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.


Congress Adjourns For the Year Following Passage of 2016 Omnibus Legislation

Congress successfully avoided a government shutdown through passage of a fiscal year (FY) 2016 omnibus spending bill and tax extenders package. Extended and deliberative debate on the bill required passage of a total of three continuing resolutions (CR) to keep the government open. A CR is a short-term stopgap spending measure that effectively prevented a government shutdown when funding for the federal government would have otherwise expired on October 1, December 11, and December 16 of 2015. The CRs allowed Congress additional time to negotiate and draft the $1.1 trillion FY 2016 omnibus legislation. The additional time was required to help develop a longer-term budget agreement to provide additional funding for discretionary programs, as well as to address controversial policy riders. In the end, very few of the controversial policy riders were included in the final package. The third CR was necessary as a result of Speaker Paul Ryan’s (R-Wis.) pledge to give members three days to review the legislation once it was unveiled. The omnibus package was approved by the House of Representatives on December 18 by a vote of 316-113, and was then passed by the Senate by a vote of 73-25. The tax package includes $680 billion in permanent and short-term extensions of tax breaks for businesses and individuals, including the research and experimentation tax credit. The spending bill adds $5.4 billion to the U.S. Department of Health and Human Services (HHS) funding, including an additional $2 billion for medical research at the National Institutes of Health (NIH). These additional research funds will specifically target research on Alzheimer’s disease as well as the brain, antibiotics, and precision medicine initiatives. Spending for the Centers for Disease Control and Prevention (CDC) was raised by $300 million, which includes funds to combat prescription drug abuse. The Food and Drug Administration (FDA) received $132 million above current spending levels, while discretionary spending for veterans’ health increased by $6.4 billion. Funding for the Centers for Medicare and Medicaid Services (CMS) will be maintained at current levels. The packages also included a two-year delay of the Cadillac tax on high-cost health plans, a two-year suspension of the medical device excise tax, and a one-year suspension of the annual Health Insurance Tax. The Congressional Budget Office (CBO) estimates that the spending bill will increase the deficit by more than $57 billion over 10 years. In order to pay for a permanent reauthorization of the program for first responders and victims of the 9/11 terrorist attacks, the omnibus uses a limitation of the durable medical equipment (DME) reimbursement rates in Medicaid to levels paid by Medicare, a reduction in federal payments for x-ray imaging services that use film instead of digital imaging, and will allow reimbursements to home health agencies for cost-effective DME. These offsets are notable because they were also used to finance the 21st Century Cures legislation, passed by the House in July. The loss of these offsets could harm the prospects of the biomedical innovation bill. The Senate Health, Education, Labor and Pensions (HELP) Committee has yet to release its version of the legislation. The House and the Senate will reconvene in early January. Before adjournment, House Majority Leader Kevin McCarthy (R-Calif.) announced that the House will vote on the budget reconciliation bill as one of the chamber’s first actions next year.

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