The Road to 218, 51

Assuming all Democrats vote against AHCA, Republicans can only afford 21 defections in the House. Seventeen members are currently on the record in opposition to AHCA, with many more leaning no or still
uncertain. In the Senate, Dean Heller (R-Nev.) and Susan Collins (R-Maine) are the latest members to state their opposition to the legislation as currently written. While other moderate Republicans are still undecided on how they would vote, President Trump is meeting with more conservative members to address their concerns about the bill. Trump met with Sen. Ted Cruz (R-Texas), Sen. Mike Lee (R-Utah), and House Freedom Caucus Chairman Mark Meadows (R-N.C.) over the weekend to discuss changes to the bill that could lower costs for consumers. Majority Leader Mitch McConnell (R-K.Y.) continues to offer assurances that the Senate will take up the House measure, and allow amendments when it comes to the
Senate floor. President Trump has expressed confidence that AHCA will pass quickly.

House Passes VA Patient Access Legislation

The House of Representatives has passed H.R. 1367, a bill aimed at improving the authority of the Secretary of Veterans Affairs (VA) to hire and retain physicians by a vote of 412-0. The bill would establish a health care and benefits fellowship program in partnership with the private sector, and create a database of mission-critical vacant positions in the Department. The VA would also be authorized to appoint a qualified former employee without the use of the competitive hiring process.

White House Budget Blueprint Released

President Trump released his fiscal year (FY) 2018 budget blueprint last week. The White House budget proposal would cut funding for the U.S. Department of Health and Human Services (HHS) by $15 billion – approximately 18 percent – in FY 2018. HHS funds to address waste, fraud and abuse and to improve substance abuse detection and treatment would increase, while funding for biomedical research and programs for low-income individuals would be cut. The Health Care Fraud and Abuse Control Program would receive an additional $70 million in funding, and the Substance Abuse and Mental Health Services Administration (SAMHSA) would receive an additional $500 million. The National Institutes of Health (NIH), however, would see a $5.8 billion budget cut. The Fogarty International Center, which conducts global health research, would be eliminated, and the Agency for Healthcare Quality and Research (AHRQ) would be absorbed into the NIH. The White House budget would double medical product user fees from a total of $1 billion to $2 billion annually, and $400 million in funding for dedicated health care professional training programs would be eliminated. The Department of Veterans Affairs (VA) would see a $4.4 billion budget increase. The additional funds would be used to expand the VA’s Choice Program and patient access to care. Many congressional Republicans and appropriators have already made it clear that they are not in agreement with all of the details of the budget blueprint. Ultimately Congress will determine the funding specifics of the FY 2018 budget through the federal appropriations process. Director of the Office of Management and Budget (OMB) Mick Mulvaney has said that the full White House budget can be expected in May, and will contain the President’s plans for reforming the Medicare program.

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