Zombies Reported in Washington

Congress can’t seem to resist tinkering with healthcare through legislation.

As we celebrate Halloween, we are seeing healthcare policy “zombies” here in Washington, D.C. – for as many times as congressional leadership has vowed to move on to other legislative topics, healthcare reform seems to always come back to life.

The big news in mid-October was the bipartisan two-year deal announced by U.S. Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wa.), funding the cost-sharing subsidies that the president had discontinued just the week prior. It also grants states more flexibility over Patient Protection and Affordable Care Act (PPACA) regulations and encourages states to meld their markets together and let more people buy low-cost, limited-coverage plans. Notably, the two-year agreement does not change the PPACA requirement that all individual market and small-group plans cover 10 categories of minimum essential benefits.

Despite having nearly two dozen bipartisan cosponsors – and, according to Senate Minority Leader Chuck Schumer (D-N.Y.), support from all 48 Senate Democrats, as well as support from many of the large provider organizations – the path forward for passage of the proposal seems bleak (even just passage by the Senate, which would take 60 votes). President Trump has wavered in his support for the proposal throughout the last few weeks. Efforts are also underway from the leaders of the House of Representatives’ Ways and Means Committee and the Senate Finance Committee to put forth an alternative proposal to fund the cost-sharing subsidies, with some additional controversial health reform changes included.

Another health policy ghost haunting the halls of Congress is the Children’s Health Insurance Program (CHIP). Progress has stalled on reauthorizing CHIP, with disagreements on how Congress can or should pay for the $8.2 billion, five-year extension of the program that covers roughly 9 million low-income children. Thus, we may not see passage of a reauthorization of the program until December.

Last week both Congress and the Trump administration also dialed in on the opioid epidemic. The House Energy and Commerce Committee held a hearing reviewing the status of the Comprehensive Addiction and Recovery Act (CARA), which passed in July 2016. Meanwhile, the president declared the nation’s opioid epidemic a public health emergency – stopping short of calling it a national emergency.

Congress is also evaluating preparedness for and response to the hurricanes that have devastated states and territories. The Energy and Commerce Committee had a hearing titled “Examining HHS’s Public Health Preparedness for and Response to the 2017 Hurricane Season.” A second installment of federal money to help areas struck by hurricanes and wildfires passed the Senate with a large bipartisan majority last week, 82-17. Lawmakers are already angling to ensure that a third aid package expected for November will provide much more money.

We’ve had two different acting U.S. Department of Health and Human Services (HHS) secretaries since Dr. Price departed, with the current Department leader being Eric D. Hargan, who had just been confirmed as deputy secretary by the Senate earlier this month. Rumors are flying on who the next nominee for secretary will be; potentials include Veterans Affairs (VA) Secretary David Shulkin and pharmaceutical executive Alex Azar, who served in the Department under then-Secretary Tommy Thompson. As for rules, providers are anxiously awaiting the release of the Quality Payment Program rule for 2018, resulting from the Medicare Access and CHIP Reauthorization Act (MACRA), as well as the Physician Fee Schedule.

We’ll all be watching closely today, as the Senate HELP Committee digs into the implementation of the 21st Century Cures Act, which features health IT provisions. Officials from the Office of the National Coordinator, Centers for Medicare & Medicaid Services (CMS), and the HHS Office of Inspector General (OIG) will give updates on topics including interoperability, regulatory burdens, and information blocking.

Finally, there’s also been a few chances for folks to weigh in with federal agencies on healthcare IT topics of interest recently, as comments were due last week on HHS’s draft strategic plan and comments on the VA’s draft telehealth expansion rule are due on Nov. 1.

As always, there’s never a dull moment here in Washington, especially with zombie policies afoot!