Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


House Appropriations Committee Begins FY 2014 Spending Allocation Process

On Tuesday the House Appropriations Committee will approve the FY 2014 302(b) spending allocations for each of its subcommittees and then take up the FY 2014 Military Construction/Veterans’ Affairs appropriations bill passed last week in subcommittee. The MilCon/VA allocation totals about $73.3 billion and the Labor/Health and Human Services/Education subcommittee is expected to be allocated about $122 billion. Chairman Harold Rogers (R-KY) said the austere subcommittee allocations are necessary in order to adhere to the House budget resolution’s FY spending cap of $967 billion (a reduction from FY 2013 appropriations totaling $1.043 trillion). The House bill also includes $344 million for the development of a single, joint electronic health record system between the VA and the Department of Defense. The Senate Appropriations Committee is expected to target a higher figure than the House; and during a budget hearing Chairwoman Barbara Mikulski (D-MD) said that she would do all she can to cancel the Budget Control Act (BCA) sequester that would shave about $19 billion from National Institutes of Health (NIH) budget over the next nine years. In related budget news, the Congressional Budget Office (CBO) released updated budget projections for FY 2013-2023 showing that accumulated deficits will shrink by about $618 billion due mainly to slower growth in health spending for Medicare, Medicaid and other federal health programs. As a result, the 10-year Medicare baseline was lowered by $85 billion and the Medicaid baseline was lowered by $77 billion.

House E&C Committee Passes Drug Supply Chain Safeguards

By voice vote the House Energy and Commerce Committee passed H.R. 1919, the Safeguarding America’s Pharmaceuticals Act of 2013, legislation designed to help ensure drug safety by establishing a uniform national standard for securing the pharmaceutical distribution supply chain. The bill would require lot-level tracking and require the Food and Drug Administration (FDA) to propose (but not finalize) regulations on unit-level tracking by 2027. Committee Democrats offered several unsuccessful amendments, including one by Rep. Frank Pallone (D-NJ) which would have required final regulations on unit-level tracking within 10 years. Critical of the bill language, which fails to require a timeline for final regulations, Rep. Henry Waxman (D-CA) said the Pallone amendment is identical to the language the Senate HELP Committee will take up May 22.

House Votes to Repeal PPACA

Last Thursday the House voted 229-195 to pass H.R. 45, the Patient’s Rights Repeal Act, which would fully repeal all aspects of the Patient Protection and Affordable Care Act (PPACA). Republican leaders hailed the repeal as a response to clear the way for patient-centered reforms that lower health costs and protect jobs. The White House threatened a veto and said the bill would “cost millions of hard working middle class families the security of affordable health coverage and care they deserve. It would increase the deficit and detract from the work the Congress needs to do to focus on the economy and create jobs.”

Republicans Call on GAO to Investigate HHS Secretary Solicitations

Republican leaders on the House Ways and Means and Energy and Commerce Committees sent letters to Health and Human Services (HHS) Secretary Kathleen Sebelius requesting information on the actions HHS has taken to solicit donations from insurers and others to help promote the PPACA and enrollment in health insurance exchanges. They say that such actions raise questions of compliance with the Antideficiency Act, which bars augmentation of congressional appropriations, and with federal ethics regulations. The Secretary was given until May 27 to respond. Senator Orrin Hatch (R-UT), Ranking Republican of the Senate Finance Committee and other committee republicans sent a similar letter asking for HHS to respond by June 7. Senator Lamar Alexander (R-TN), Ranking Republican of the Senate Health, Education, Labor and Pensions (HELP) Committee, said he is also requesting the Government Accountability Office (GAO) to investigate the Secretary’s actions and charged that they were an effort “to avoid the constitutional limits on the Department of Health and Human Services’ appropriations by fundraising for, and coordinating with, the private nonprofit Enroll America. These actions are inconsistent with federal separation of powers principles and may violate federal appropriations laws.”

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