What's Next for Health Reform?

Republicans remain divided on a path forward following the collapse of efforts to repeal and replace the Affordable Care Act (ACA). Lawmakers like Sens. Bill Cassidy (R-La.), Rob Portman (R-Ohio), John McCain (R-Ariz.), and Lisa Murkowski (R-Alaska) are urging their colleagues to begin work on a bipartisan plan that moves through regular order. Additionally, Sen. Bill Nelson (D-Fla.) has said that he has already begun work with Sen. Susan Collins (R-Maine) and a small group of senators from both parties on a bipartisan approach to stabilizing the market and making health insurance more affordable. Others, like Sen. Ted Cruz (R-Texas) and House Freedom Caucus Chairman Mark Meadows (R-N.C.) have dismissed any suggestions of working across the aisle, and wish to continue pursuing GOP-only health reform efforts. Other lawmakers are turning away from comprehensive health care reform altogether. Chairman of the House Energy and Commerce Committee Greg Walden (R-Ore.) has expressed interest in appropriating cost-sharing reduction payments to strengthen the individual market as soon as the House of Representatives returns from August recess.

While President Trump initially appeared to support waiting for the collapse of Obamacare before returning to health care reform, he has since expressed optimism about a plan from Sens. Lindsay Graham (R-S.C.), Bill Cassidy (RLa.), and Dean Heller (R-Nev.). Their proposal would provide hundreds of billions in federal money from ACA taxes to states for the purpose of designing their own health insurance market. Sen. Graham has said that he is including members of the House Freedom Caucus in discussions of the block grant proposal.

House Completes Work on Four Appropriations Bills

Before adjourning for August recess, the House completed work on its first spending legislation for fiscal year (FY) 2018, packaging together appropriations for Defense, Military Construction-VA, Energy and Water Development, and the Legislative Branch. Combined, the bill comprises 66 percent of federal discretionary spending. When the House of Representatives returns from August recess on September 5, leadership plans to bring the eight remaining spending bills to the floor for a vote. It is unclear when the Senate will move any appropriations bills to the floor. According to Speaker Ryan, tax reform will also be high on the House GOP agenda when members return from recess.

Ways and Means Launches Project to Cut Medicare Red Tape

The House Ways and Means Committee has launched an initiative aimed at scaling back regulatory and legislative burdens in the Medicare program. The Medicare Red Tape Relief Project requests comments from health care stakeholders about mandates that raise costs and hinder innovation and care quality. Lawmakers hope to work with the health care industry to find and eliminate such regulations either through legislation or administrative action, in conjunction with the U.S. Department of Health and Human Services (HHS). Health Subcommittee Chairman Pat Tiberi’s (R-Ohio) ultimate goal is to improve efficiency and care quality for Medicare beneficiaries. The initiative will also include congressional roundtables with stakeholders across the country. Comments are due by August 25.

House Passes Medicare Part B Package

The House of Representatives passed H.R. 3178 by voice vote last week. The Medicare Part B Improvement Act is a package of changes to the Medicare Part B home infusion and dialysis benefits. It would create a transitional payment for providers of home infusion services before 2021, and would extend a demonstration project that pays for in-home administration of intravenous immunoglobulin (IVIG). The bill would also allow dialysis centers to use telehealth for home patient monitoring, and would make it easier for beneficiaries to access customized orthotics and prosthetics.

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