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 Completes Votes on Health Care Legislation, Adjourns for August Recess

The House of Representatives passed four bipartisan health care workforce bills last week: H.R. 3728, the Educating Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act, H.R. 5385, the Dr. Benjy Frances Brooks Children’s Hospital GME Support Reauthorization Act of 2018, H.R. 1676, the Palliative Care and Hospice Education and Training Act (PCHETA), and H.R. 959, the Title VIII Nursing Workforce Reauthorization Act of 2017. Each was passed by voice vote.

H.R. 6138, the ASC Payment Transparency Act of 2018 was also passed by voice vote. The bill would require that ambulatory surgical centers (ASCs) be represented on the advisory panel of providers that is consulted for Medicare outpatient payment reviews. The Centers for Medicare and Medicaid Services (CMS) would also be required to cite the specific criteria it used if the agency decides to exclude a procedure from its list of approved procedures for this setting.

Additionally, the House voted to permanently repeal the Affordable Care Act’s (ACA) 2.3 percent tax on medical devices. H.R. 184, the Protect Medical Innovation Act of 2017, passed by a vote of 283-132 with support from 226 Republicans and 57 Democrats. Rep. Walter Jones (R-N.C.) was the only Republican lawmaker to oppose the bill; he believes that tax cuts should be paired with spending cuts of equal amount. It is estimated that repeal of the medical device tax, which has already been delayed twice, would cost $19 billion over the next decade. Critics of the tax now turn their focus to the Senate, where they are two to four votes short of enough support to pass repeal legislation. Both Majority Leader Mitch McConnell (R-Ky.) and Minority Leader Chuck Schumer (D-N.Y.) are supportive of repeal.

The House also passed legislation intended to address rising health insurance premiums and to encourage the use of health savings accounts (HSAs). The measures consolidate several bills advanced by the Ways and Means Committee. The Restoring Access to Medication and Modernizing Health Savings Accounts Act passed by a vote of 277-142, with the support of 46 Democrats. H.R. 6199 would allow nonprescription drugs, menstrual care products, and fitness expenses to be considered qualified medical expenses for the purposes of HSA reimbursement. It would also allow a high-deductible health plan to cover as much as $250 of non-preventive care for an individual before the deductible is met, which would allow insurers to cover services such as telehealth, diabetic testing strips, and primary care visits. The bill would cost $19.95 billion over the next ten years. The Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act passed by a vote of 242-176, with the support of 12 Democrats. H.R. 6311 suspends the health insurance tax, which has already been suspended for 2019, through the year 2021. It would also increase the use of HSAs and the HSA contribution limit, as well as the number of enrollees eligible to purchase catastrophic insurance coverage. The Joint Committee on Taxation estimates that it will cost $48.94 billion over the next decade. Neither bill included offsets.

Several bills dealing with veterans’ health care were also passed, including the Long-Term Care Veterans Choice Act (H.R. 5693). The legislation, which was passed via voice vote, would allow the Secretary of Veterans Affairs (VA) to enter into contracts and agreements for the placement of veterans in non-Department medical foster homes for certain veterans who are unable to live independently.

Finally, the National Suicide Hotline Improvement Act (H.R. 2345) passed the House by a vote of 379-1. The bill requires the Federal Communications Commission (FCC) to coordinate with the Substance Abuse and Mental Health Services Administration (SAMHSA) and to consult with the VA to examine: (1) the feasibility of designating a three-digit dialing code for a national suicide prevention and mental health crisis hotline system; and (2) the effectiveness of the current National Suicide Prevention Lifeline (1-800-273-TALK), including how well it addresses the needs of veterans.

The House adjourned for its five-week August recess but the Senate remains in session. This week, the chamber is expected to vote on an appropriations minibus (H.R. 6147) covering Interior-Environment, Financial Services, Agriculture-FDA, Transportation-HUD, as well as the National Defense Authorization Act (NDAA) conference report (H.R. 5515), legislation to extend the national flood insurance program that expires on July 31 (S. 1182), and Federal Aviation Administration (FAA) legislation.

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