Congressional Corner

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Sept. 28, 2017

Senate Will Not Vote on Latest Health Reform Effort

Yesterday, Senate leaders announced they will not hold a vote on the Graham-Cassidy legislation to overhaul ACA. Sen. Collins (ME), Sen. Paul (KY), and Sen. McCain (AZ) indicated they would not vote for the legislation. Leadership needed at least 50 yes votes to garner approval. Republicans currently hold a 52 seat majority. Shortly after, Sen. Alexander (TN) issued a press statement indicating a willingness to work on a bipartisan basis to stabilize the individual insurance market.

Emergency Supplemental Funding

This week, members of Congress spoke about the need for emergency supplemental funding to aid Puerto Rico in its hurricane recovery efforts. While conversations are ongoing, it is expected the supplemental package will not be available for Congressional approval until mid-October.

Additional funding is also needed for Texas and Florida. Moreover, some senators are also requesting additional funding for the western states who are currently dealing with forest wildfires.

Senate Hearing on the Opioid Epidemic

On Oct. 5 at 10 a.m., the Senate Health, Education, Labor and Pensions Committee will hold a hearing entitled, “The Federal Response to the Opioid Crisis.” Witnesses include:

  • Elinore F. McCance-Katz, MD, PhD, assistant secretary for SAMHSA.
  • Brenda Fitzgerald, MD, director of CDC and administrator of the Agency for Toxic Substances and Disease Registry.
  • Francis Collins, MD, PhD, director of NIH.
  • Scott Gottlieb, MD, commissioner of FDA.

There are many programs that, absent congressional intervention, will experience funding lapses on Sept. 30. These include the Children’s Health Insurance Program (CHIP), the Maternal, Infant and Early Childhood Home Visiting Program (MIECHV), and the Community Health Center Fund. The disproportionate share hospital payments are also slated to receive deep cuts. Please note the updates provided below are current as of Sept. 27. ASTHO will continue to monitor.

Children’s Health Insurance Program

Funding for CHIP expires on Sept. 30. As of Sept. 27, it was unclear whether Congress would be able to approve a bill in advance of the deadline. Some members of Congress feel that states, even those running out of funding, can make do until closer to the new Dec. 8 deadline for funding the government.

Sen. Hatch (UT) and Sen. Wyden (OR) introduced the Keep Kids’ Insurance Dependable and Secure Act of 2017 (S. 1827), a bipartisan bill that, if enacted, would extend the program for five years. To date the Finance Committee has not marked up the bill. However, members of the House Energy and Commerce Committee have not yet reached a deal to extend funding for CHIP.

Maternal, Infant and Early Childhood Home Visiting Program

On Sept. 26, the House approved the Increasing Opportunity and Success for Children and Parents through Evidence Based Home Visiting Act (H.R. 2824) by a 214-204 vote. This legislation extends the MIECHV program at current levels through FY22. H.R. 2824 requires a state-match requirement beginning in FY20. The House did approve an amendment submitted by Rep. Susan DelBene (WA) which would protect tribal communities from being required to match federal the MIECHV money. ASTHO opposes the state match requirement and partnered with AMCHP to express our opposition to this provision in the bill.

On the other hand, the Senate introduced the Strong Families Act of 2017 (S. 1827), a bipartisan bill to reauthorize the MIECHV program which does not include the state match requirement. Funding for this program expires on Sept. 30.

Additional Programs May Receive Cuts

Absent a last minute Congressional intervention, community health centers could lose approximately 70 percent of funding by the end of the week. According to a press release issued by the National Association of Community Health Centers, this could lead to the closure of 2,800 health centers, elimination of more than 50,000 provider and staff positions, and a loss of access to care for nine million patients.

Additionally, disproportionate share hospitals payments are scheduled for a cut on Oct. 1. According to CQ Healthbeat, this would put into motion “a series of yearly cuts that would slash the roughly $12 billion program by two-thirds by 2025.” On Sept. 25, members of Congress sent a letter urging a two-year delay of the cut.