POLICY BRIEFINGS


Health Legislation Cleared Before Congress Adjourns


The House acted last week on the Senate passed version of S. 2154, the Emergency Medical Services for Children Reauthorization Act, and the President signed the bill into law. The Senate also sent to the President the bill H.R. 4994, the Improving Medicare Post-Acute Care Transformation Act (IMPACT Act), that would require providers to submit standardized data by 2019 to allow Medicare to compare quality across different post-acute care settings in long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities and home health agencies. Sponsors intend that the data obtained will assist in making changes to post-acute payment system via a new site-neutral or bundled payment system, etc. To help boost compliance the bill would allow HHS to reduce payments to skilled nursing facilities by 2% if they fail to report the required information. The bill also included several hospice program integrity provisions. The Senate also sent to the President the House-passed bill H.R. 4276, the Veterans Traumatic Brain Injury Care Improvement Act of 2014, which among other things increases to $250 million a comprehensive service program for homeless veterans. In addition, the Senate sent to the President for his signature the House-passed bills H.R. 4771, the Designer Anabolic Steroid Control Act of 2014; and H.R. 594, the Paul D. Wellstone Muscular Dystrophy Community Assistance, Research and Education Amendments of 2014. The Senate also passed S. 2539, the Traumatic Brain Injury Reauthorization Act, and S. 2141, the Sunscreen Innovation Act, which amends the Federal Food, Drug, and Cosmetic Act to provide an alternative process for the review of safety and effectiveness of nonprescription sunscreen active ingredients.


House Passes Bill to Repeal PPACA Medical Device Tax


Before adjourning, the House took one last shot at the Patient Protection and Affordable Care Act (PPACA) by passing H.R. 4, tax legislation that among other things would repeal the PPACA’s 2.3% medical device excise tax. However, the Senate rejected the unanimous consent request by Senator David Vitter (R-LA) to pass H.R. 3522, the Employee Health Care Protection Act, the House-passed bill that would allow health insurers to continue to offer group health insurance coverage in 2014 outside of PPACA exchanges to the extent that such policies were offered on any date in 2013 (even though they do not meet PPACA minimum essential coverage provisions).


House Republicans Take Parting Shot at Obamacare


At a House Oversight and Government Reform Committee hearing held before Congress adjourned, the Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner touted the PPACA, saying “A new wave of evidence shows that the Affordable Care Act is working to make health-care coverage more affordable, accessible and of higher quality, for families, seniors, businesses and taxpayer alike….” Nonetheless, upon questioning she admitted that only about 7.3 million people had paid for their exchange-related health coverage on August 15th which is 9% less than the 8 million figure reported by CMS in May. Chairman Darrell Issa (R-CA) and other Republicans peppered the Administrator with questions about the security of HealthCare.gov and missing emails. Rep. Issa said that “this administration has not complied with, nor caused their key executives including political appointees, to comply with the federal records act….” which he said has hindered his committee’s investigation of the law’s implementation. In response the CMS Administrator said that the website has not had a major data security problem that has accessed personally identifiable information, despite what the committee insists is evidence from a Government Accountability Office (GAO) audit that the website has had thirteen security incidents. Another House committee, the Small Business Subcommittee on Health and Technology, held a hearing in which Chairman Chris Collins (R-NY) pressed a CMS official in charge of state health insurance exchanges about the lack of response to earlier requests on the level of enrollment under the Small Business Health Options Program (SHOP). The witness responded that after CMS has collected the data from the state SHOPs it will give the information to Congress and the public as soon as it’s available. On a positive note, HHS reported that $290 million in savings for individuals and $703 million in savings for small employers resulted from the law’s provisions requiring the reporting of premium increases over 10%. Also, CDC reported that the PPACA reduced the percentage of individuals in the U.S. without health insurance by 2% earlier this year. However, the agency also said that about 42 million individuals lacked health insurance in 2013. Covered individuals also face additional hurdles in keeping their plans and subsidies. CMS reported that about 115,000 individuals have yet to verify their citizenship or immigration status to ensure they are eligible for coverage and will lose it beginning in October if they fail to certify their status. Another 279,000 households may have their premium subsidies reduced or eliminated in 2015 if they do not clear up discrepancies in their reported income.



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