POLICY BRIEFINGS

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.


THIS WEEK'S BRIEFING - JANUARY 21, 2019

Democrats Reject WH DACA/Border Wall Proposal to End Shutdown


There have been no signs of a breakthrough to end the partial government shutdown, the longest in modern history, as it enters its 31st day. Over the weekend, Democrats rejected a proposal from the White House to link $5.7 billion in funding for a border wall to temporary protections for Deferred Action for Childhood Arrivals (DACA) program recipients and Temporary Protected Status (TPS) holders. The proposal was originally introduced by Sens. Lindsey Graham (R-S.C.) and Dick Durbin (D-Ill.) as the BRIDGE Act. Senate Majority Leader Mitch McConnell (R-Ky.) plans to bring the plan to a vote this week.

Should the shutdown continue through Jan. 24, the Office of Management and Budget (OMB), under the current pay-as-you-go (PAYGO) statute, would be required to make $839 million in sequestration cuts from nonexempt, mandatory programs across the federal government. This figure represents the new amount added to the fiscal year (FY) 2019 deficit by laws enacted last year. Approximately 90 percent of the sequestration cuts, or $752 million, would come from the Medicare program. But according to a senior OMB official, the administration does not plan to execute the cuts until the relevant documentation is no longer “on hold” due to the shutdown. Congress routinely wipes the PAYGO scorecard clean at the end of the year, and House Democrats have included such provisions, which would eliminate the potential automatic cuts, in the spending measures they have sent to the Senate to reopen the government. If the cuts come to pass, this would be the first time the reductions have been triggered since the 2010 law was enacted.

Last week, the Commissioner of the Food and Drug Administration (FDA) opted to expand the number of employees reporting to work after the agency leaders decided crucial drug, device, and food inspection needs were not being met. While the agency similtanesouly opted to furlough other individuals in an attempt to prioritize activities within the core msssion, the agency will run out of carryover funding in approximately five weeks should the shutdown continue. The FDA is attempting to stretch the user fees as long as possible. Once those funds are depleted, drug approval times will be impacted. To ease the backlog of regulations, the Trump administration recently altered the rules for the Federal Register during the partial government shutdown, allowing agencies to publish rules certifying that delaying publication until the government reopens would prevent or significantly damage funded functions.

The President signed legislation last week that would give federal workers back pay for work during the shutdown. The Senate had passed the Government Employee Fair Treatment Act of 2019 (S. 24) by voice vote; the bill subsequently passed the House by a vote of 411-7. Meanwhile, Sen. Ron Wyden (D-Ore.) has requested clarification from the Office of Personnel Management (OPM) on conflicting health care coverage information provided to furloughed federal employees and whether the Federal Employee Health Benefits (FEHB) program will continue during the shutdown.

Democrats in the House have released six new spending bills to end the shutdown, but the legislation is unlikely to be considered in the Senate due to the lack of funds for the construction of a border wall. The House plans to vote on all six bills as a package (H.R. 648). The Agriculture-FDA bill would provide approximately $23 billion in discretionary funding, $32 million above current levels.

While she has not yet officially rescinded the President’s invitation to speak, Speaker of the House Nancy Pelosi (D-Calif.) has asked President Trump to postpone his State of the Union address, scheduled for Jan. 29, until the partial government shutdown is over. Congressional leadership has also decided to cancel the week-long Martin Luther King Jr. Day recess.



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