March 25, 2024 This Week in Health Policy for March 25 This Week (March 25 - 29) Congress on March 25 will begin a two-week Spring recess. Last Week (March 18-22) Health Care Highlights Congress reaches final spending deal for FY 2024. On Friday (March 22), the House voted 286-134 to pass a $1.2 trillion package, the Further Consolidated Appropriations Act of 2024, that will fund all remaining federal agencies, including the Department of Health and Human Services (HHS), through September 30. The Labor-HHS-Education appropriations bill would provide $117 billion in total funding for HHS, about a 1% increase over fiscal year 2023. The bill includes:
The package includes only a one-year reauthorization for the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) — which is typically reauthorized every five years, and would rescind $4.3 billion in COVID-19 funding from the American Rescue Plan Act that has not yet been obligated. The package does not include other health care proposals previously under discussion, including policies to increase price transparency, reform pharmacy benefit managers (PBMs), and expand site-neutral provisions. It is expected some or all of those policies could be revisited during the lame duck session in December. The Senate is expected to take up the bill by Saturday after which it will go to President Biden for his signature. Biden admin touts ACA exchanges' 10-year anniversary. On Friday (March 22), the Biden administration released a series of reports highlighting enrollment and coverage options in the Affordable Care Act's (ACA) exchanges. The reports mark the 10-year anniversary of the ACA exchanges. Links to the reports are below.
House passes CBO scoring bill. On Tuesday (March 19), the House passed the bipartisan, bicameral Preventative Health Savings Act (H.R.766), which would require the Congressional Budget Office to consider savings from preventive health measures over a 30-year period, rather than the current 10-year period. FCC proposes georouting wireless 988 calls. On Thursday (March 21), FCC Chairwoman Jessica Rosenworcel unveiled a proposal to use georouting to route wireless calls to the 988 Suicide & Crisis Lifeline based on the callers location instead of their area code. The proposal has raised privacy concerns among some stakeholders. If adopted by the full committee, the FCC would issue a Notice of Proposed Rulemaking to seek comment. Republican Study Committee releases FY 2025 budget proposal. On Wednesday (March 20), the Republican Study Committee (RSC), which consists of about 180 House conservative Republicans, released their FY 2025 budget priorities. The budget includes several health care proposals, including eliminating the enhanced and expanded ACA exchange subsidies that are set to expire in 2025, repealing the Inflation Reduction Act, including the drug price negotiation program, and eliminating the Title X family planning program. The budget also includes proposals to expand Health Savings Accounts, codify Trump administration's rules expanding Association Health Plans and individual coverage health reimbursement arrangements (ICHRA), and convert Medicaid and the Children's Health Insurance Program into state block grants. In addition, the budget includes proposals to reform the 340B Drug Discount Program, shore up the Medicare trust fund, and reform the tax treatment of private health insurance. The proposals are non-binding and serve as a guide into Republicans' health policy priorities. CMS unveils new primary care model for ACOs. On Tuesday (March 19), the Centers for Medicare & Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI) announced a new voluntary model to better enable primary care providers participating in certain accountable care organizations to use a team-based, patient-centered approach. The ACO Primary Care Flex (ACO PC Flex) Model is a five-year voluntary model that will focus on low-revenue Medicare Shared Savings Program ACOs, offering those providers new financing opportunities through one-time advanced shared savings payments and monthly prospective primary care payments. Click here for an FAQ on the ACO PC Flex Model. Click here for a fact sheet on the model. Biden signs EO to bolster women's health research. On Monday (March 18), President Biden signed an Executive Order (EO) on Advancing Women's Health Research and Innovation. The EO directs federal agencies to consider actions to develop or strengthen research and data standards that enhance the study of women's health across federally funded research and funding opportunities and to prioritize grantmaking and other awards to advance women's health research. Click here for a fact sheet. CMS issues guidance related to Change Healthcare for Medicaid agencies. On Monday (March 18), CMS announced new flexibilities for state Medicaid programs to support Medicaid providers impacted by the Change Healthcare cybersecurity incident, including making interim payments retroactively. CMS said states should submit Medicaid state plan amendments for authority to use those flexibilities. Hearings, Markups, and Other Committee Activity House Ways and Means Committee held a field hearing on "Access to Health Care in America: Ensuring Resilient Emergency Medical Care." On Monday (March 18), the Committee held a field hearing in Denton, Texas, on improving access to emergency medical care. During the hearing, lawmakers heard from a panel of local witnesses representing emergency care patients, air and ground medical transportation companies, ambulance companies, a rural emergency hospital, and a freestanding emergency center. Most of the hearing's conversation focused on ways to improve reimbursement for emergency medical services and ways to improve the implementation of the No Surprise's Act's independent dispute resolution, including calculating the qualified payment amounts and ensuring providers receive payments for adjudicated cases.
House Energy and Commerce Committee held a markup of 28 bills. On Wednesday (March 20), the Committee advanced 28 bills, including 17 health care bills. The health care bills include proposals to improve the quality of care for those with chronic diseases, improve the quality of life for individuals with disabilities, and improve access to care and medical innovation in rural areas. The bills advanced include reauthorizations for programs related to Alzheimer's Disease, as well as other proposals to facilitate the use of mental health and substance use disorder services among health care providers.
Senate Judiciary Committee held a hearing on "the Continued Assault on Reproductive Freedoms in a Post-Dobbs America." On Wednesday (March 20), the Committee held a hearing on the impact the Dobbs v. Jackson Women's Health Organization Supreme Court ruling has had on reproductive health care. During the hearing, Democrats on the committee discussed the challenges women have faced accessing reproductive health care following the recent Alabama Supreme Court ruling related to in vitro fertilization (IVF), as well as the Supreme Court's June 2022 Dobbs decision. Lawmakers expressed bipartisan support for IVF access and Republicans spoke about the need to find common ground on limits on abortion.
House Ways and Means Committee, House Appropriations Committee, and House Budget Committee held hearings on "Fiscal Year 2025 Budget Request for the Department of Health and Human Services." On Wednesday (March 20), both the House Ways and Means Committee and the House Appropriations Committee held separate hearings with HHS Secretary Xavier Becerra on the Biden administration's proposed FY 2025 HHS budget. The House Budget Committee held its HHS budget hearing on Thursday (March 21). During the hearings, Secretary Becerra fielded questions on several topics, including pushback from Republican members on the upcoming nursing home staffing rule, the Department's role in caring for migrant children, and the administration's implementation of the No Surprises Act. During the hearings, Secretary Becerra said he would work with Congress to extend Medicare telehealth flexibilities set to expire at the end of the year.
House Energy and Commerce Health Subcommittee held a hearing on "Evaluating Approaches to Diagnostic Test Regulation and the Impact of the FDA's Proposed Rule." On Thursday (March 21), the Subcommittee held a hearing on a proposed rule from the FDA, which could be finalized as soon as April, that would newly require medical facilities that use in-house developed laboratory tests to receive FDA approval. Witnesses, which included representatives for clinical and medical lab groups, think tanks, and academic coalitions, expressed different views on the proposed rule. While lawmakers generally agreed laboratory-developed tests need more oversight, subcommittee members were divided on the best path forward. Some Democrats, including full committee ranking member Frank Pallone (D-NJ), spoke favorably of the proposed rule, while many Republicans, including full committee chair Cathy McMorris Rodgers (R-WA) raised concerns that the proposed rule went too far, and that the FDA lacked the capacity to oversee those tests. Some lawmakers also spoke about alternative approaches such as those included in the VALID Act, which has stalled in Congress.
House Committee on Oversight and Accountability Select Subcommittee on the Coronavirus Pandemic held a hearing on "Assessing America's Vaccine Safety Systems, Part 2." On Thursday (March 21), the Subcommittee held its second hearing on vaccine safety in the US. The hearing focused primarily on COVID-related vaccines and on ways to strengthen US vaccine safety systems, including the vaccine injury compensation program and the Countermeasures Injury Compensation Program. During the hearing, some Republican members took aim at COVID-era vaccine mandates, while Democrats generally spoke favorably of the Biden administration's efforts to improve vaccine uptake and improve education and public health campaigns.
Reports, Studies, and Journals Congressional Budget Office: How Would Medicare's Coverage of Anti-obesity Medications Affect the Federal Budget? The report projects that Medicare coverage of anti-obesity medications would increase demand and use for the drugs, but said direct costs would be determined in part by future prices, which could be impacted by generic introduction and potential selection in the Medicare Drug Price Negotiation Program. Congressional Budget Office: CBO's Work on Health Care and a Call for New Research. The report highlights how various health care programs and spending impact federal budget projections, and notes that CBO is exploring factors contributing to a recent slow down in health care spending and the role of health behaviors and preventive measures, such as anti-obesity drugs and hepatitis C treatments, beyond the usual 10-year budget window. Health Affairs: Update On The Medicare Value-Based Care Strategy: Alignment, Growth, Equity. In the blog, CMS officials provide an update on their July 2022 strategy to align value-based care programs and models, increase enrollment and participation in ACOs, and advance equity.
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