Congressional Corner




Nov. 30, 2017

Congressional To-Do List

The checklist for Congress is quite long right now, including legislation that impacts state public health. Legislation that ASTHO is closely monitoring includes:

  • FY2018 appropriations.
  • Raising the spending caps through a budget deal.
  • Emergency supplemental funding for states and territories impacted by hurricanes, including funds for HHS.
  • Reauthorization of funding for the Children’s Health Insurance Program, community health centers, and the National Health Service Corps.
  • Reauthorization of Maternal, Infant, and Early Childhood Home Visiting Programs.
  • Tax reform.
  • Opioid funding.

More information about the legislation, the current state of play, and ASTHO advocacy efforts can be found here.

Continuing Resolution Status

According to reports on Wednesday, it appears that Congress will develop another short-term continuing resolution (CR). The next CR would only last a few weeks later in December, but congressional appropriators are open to potentially developing another CR that lasts into January, if needed, to wrap up this year’s business. The current CR expires on Dec. 8. ASTHO will continue to monitor the status and provide updates.

Tax Reform and Potential Impact on Health

On Nov. 14, the Senate Finance Committee included a repeal of ACA’s individual mandate along with a measure to stabilize the insurance markets by funding cost-sharing reduction payments and increasing state flexibility in their tax reform proposal.

The Congressional Budget Office (CBO) estimates that over a decade repeal of the individual mandate could increase the number of uninsured by 13 million and increase premiums by 10 percent in most years. However, this could also save the federal government $338 billion. CBO also reports that most markets would remain stable.

Sen. Collins (R-ME) and Sen. Nelson (D-FL) are also working to include in the tax reform bill a provision to provide $2.25 billion annually for states to set up reinsurance programs to fund high-cost patients.

Additionally, the tax bill could pose a threat to the Prevention and Public Health Fund (PPHF) through the Statutory Pay-As-You-Go Act of 2010. For more information, ASTHO developed a factsheet about current proposed cuts to the PPHF.  

The content included in the final tax reform package remains in flux. ASTHO will continue to monitor the situation as it develops.

HHS Secretary Hearing

Alex Azar, President Trump’s nominee for secretary of HHS, attended his first confirmation hearing on Wednesday with the Senate Health, Education, Labor and Pensions Committee. Much of the hearing focused on prescription drug pricing. Azar also provided insight into what his priorities would be if confirmed and discussed his ideas about how to make healthcare more affordable and available by shifting Medicare further in the direction of creating incentives for good health outcomes rather than volume of medical care, as well as fighting the “scourge of the opioid epidemic.” In addition, the hearing covered the structure of the Medicaid program and ACA implementation. There will be future hearings on his confirmation.

Opioid Hearings

On Nov. 28, the House of Representatives Full House Committee on Oversight and Government Reform held a hearing entitled “Combating the Opioid Crisis” to discuss the findings and recommendations from the President’s Commission on Combating Drug Addiction and the Opioid Crisis, as well as to review the City of Baltimore’s efforts to address the opioid epidemic in their community.

The hearing included testimony from local and federal health and drug agencies and ended with a question and answer session with Chris Christie, chair of the President’s Commission. Recommendations included campaigns to address stigma, research and evaluation for alternative pain management options, education for providers, access to naloxone, implementation of a drug court, and better screening procedures to catch imported fentanyl.

Today, the Senate Committee on Health Education, Labor and Pensions held a hearing entitled, “The Front Lines of the Opioid Crisis: Perspectives from States, Communities, and Providers.” ASTHO will provide more details next week.

Next week, the Labor, Health and Human Services, Education and Related Agencies Subcommittee of Senate Appropriations Committee will hold a hearing on the opioid crisis, focusing on prevention, treatment, and recovery. The hearing is scheduled to take place on Dec. 5, at 10 a.m. ET.