Both Chambers Consider Budget Rule Changes

The House will begin using a structured rule process (instead of an open-rule process) for floor consideration of appropriations bills, beginning with debate on the fiscal year (FY) 2017 Defense appropriations bill this week. The decision was made by House Republican leadership following a conference meeting last Wednesday, both in order reduce the number of controversial amendments offered by Democrats, and to move forward more quickly with the remaining FY 2017 spending bills. Amendments will now have to be approved by the House Rules Committee before debate on the floor. The announcement received strong criticism from Democrats. Some rank and file Republican conservatives are also concerned with the decision, and worry that their own amendments will not be brought up for consideration. On the other side of the Capitol, the Senate Budget Committee held a closed-door meeting last week with former Senate Budget Committee chairmen Judd Gregg (R-NH) and Kent Conrad (D-ND) to discuss overhauling their chamber’s budget process. The former senators recommended the formation of a new fiscal commission to strengthen the budget process. A related bill is expected to be released and marked up in the Senate before Congress leaves for recess on July 15.

Zika Update

Last week, the Senate agreed by voice vote to join the House in a conference committee to resolve the differences in each chamber’s Zika response legislation. The House bill is fully offset and would provide $622 million in funding through the end of fiscal year (FY) 2016. The Senate bill is not offset, and would provide $1.1 billion in funding with no expiration date. The Republicans representing the Senate in conference are Sens. McConnell (KY), Blunt (Mo.), Kirk (Ill.), Graham (S.C.), Collins (Maine), Murkowski (Alaska), Hoeven (N.D.), Boozman (Ark.), Capito (W.V.), and Cochran (Miss.). The Democrats representing the Senate are Sens. Mikulski (Md.), Murray (Wash.), Tester (Mont.), Reed (R.I.), Udall (N.M.), Schatz (Hawaii), Baldwin (Wis.), Murphy (Conn.), and Leahy (Vt.). Meanwhile, the administration released a draft action plan for combatting the transmission of the Zika virus last week during a teleconference with officials from the states most vulnerable to an outbreak. The Centers for Disease Control and Prevention (CDC) will provide states with a step-by-step emergency plan to respond to locally transmitted cases of Zika. The administration’s protocol has not yet been made public. The World Health Organization (WHO) released new guidance last week that urges people to consider delaying pregnancy in areas where Zika is actively spreading. This represents the organization’s strongest warning yet about the virus, and would apply to 46 countries as well as the U.S. territory of Puerto Rico.

House Passes Hospital Legislative Package

Last week, the House of Representatives unanimously passed the bipartisan Helping Hospitals Improve Patient Care Act (H.R. 5273). The legislation would allow additional hospital outpatient facilities to receive grandfathered status to exclude them from the site-neutral payment rules included in last year’s budget agreement. It would also add beds for long-term care hospitals (LTCHs), extend a rural hospital demonstration, and delay the administration’s authority to terminate some Medicare Advantage (MA) contracts. There is no companion legislation in the Senate, and the Finance Committee has no immediate plans to act on the bill.

Lawmakers Inquire About the Availability of Naloxone

Chairman and Ranking Member of the Senate Aging Committee Susan Collins (R-Maine) and Claire McCaskill (D-Mo.) have sent identical letters to five drug companies questioning their efforts to make the opioid reversal drug naloxone accessible to the public. The senators cite reports that the price of one version of the drug rose 17-fold in the last two-years. Some hospitals have also reported difficulty obtaining sufficient amounts of the drug. “Given these reports, we request that you provide insight into what actions you are taking to ensure continued and improved access to naloxone, an explanation for price changes in your company’s naloxone product, and a description of the available resources and tools to prevent barriers to access and shortages of this critical and life-saving medication,” the lawmakers write.

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