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.


Price Resigns as HHS Secretary

Tom Price, MD has resigned from his Cabinet position as Secretary of the U.S. Department of Health and Human Services (HHS). The announcement follows reports that Price used military flights and private jets for travel totaling more than $1 million since May. In his resignation letter, Price expresses regret for creating a distraction from the important objectives of HHS and pledges to continue to support the Administration’s priorities in the future. Prior to being confirmed as Secretary, Price had served in the House of Representatives and authored legislation to repeal the Affordable Care Act (ACA).

Don J. Wright will serve as Acting HHS Secretary. Wright has worked as the Deputy Assistant Secretary for Health and Director of the Office of Disease Prevention and Health Promotion since 2012. He joined HHS in 2007 during the Bush Administration and previously served as the Deputy Assistant for Health Care Quality. During his time at HHS, he has worked on efforts to reduce adverse drug events and to monitor the nation’s leading health indicators. He previously worked on health and safety issues at the Department of Labor as Director of the Office of Occupational Medicine. He is board certified in both family medicine and preventive medicine and holds a master’s degree in public health.

The short-list to replace Price includes several current members of the Administration, including Acting HHS Secretary Don Wright, Administrator for the Centers for Medicare and Medicaid Services (CMS) Seema Verma, Secretary of Veterans Affairs David Shulkin, Commissioner of Food and Drugs Scott Gottlieb, and Housing and Urban Development Secretary Ben Carson. Former Louisiana Gov. Bobby Jindal, former Sen. Rick Santorum (R-Pa.), Florida Governor Rick Scott, and Rep. Marsha Blackburn (R-Tenn.) also appear to be in the running.

The acting head of the Drug Enforcement Administration (DEA) Chuck Rosenberg also stepped down as of October 1. It is not clear who will replace him.

GOP Scraps Plans to Repeal and Replace This Year

Senate Republicans decided not to hold a vote on the Graham-Cassidy-Heller-Johnson proposal to repeal and replace the Affordable Care Act (ACA) after it became apparent that they lacked the 50 votes needed to successfully pass the legislation. The plan would have eliminated insurance mandates and converted Obamacare funding into block grants for states to set up and regulate their own health insurance markets.

Sen. Susan Collins (R-Maine) provided the decisive third ‘no’ vote from the Republican caucus, following earlier announcements from Sens. Rand Paul (R-Ky.) and John McCain (R-Ariz.). Even under the fast-track budget process known as reconciliation, Republicans could not afford to lose more than two votes and still pass the bill with Vice President Pence serving as the 51st vote.

Sen. Collins had been waiting to see a score from the Congressional Budget Office (CBO) before making a final decision about the proposal. The agency’s preliminary score found that the plan would reduce the number of people with health insurance by millions, while cutting the budget deficit by at least $133 billion over the next decade. The CBO considered an earlier version of the legislation; bill sponsors had unveiled a revised bill targeting both conservative and centrist holdouts earlier in the day. While leadership ultimately chose not to bring the bill to the floor, Republicans disagreed on whether a vote should be held. Some wanted to go on the record, even if the bill were to fail, while others looked to the 2018 midterm elections and did not want to waste political capital on a failed vote.

While Republicans’ ability to use reconciliation on health care reform expired on Saturday, President Trump and congressional Republicans have pledged that they are not abandoning their promise to repeal and replace Obamacare. The GOP has decided to focus their fiscal year (FY) 2018 budget resolution on tax reform but a repeal effort could resume in FY19. Sen. Graham (R-S.C.) and others have stated that going forward, Republicans will prioritize regular order in order to win the support of those lawmakers upset by the timeline constraints and process used this year.

The President has also indicated than an executive order allowing the sale of health insurance across state lines is forthcoming.

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