Appropriations Issues

To put pressure on House Republicans to scotch any plans they may have had for passing an omnibus FY 2012 appropriations bill, the Senate Majority Leader Harry Reid said his intent is to finish as many of the twelve bills as possible before the Super Committee issues its deficit reduction recommendations by November 23rd.  The first of several “minibus” bills is expected to reach the Senate floor this week and will include the Agriculture/FDA bill, H.R. 2112, the Commerce/Justice/Science bill, H.R. 2596, and the Transportation/HUD bill, S. 1596.  The first minibus could be followed by another which could include several or all of the following appropriations for: Defense, H.R. 2219, Energy/Water, Homeland Security, the Legislative Branch and State/Foreign Operations.  The disposition of the Labor/HHS/Education bill remains uncertain given the partisan vote on this bill in the Senate Appropriations Committee and the lack of House action on this measure.  House Republicans will likely insist that all spending bills adhere to a Budget Control Act provision capping all FY 2012 spending at $1.019 trillion. 

Members Finalize Recommendations to Super Committee

Faced with last Friday’s deadline for committees to provide their recommendations to the Joint Select Committee on Deficit Reduction, members in both houses delivered their recommended priorities for spending reductions and for saving various health-related program spending levels.  Given the partisan divide over spending and tax issues, bipartisan recommendations were not marked up in any committee.  Senate HELP Committee Chairman Tom Harkin told the Super Committee to avoid cutting the PPACA’s Prevention and Public Health Fund which is slated to receive $15 billion over ten years and funding for state health insurance exchanges.  He instead steered the committee to find savings by streamlining the development process for biologic drugs and by expanding hospital drug discount programs for Medicaid patients.  In contrast, Senate Finance Committee Republicans suggested the committee repeal the PPACA, consider raising the Medicare eligibility age, block grant Medicaid, and reduce waste-fraud-abuse under federal health programs among other recommendations.  In related news, the Senate Special Committee on Aging held hearings on the financial challenges facing Medicare.  Witnesses testified that provider reimbursement cuts could save a significant amount of money over the next 10 years, but that such changes would not adequately address the program’s actuarial deficit and that fundamental reform is needed, including delivery system reforms that would change the fee-for-service structure.  Senator Herb Kohl sent the Super Committee recommendations he said would save $140 billion over ten years, including speeding generic drugs to the market by ending pay-for-delay settlements and allowing CMS to directly negotiate prescription drug prices under Medicare Part D.

CLASS Dismissed!

HHS Secretary Kathleen Sebelius responded to Republican calls for hearings and information on the viability of the PPACA long-term care CLASS Act by writing to House Speaker John Boehner that HHS had pulled the plug on the program.  She said that “….despite our best analytical efforts, I do not see a viable path forward for CLASS implementation at this time….”  A full report is to be sent to Congress on the results of the 19-month analysis of the program.  Senate HELP Committee Ranking Member Mike Enzi said “The CLASS Act was unsustainable and fiscally unsound from the start and Secretary Sebelius made the right decision not to implement this program.”  The demise of the program leaves a hole in the financing of the PPACA given that premiums would be paid for three years before benefits under the program would begin.

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