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.


Both Republican and Democratic Senators Await Obamacare Repeal Text

Republican senators continue to negotiate legislation to repeal and replace the Affordable Care Act (ACA), while attempting to avoid Byrd rule problems that would prevent the bill from being passed with a simple majority under reconciliation. The GOP does not yet have 51 votes to bring a bill to the floor.

Over the last week, sources have stated that Republicans are considering adding funding for opioid abuse treatment to their repeal bill. Senators may also be considering whether to vary Medicaid payment rates by state in order to address discrepancies between those states that have expanded their programs and those that have not. Moderate Republicans like Susan Collins (R-Maine) continue to express concerns about the Republican approach to changing Medicaid, acknowledging the need to reduce program costs, but wary of changes that would reduce program enrollment. The most conservative members of the GOP, however, are worried that Senate proposals have not gone far enough to repeal Obamacare regulations. Another sticking point is the issue of Planned Parenthood. A provision that would eliminate the entire $555 million in federal funding for the organization may need to be dropped in order to gain the support of members like Sen. Collins and Sen. Lisa Murkowski (R-Alaska). There is a general consensus that achieving success is going to be difficult. Latest reports indicate that the Senate bill is not as drastically different from the Housepassed American Health Care Act (AHCA) as originally assumed.

The President met with Secretary of the U.S. Department of Health and Human Services (HHS) Tom Price, Administrator of the Centers for Medicare and Medicaid Services (CMS) Seema Verma, and a group of thirteen GOP senators last week: Rob Portman (Ohio), John Thune (S.D.), Pat Toomey (Pa.), Mike Lee (Utah), Ted Cruz (Texas), Lamar Alexander (Tenn.), John Barrasso (Wyo.), Cory Gardner (Colo.), Tom Cotton (Ark.), Lisa Murkowski (Alaska), Susan Collins (Maine), Joni Ernst (Iowa), and Orrin Hatch (Utah).

While the meeting did not produce any breakthroughs, the President did indicate that he may support a more generous bill that includes additional funding beyond that included in the AHCA.

A group of eight major stakeholder organizations including patients, providers, and advocates have announceda series of events to pressure the Senate not to repeal the health care law. The groups include AARP, the American Cancer Society Cancer Action Network, the American Diabetes Association, the American Heart Association, American Hospital Association, the American Medical Association, the Federation of American Hospitals, and the March of Dimes. The organizations will start by targeting states that expanded Medicaid but are represented by Republican senators – Colorado, Ohio, Nevada, and West Virginia. They are warning against jeopardizing the coverage of the expanded Medicaid population and the affordability of coverage for those with pre-existing conditions.

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