Congressional Corner




Jan. 11, 2018

Federal Funding Update

The current continuing resolution (CR) expires on Jan. 19. Congress will most likely approve another short-term CR to keep the government running through mid-February to allow more time for negotiations on broader issues such as immigration and opioid funding. However, the potential for a government shutdown cannot be entirely ruled out and the legislative text for the new CR has not been released. ASTHO will continue to monitor these developments and provide timely updates as soon as additional information is available.

CHIP and Other Public Health Program Renewal

A short-term spending bill to fund the government through mid-February could include reauthorization of CHIP and other health measures. Last Friday, the Congressional Budget Office revised its estimate of the cost of the Keep Kids’ Insurance Dependable and Secure Act of 2017 (S 1827) to reauthorize the program, reporting that it was less than previously projected in a letter sent to Sen. Hatch (R-UT). The report states that reauthorizing the program for 10 years more would save as much as $6 billion over 10 years, at a cost of $800 million over 10 years, since it is estimated that fewer children would be covered in private Affordable Care Act exchange plans. It is also rumored that the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) program is included and could move with the CR legislation. ASTHO will continue to monitor this bill and provide an update as soon as possible.

CMS Issues Guidance for States to Test Community Engagement for Able-Bodied Adults in Medicaid

Today, the Centers for Medicare and Medicaid Services (CMS) announced new guidance that it “will support state efforts to improve Medicaid enrollee health outcomes by incentivizing community engagement among able-bodied, working-age Medicaid beneficiaries.” Further, CMS has updated to include information on how states can pursue Medicaid section 1115(a) demonstration authority to test incentives that make participation in work or other community engagement a requirement for continued Medicaid eligibility or coverage for certain adult Medicaid beneficiaries. In the press release, CMS shared that this change “signals a new, broader view of these demonstrations in which states can focus on evidence-based approaches that drive better health outcomes, and quality of life improvements, and support upward mobility and self-sufficiency.” ASTHO will provide a memo on this announcement in next week’s Pulse.

Updated Senate Democratic Committee Assignments

On Jan. 9, Senate Minority Leader Chuck Schumer (D-NY) announced his party’s assignments for the second session of the 115th Congress.

HHS Secretary Nomination Hearing

On Jan. 9, the Senate Finance Committee held a hearing on the nomination of Alex Azar to serve as the next secretary of HHS. Azar highlighted his possible four main issue areas: (1) rising drug prices, citing his intention to “tackle these issues while still encouraging discovery,” (2) the affordability and accessibility of healthcare, (3) fully harnessing the “power of Medicare” by prioritizing preventative health, rather than procedures and sickness, and (4) the opioid epidemic, which requires “aggressive prevention, education, regulatory efforts,” and less legal and illegal drug use. Drug pricing, Medicaid, Medicare, the Affordable Care Act, reproductive health, and the opioid epidemic were key areas of interest among the committee members. Find more information and a recording of the hearing here.

Senate HELP Committee Opioid Hearing

On Jan. 10, the Senate Health, Education, Labor and Pensions Committee held a hearing entitled, “The Opioid Crisis: An Examination of How We Got Here and How We Move Forward.” The single witness was Sam Quinones, author of Dreamland. The hearing stayed away from political flashpoints except around Medicaid expansion and its contribution to addiction. The witness acknowledged that while Medicaid does open the door for access to clinicians and therefore opioids in some cases, it is also undeniable that it is essential for access to recovery. It was also discussed whether the federal government has a role in solving this problem. Other themes included:

  1. There is no magic wand for solving this problem. It took 20 years to get here and will take long, sustained, incremental, community-level solutions supported by the federal government in ways such as funding office space and telephone lines. Communities are great at coming up with solutions.
  2. There is no magic, non-addictive pain reliever, and pain relievers should not be thought of something that will solve this problem. America has now started to think that everything is easily solved with a pill, rather than other methods.
  3. Law-enforcement is doing wonderful things and needs continued support for its work.
  4. The witness “had never written about healthcare before this book and is in total awe of what local public health and CDC do in this country.”
  5. The witness emphasized the real importance of sustained, long-term funding and dedication to turning the tide on this problem.
  6. This epidemic is born from the deterioration of communities. To solve it, it will need to be dealt with in that way.
  7. This problem is also a supply problem. There was not this problem before the onslaught of pills into our communities, prescribed by mostly well-meaning doctors.

Senate HELP Committee Hearing on Public Health Preparedness

On Jan. 17, the Senate Health, Education, Labor and Pensions Committee will hold a hearing entitled, “Facing 21st Century Public Health Threats: Our Nation’s Preparedness and Response Capabilities, Part I.” Witnesses include: Robert Kadlec, MD, assistant secretary for preparedness and response, HHS; Scott Gottlieb, MD, commissioner, FDA; Brenda Fitzgerald, MD, director of CDC and administrator for the Agency for Toxic Substances and Disease Registry.