Democrats Eye Reconciliation to Advance Policy Priorities

During the 117th Congress, Democrats have the option of employing a budgetary maneuver known as reconciliation to avoid a Senate filibuster and pass some of the top priorities on their agenda. The reconciliation process is limited to measures that have a budgetary impact and allows for legislation to be passed with a simple majority if a bill cannot garner the 60 votes necessary to succeed through regular order. The Senate Parliamentarian is responsible for determining whether legislation complies with the Senate rules of reconciliation (especially the Byrd rule to determine germaneness). While the President has indicated his preference for a bipartisan COVID-19 relief bill, the administration has also said that it is not going to take any tools off the table. House Budget Committee Chair John Yarmuth (D-Ky.) has said that his panel could provide reconciliation instructions quickly should it be necessary to pass additional COVID relief. It is likely, however, that parts of President Joe Biden’s proposal would not qualify for the rules of reconciliation, such as the increase to the minimum wage.

Hart Health Strategies Inc. has prepared a primer on the budget reconciliation process that can be found as an addendum to this newsletter.

Burgess Loses Top Republican Spot on Health Panel

Rep. Michael Burgess (R-Texas) has lost his spot as the top Republican on the House Energy and Commerce Health Subcommittee, though he will continue to serve on the subcommittee panel. Burgess will be replaced by Rep. Brett Guthrie (R-Ky.). The decision was made after internal party discussions with new Committee Ranking Member Cathy McMorris Rodgers (R-Wash.). It was also announced that the Subcommittee on Oversight and Investigations will be led by Rep. Morgan Griffith (R-Va.) during the 117th Congress.

Murkowski to Stay With GOP

Sen. Lisa Murkowski (R-Alaska) has announced that she will remain a Republican, despite frustration with the party and with former President Donald Trump. Murkowski had publicly questioned her future as a Republican following the insurrection at the Capitol and some of her colleagues’ decisions to question the results of the presidential election. She is up for reelection in 2022.

Democrats Ask CMS to Reverse Waiver Change

House Energy and Commerce Chair Frank Pallone (D-N.J.) and Senate Finance Chair Ron Wyden (D-Ore.) have asked the Centers for Medicare and Medicaid Services (CMS) to rescind a guidance that would make it more difficult for the new administration to reverse recent changes to the Medicaid program. The “letter of agreement” would establish procedures for the withdrawal of section 1115 demonstration waivers, providing for a nine-month process if the agency would decide to terminate, amend, or withdraw a Medicaid waiver in the future and making it more difficult Medicaid waivers to be overturned. The lawmakers characterize the policy as a “hastily-drafted, transparent attempt to tie the hands of the Biden administration for at least nine months.” The full letter can be found here.

Lawmakers Request Info On Coronavirus Variants

Reps. Don Beyer (D-Va.) and Abigail Spanberger (D-Va.) have requested a briefing from the Centers for Disease Control and Prevention (CDC) about how the agency is tracking new variants of COVID-19. The lawmakers express concerns that the nation’s public health surveillance system cannot adequately track mutations of the virus. “The U.S. is not systematically or thoroughly collecting and tracking viral genetic samples. It’s impossible therefore to fully landscape or track SARS-CoV-2 mutations,” the letter states.

Dates to Watch

As lawmakers work to confirm the new administration’s executive nominees and continue to respond to the ongoing coronavirus pandemic, they will also have to juggle the need to consider must-pass legislation dealing with expiring programs and government funding. February 1 is the statutory deadline for the President to submit his budget proposal to Congress, though this date is often missed. The Medicare sequestration cuts were postponed until April 1. The 2020 end-of-the-year spending and pandemic relief package extended the Paycheck Protection Program (PPP) and Medicare sequestration suspension through March 31. The debt limit comes back into effect on August 1, though the Treasury Department can use extraordinary measures to extend this deadline. Government funding is set to expire at the end of the fiscal year on September 30. The 3.75 percent increase in the Medicare physician fee schedule ends on December 31.

Dr. Rachel Levine Picked As Assistant HHS Secretary

President Joe Biden has tapped Rachel Levine to be his assistant secretary of Health and Human Services. Dr. Levine is a physician and professor of pediatrics and psychiatry at the Penn State College of Medicine, and has been leading the state’s response to the coronavirus pandemic. If confirmed, Dr. Levin would make history as the first openly transgender Senate-confirmed federal official.

Richter, Wu To Lead CMS in Absence of Biden Nominee

The new administration appointed long-time career staffer Liz Richter to serve as acting CMS administrator. She has been with CMS for over 30 years, most recently serving as the deputy center director of the Center for Medicare. Jeff Wu will work as her acting deputy. Wu has been with CMS since 2011 and has been working to lead the agency’s work on Affordable Care Act (ACA) health insurance reforms at the Center for Consumer Information and Insurance Oversight (CCIIO). President Biden has not yet nominated an individual to run CMS on a permanent basis.

Hart Health Strategies COVID-19 Resources

Hart Health Strategies Inc. continues to update the following resources related to the coronavirus pandemic. Please remember to clear your cache to ensure you download the most recent documents.

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