Policy Updates: Hill Happenings and Administration Activities

By Emily McCloskey January 29, 2018

Hill Happenings

Appropriations and Shutdown Updates 
Last Monday, the House and Senate approved a continuing resolution (CR) to fund the government until February 8. The Senate overwhelmingly accepted the measure, in an 81-18 vote, spurred by a leadership commitment to consider an immigration program renewal. The measure passed the House by a 266-150 vote and President Trump signed the legislation. The bill extends the Children’s Health Insurance Program (CHIP) for another six years. The deal also suspends or delays three taxes imposed by the Affordable Care Act (ACA): a tax on medical devices, the “Cadillac tax” on generous employer-sponsored health plans, and a tax on health insurance companies.

The CR did not include money for community health centers. Their funding will expire in March. It is being reported that Congress will tackle funding for community health centers in the next spending bill it takes up before the February 8 deadline. 

Senate Majority Whip John Cornyn (R-TX)  said last Wednesday lawmakers may need to pass additional CRs to accommodate decisions on spending caps, plus an immigration compromise. The decisions could then determine the timetable for extending a group of health care programs, including funding for federal health centers, the extension of expired Medicare provider payments, and reversal of cuts to disproportionate share hospital payments. As FY2018 funding is not yet finalized, funding levels for HIV and hepatitis programs have not been determined. However, due to CRs, we anticipate that health departments will receive partial awards. 

NASTAD will continue to advocate for the highest possible funding amounts for HIV and hepatitis programs.  

Budget Update
Congress continues to work on an agreement to raise spending caps. “The set caps, established by a 2011 deficit reduction compromise, have not been updated for FY2018, though lawmakers were reportedly close to an agreement prior to last weekend's shutdown battle. Without adjusted caps, the funding levels included in the FY2018 spending bills cannot be finalized.” Politico reports that "while the figures are still in flux, multiple sources say Congress would raise military spending by at least $70 billion above the caps for fiscal 2018 and $80 billion in fiscal 2019."  NASTAD continues advocacy around parity between defense and non-defense appropriations.

Democratic senators agreed last week to keep a deal for Dreamers separate from budget negotiations, signaling a possible breakthrough in talks.

Presidential Appointments
The Senate voted 55-to-43 last Wednesday to confirm Alex Azar, a former drug industry executive, as the next secretary of the Department of Health and Human Services (HHS). Alex Azar previously served as a chief executive of Eli Lilly and Company. Azar worked at HHS under President George W. Bush as General Counsel and Deputy Secretary of HHS. His experience and expertise within the Department has been lauded on both sides of the aisle, but drug pricing advocates are concerned about his position at Eli Lilly and the increases in drug prices during his time there. He will become the Trump administration’s second HHS leader in 11 months; his predecessor, Tom Price, resigned in the fall amid an investigation of his use of expensive private planes for official business.

NASTAD will write Secretary Azar to share NASTAD priorities and seek opportunities for collaboration.

Administration Activities  

Medicaid Updates
Last Tuesday, Oregon voters approved a tax on hospitals and health insurance plans to continue their Medicaid expansion. The tax could raise as much as $320 million over two years. This is the first such measure approved by voters anywhere in the country. “Measure 101 would impose a 0.7 percent tax on some hospitals and a 1.5 percent tax on the gross health insurance premiums collected by insurers and on managed care organizations, raising anywhere from $210 million to $320 million over the next two years,” the Associated Press reports. The additional funding will help cover more than 350,000 low-income Oregonians added to Medicaid since 2014. More information can be found here

Medicaid Waivers
Advocacy groups filed the first lawsuit challenging the Trump administration's efforts to overhaul Medicaid by allowing states to require some beneficiaries to work or pursue jobs. “Fifteen Kentuckians enrolled in Medicaid today filed a class action lawsuit against the Trump administration challenging its approval of sweeping changes to Medicaid law that will endanger the health care of tens of thousands of low-income individuals and families in the state. The plaintiffs are represented by the National Health Law Program (NHeLP), Kentucky Equal Justice Center (KEJC), and the Southern Poverty Law Center (SPLC).” NHeLP’s statement can be found here

NASTAD is available as a resource to discuss the implications of 1115 waivers on health department programs and the people they serve in your jurisdiction and how best to ensure uninterrupted access to prevention, care, and treatment.

Opioid Epidemic
A member of President Trump's opioid commission said he believes the group's work is a "sham." Former Congressman Patrick Kennedy (D-RI) told CNN that its members are "willing to tolerate the intolerable — and not do anything about it." Earlier this month, the administration extended the opioid public health emergency for another 90 days. 

NASTAD, Harm Reduction Coalition, and The AIDS Institute released a joint statement calling on Congress to include $100 million in new funding for the Centers for Disease Control and Prevention's (CDC) Viral Hepatitis programs to confront the looming threat of infectious diseases linked to the opioid crisis.

President’s Budget
Last Wednesday, a spokeswoman for the Office of Management and Budget (OMB) announced that the President’s FY2019 budget proposal will be delayed by a week and will be released on Monday, February 12. The White House has reported delaying the release of the budget proposal because of the three-day government shutdown. More information can be found here

NASTAD will continue to advocate for full funding for HIV and hepatitis programs. We will keep you updated with additional details as they become available.

HHS Report on 2017 Accomplishments
Last week, HHS released, 2017: A Year of Accomplishment, a report detailing Administration’s actions in 2017. 

Please contact the Policy & Legislative Affairs team if you have any questions.