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Oct. 12, 2017

The Senate is in recess this week and will return next week. The House will be in recess next week and return on Oct. 23.

Executive Order on Healthcare

This morning, President Trump signed an executive order that could result in changes to the healthcare marketplace. The executive order does not offer much in the way of specific policy proposals, but rather offers specific instructions to various departments. This includes:

  1. Directing the secretary of labor to consider expanding access to Association Health Plans, which could potentially allow American employers to form groups across state lines.
  2. Directing the departments of the Treasury, Labor, and HHS to consider expanding coverage through low-cost, short-term limited duration insurance.
  3. Directing the departments of Treasury, Labor, and HHS to consider changes to Health Reimbursement Arrangements so that employers can make better use of them for their employees.

According to a Q&A document released by the White House, “any proposed regulations would comply with the public notice and comment process required by the Administrative Procedure Act, which requires publication in the Federal Register and a public comment period.” With ACA open enrollment slated to begin on Nov. 1, it is unclear whether the departments will propose or finalize any rules related to the executive order in time for 2018. The executive order is expected to be released on the White House website on Thursday.

CHIP Extension Update

Rep. Walden, chairman of the House Energy and Commerce Committee, announced that the House of Representatives will delay consideration of a bill to extend funding for the Children’s Health Insurance Program and other public health programs. The hope is to reach a bipartisan agreement on offsets. If the House is unable to reach a deal by the end of the week, it will consider committee-approved bills upon return from recess on Oct. 23.

Acting Secretary of HHS

On Oct. 10, the Trump Administration announced that Eric Hargan will serve as acting secretary of HHS.

Emergency Supplemental

This week, the House Appropriations Committee unveiled $36.5 billion emergency supplemental funding for hurricane and wildfire relief recovery. According to a press statement issued by House Appropriations Committee Chairman Rep. Frelinghuysen, the legislation includes $18.7 billion for the Federal Emergency Management Agency’s (FEMA) Disaster Relief Fund, $576.5 million for wildfire efforts, and $16 billion for debt relief for the National Flood Insurance Program. The bill also includes a provision for the Disaster Nutrition Assistance Program to enable low-income residents in Puerto Rico to receive the same emergency nutrition assistance that other hurricane-affected states already receive.

ASTHO expects another emergency supplemental bill to be developed in the upcoming weeks to address the public health needs of these communities. ASTHO will urge Congress to provide emergency supplemental funding for critical public health, healthcare, and behavioral health services to address the ongoing crises in Texas, Florida, Puerto Rico, and the U.S. Virgin Islands.

The Centers for Medicaid and Medicare (CMS) Approves West Virginia Request to Expand Substance Abuse Treatment

CMS recently approved a proposal to expand Medicaid coverage for substance abuse treatment via a five-year section 1115 demonstration entitled, “Creating a Continuum of Care for Medicaid Enrollees with Substance Abuse Disorder.” According to an article in Politico Pulse, “in December, officials from West Virginia asked CMS to lift a decades-old restriction on Medicaid payments for inpatient treatment at large residential facilities. This waiver also allows the state Medicaid program to cover naloxone, peer support services, and methadone. The federal government will fund 80 percent of expenses incurred under the waiver.”

340B Drug Pricing Program

Today, the House Energy and Commerce Committee held a hearing entitled, “Examining How Covered Entities Utilize the 340B Drug Pricing Program.” Witnesses included:

Shannon A. Banna, director of Finance and System Controller, Northside Hospital, Inc.
Mike Gifford, president and CEO of the AIDS Resource Center of Wisconsin.
Ronald A. Paulus, president and CEO of Mission Health Systems, Inc.
Charles Reuland, executive vice president and COO of Johns Hopkins Hospital.
Sue Veer, president and CEO of Carolina Health Centers, Inc.

Read the Energy and Commerce Committee background memo here.

House Energy & Commerce Committee Hearing on the Opioid Crisis

On Oct. 12, the House Energy and Commerce Committee held a hearing to enable members of Congress to provide testimony and proposals on the opioid crisis. ASTHO will provide additional information in next week’s Congressional Corner.