Appropriations Actions to Slide into September

The House and Senate continue at odds over the Health and Human Services (HHS) supplemental spending bill which would help pay for the costs of caring for illegal migrant children. The House Appropriations Committee has not scheduled action on the fiscal year (FY) 2015 Labor/HHS/Education appropriations bill while in the Senate, Senator Tom Harkin (D-IA) released a draft bill for full committee consideration which will likely be used as a guide for negotiations over an omnibus spending bill which appears inevitable, most likely after the November elections (although the Senate would prefer earlier action). The bill which would fund PPACA implementation at FY 2014 levels and give the National Institutes of Health (NIH) a 2% increase in funding over FY 2014 levels generally follows the terms of the previously reported subcommittee bill. Appropriations Committee Chairwoman Barbara Mikulski (D-MD) remains intent to have the Senate take up the Military Construction/Veterans Affairs (VA) FY 2015 spending bill before the beginning of the new fiscal year. It is almost certain that a continuing resolution (CR) will be passed before October 1, with the Defense appropriations bill possibly being approved so as to avoid the CR spending restrictions.

PPACA Implementation Moves Forward Amid Republican Criticism

At a House Ways and Means Subcommittee on Oversight hearing, a Government Accountability Office (GAO) official testified that the agency’s investigation of the law’s HealthCare.gov enrollment process resulted in 11 out of 12 fraudulent applications for individual subsidies when using false identities and citizenship and forged documents. Chairman Charles Boustany (R-LA) said that the Centers for Medicare and Medicaid Services (CMS) is “either unaware or unable to screen out fraudulent applications nationwide with regard to subsidies….This is all very troubling.” GAO said that the limited test indicates that controls, particularly at the front-end of the enrollment process, are ineffective. HHS issued a statement that the agency is “examining this report carefully and will work with GAO to identify additional strategies to strengthen our verification processes.” Democrats said that HHS and the Internal Revenue Service (IRS) need adequate funding to prevent fraud. HHS also reported on enrollment progress, released a study finding that 10.3 million previously uninsured adults gained coverage during the first open enrollment period, thus reducing the age 18-64 uninsured rate from 21% to 16.3%. Also, the agency reported that the law’s medical loss ratio (MLR) rule resulted in 6.8 million insured receiving refunds totaling $330 million, or about $80 per family. HHS also eased the application of the law’s provisions relating to--community rating, preexisting conditions, essential health benefits, and medical loss ratios, et al--for U.S. territories using administrative authority to remove the territories from the term covered “state”. The territories are not subject to the individual mandate and their residents are not eligible for subsidies. The IRS also released “Health Coverage” and “Employer-Provided Health Insurance Offer and Coverage” forms employers must submit pursuant to the law’s employer mandate. Failure to comply would result in penalties capped at $2,448 for individuals and $12,240 for families with five or more members. The IRS/Treasury also issued regulations which would allow victims of abandonment and domestic abuse who file separate tax returns to be eligible for PPACA premium subsidies.

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