennedy (R-La.), Lisa Murkowski (R-Alaska), and Dan Sullivan (R-Alaska) – voted with Democrats in the 57-43 vote. A $35 insulin cap for Medicare beneficiaries, however, remains in the package. The bill will need to be passed by


Senate Passes Veteran Burn Pit Legislation


The Senate passed the PACT Act (S. 3373) in an 86-11 vote last week. The bill would expand health benefits for veterans exposed to toxic burn pits and substances like Agent Orange while on active duty. Bill passage had previously been delayed by Senate Republicans due to a disagreement over a technical issue related to mandatory entitlement spending. The legislation will now be sent to President Joe Biden to be signed into law.


Pallone Submits Comments on Menthol Proposed Rule


House Energy and Commerce Committee Chair Frank Pallone (D-N.J.) sent a letter last week reiterating his support for the administration’s plans to ban menthol cigarettes. Pallone’s comment letter to the Food and Drug Administration urges the agency to utilize “its tobacco product standard authority to ban flavored tobacco products that attract kids, hook new users, and lead to tobacco-related disease and death.” The comment period for the FDA’s proposed rule Tobacco Product Standard for Menthol in Cigarettes closed last week.


Indiana Congresswoman and Two Staffers Killed in Car Accident


Congresswoman Jackie Walorski (R-Ind.) died last week following a head-on car crash in Elkhart County, Indiana. Walorski’s communications director Emma Thompson and her district director Zachery Potts also died in the accident. Walorski was serving her fifth term in the House of Representatives. She was a member of the Ways and Means Committee and the Ranking Member of the House Ethics Committee. In accordance with Indiana election law, a special election to complete Walorski’s term will be held because the vacancy occurred more than 74 days before the general election.


More Breakthrough COVID-19 Cases on Capitol Hill


Sen. John Cornyn (R-Texas) announced last Monday that he had tested positive for COVID-19. He is fully vaccinated and boosted and tweeted that he would quarantine “consistent with CDC guidelines.” House Budget Committee Chair John Yarmuth (D-Ky.) announced on Thursday that he had tested positive for COVID-19. Yarmuth is fully vaccinated and double-boosted and was experiencing very mild symptoms.



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