POLICY BRIEFINGS


Trump to Address Congress


Speaker of the House Paul Ryan (R-Wis.) announced that he has invited the President to speak before a joint session of Congress on February 28. President Trump’s remarks will not be considered a State of the Union address; it is traditional for incoming presidents to speak before Congress during their first months in office. It is unknown whether the President will focus his speech on a particular topic.


Finance Committee Questions Price, Vote Scheduled for Tuesday


Rep. Tom Price (R-Ga.) completed his second confirmation hearing, this time before the Senate Finance Committee, last week. Democrats once again questioned him about the ethics of his trading of medical stocks. Eight of the 11 Democrats on the Senate Health, Education, Labor, and Pensions (HELP) Committee penned a letter last week to the Securities and Exchange Commission (SEC) calling on them to investigate the nominee’s stock trades. Rep. Price continued to deny any wrongdoing. He was praised by Republican Committee members for his experience as both a legislator and a medical provider. Both sides were eager to learn more about the President’s Affordable Care Act (ACA) replacement plan. President Trump has said he is working on the plan with Rep. Price and would unveil it following Price’s confirmation. Rep. Price did not provide any details of what the Trump Administration’s health care plan would look like, but instead reiterated that it would ensure access to affordable coverage. Democrats also questioned Rep. Price about his past proposals to restructure the Medicare and Medicaid programs. He spoke in favor of giving states more flexibility to administer their Medicaid programs, and said he is in favor of an eight-year extension of the Children’s Health Insurance Program (CHIP). But on the issue of Medicare reform he stressed that his role as Secretary of the U.S. Department of Health and Human Services (HHS) would be very different than his job as a legislator. The President campaigned on a promise not to cut spending for Social Security, Medicare or Medicaid. The Senate Finance Committee is scheduled to vote on Price’s confirmation this week. During his own confirmation hearing to head the Office of Management and Budget (OMB), Rep. Mick Mulvaney (R-S.C.) acknowledged that his own views on the subject differ from the President’s. He said that he would be frank with President Trump about the state of entitlement programs, and not back down from promises to reform program spending. During his time in Congress Rep. Mulvaney has been a fiscal hawk in favor of reforming Medicare and Social Security. He supports raising the retirement age and means-testing under Medicare, but promised not to cut benefits for current recipients. For updated information on the Trump Administration Personnel, please see the attached document prepared by Hart Health Strategies Inc.


Trump Withdraws from TPP


Last week, the President signed an executive order announcing his plan to withdraw from the Trans-Pacific Partnership (TPP) trade deal. His plan is to instead negotiate individual trade agreements with the countries in the partnership, according to reports.


Senators Outline ACA Replacement Plans


Sens. Bill Cassidy (R-La.) and Sen. Susan Collins (R-Maine) introduced the Patient Freedom Act (S. 191) which would keep many of the 2010 health care law’s taxes in place, and give states the choice of whether they want to keep the ACA insurance market in operation, complete with the current law’s subsidies, mandates, and protections for people with preexisting conditions. States that do not choose to keep the ACA framework could opt into an alternative plan with many of the same consumer protections but fewer regulations. This plan would likely be cheaper, but less comprehensive. It would provide an age-based, uniform tax credit linked to a health savings account (HSA), which could be used to purchase basic
health insurance coverage. Sen. Cassidy acknowledged that the tax credit would not cover every dollar up to the high deductible that the state catastrophic insurance plan would entail, but would instead allow low-income people to begin accessing health services. Every eligible American would be auto-enrolled. States that have not expanded Medicaid would still have the option to do so and receive the federal funding associated with expansion. The bill’s sponsors are hopeful that this compromise will both lower premiums and help to garner support from Senate Democrats, though Senate Minority Leader Chuck Schumer (D-N.Y.) has already expressed opposition to the legislation. The plan will likely be opposed by
many conservatives as well, for failing to repeal all of the ACA’s taxes. Sen. Johnny Isakson (R-Ga.) and Sen. Shelley Moore Capito (R-W.V.) joined Sens. Cassidy and Collins in introducing the legislation. Sen. Rand Paul (R-Ky.) also introduced his own ACA replacement plan last week – the Obamacare Replacement Act. Sen. Paul has been a strong proponent of quick and simultaneous repeal and replace. His bill includes a tax credit of up to $5,000 per person for the purpose of an HSA to pay for medical care, as well as a tax deduction for people buying health insurance on their own. He would repeal the individual mandate and eliminate requirements for minimal essential benefits that health plans must cover. The bill
includes protections for people with pre-existing conditions only if they maintain continuous coverage, and would allow insurers to sell plans across state lines.


Upcoming Congressional Hearings and Meetings


House Energy and Commerce Subcommittee on Oversight and Investigations hearing entitled “Medicaid Oversight: Existing Problems and Ways to Strengthen the Program;” 10:00 a.m., 2123 Rayburn Bldg.; January 31

Senate Finance Committee open executive session to consider the nomination of Thomas Price to be Secretary of Health and Human Services;” 10:00 a.m., 215 Dirksen Bldg.; January 31

House Oversight and Government Reform Health Care, Benefits and Administrative Rules Subcommittee hearing entitled “Fraud, Waste, and Abuse under the Affordable Care Act;” 2:00 p.m., 2247 Rayburn Bldg.; January 31

Senate Health, Education, Labor, and Pensions Committee hearing entitled “Obamacare Emergency: Stabilizing the Individual Health Insurance Market;” 10:00 a.m., 430 Dirksen Bldg.; February 1

House Energy and Commerce Health Subcommittee hearing entitled “Strengthening Medicaid and Prioritizing the Most Vulnerable,” 10:00 a.m., 2123 Rayburn Bldg.; February 1

House Energy and Commerce Health Subcommittee hearing entitled “Patient Relief from Collapsing Health Markets;” 10:30 a.m., 2123 Rayburn Bldg.; February 2


Recently Introduced Health Legislation


H.R. 592 (introduced by Rep. Guthrie): A bill to amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services; Energy and Commerce, Ways and Means

S. 183 (introduced by Sen. Klobuchar): A bill to allow for expedited approval of generic prescription drugs and temporary importation of prescription drugs in the case of noncompetitive drug markets and drug shortages; Health, Education, Labor, and Pensions

S.191 (introduced by Sen. Bill Cassidy): A bill to improve patient choice by allowing States to adopt market-based alternatives to the Affordable Care Act that increase access to affordable health insurance and reduce costs while ensuring important consumer protections and improving patient care; Finance

S.194 (introduced by Sen. Sheldon Whitehouse): A bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Health, Education, Labor, and Pensions

H.R.626 (introduced by Rep. Glenn Thompson): To amend title XVIII of the Social Security Act to include recreational therapy among the therapy modalities that constitute an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit; Ways and Means.

H.R.628 (introduced by Rep. Rodney Davis): To amend the Public Health Service Act to prohibit application of preexisting condition exclusions and to guarantee availability of health insurance coverage in the individual and group market, contingent on the enactment of legislation repealing the Patient Protection and Affordable Care Act, and for other purposes; Energy and Commerce.

H.R.633 (introduced by Rep. Gregg Harper): To authorize health insurance issuers to continue to offer for sale health insurance coverage offered in the individual market before the enactment of the Patient Protection and Affordable Care Act in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes; Energy and Commerce, Ways and Means.

H.R.635 (introduced by Rep. Janice D. Schakowsky): To amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Energy and Commerce.

H.R.640 (introduced by Rep. Rick W. Allen): To amend title I of the Patient Protection and Affordable Care Act to require that a State awarded a Federal grant to establish an Exchange and that terminates the State operation of such an Exchange provide for an audit of the use of grant funds and return funds to the Federal Government, and for other purposes; Energy and Commerce.

H.R.661 (introduced by Rep. Brett Guthrie): To authorize health insurance issuers to offer for sale previously available health insurance coverage in the small group market in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes; Energy and Commerce, Ways and Means.

H.R.662 (introduced by Rep. Lynn Jenkins): To enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Energy and Commerce.

H.R.664 (introduced by Rep. David P. Joyce): To prevent the abuse of opiates, to improve response and treatment for the abuse of opiates and related overdoses, and for other purposes; Energy and Commerce, Judiciary, Oversight and Government Reform, Armed Services.

H.R.676 (introduced by Rep. John Conyers, Jr.): To provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; Energy and Commerce, Ways and Means, Natural Resources.

H.R.682 (introduced by Rep. Markwayne Mullin): To amend titles XIX and XXI of the Social Security Act to eliminate the CHIP maintenance of effort requirement and to eliminate DSH cuts for States not implementing the ACA Medicaid expansion; Energy and Commerce.

S.196 (introduced by Sen. Bill Cassidy): A bill to provide for a Public Health Emergency Fund, and for other purposes; Health, Education, Labor, and Pensions.

S.204 (introduced by Sen. Ron Johnson): A bill to authorize the use of unapproved medical products by patients diagnosed with a terminal illness in accordance with State law, and for other purposes; Health, Education, Labor, and Pensions.

S.207 (introduced by Sen. Amy Klobuchar): A bill to amend the Controlled Substances Act relating to controlled substance analogues; Judiciary.

S.222 (introduced by Sen. Rand Paul): A bill to repeal provisions of the Patient Protection and Affordable Care Act and provide private health insurance reform, and for other purposes; Finance.



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SERVICES




BRIEFING ARCHIVE


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