Policy Updates: Hill Happenings and Administration Activities

By Mike Weir June 11, 2018

Hill Happenings

FY2018 Rescissions Package          

The White House delivered its revised version of its rescissions package to the Hill and was quickly added to the Rules Committee agenda and passed out of committee (HR 3) late Wednesday. The House went on to narrowly pass the $14.7 billion rescissions package by a 210-206 vote. 

The rescissions bill now heads to the Senate, where it is expected to be challenged by Senators Richard Shelby (R-AL), Lisa Murkowski (R-AK), and Susan Collins (R-ME) over some of the proposed cuts. The deadline for Congressional action on the White House’s rescissions package is June 22, at which point the Senate will lose its filibuster-proof powers in the Senate. Under the Budget Act of 1974, the House and Senate Appropriations Committees have 25 days to either approve, disapprove or amend the rescissions request. If the committees do not act within 25 days, the measure is subject to discharge from the committee and can go to the full House and Senate chambers for action.

August Recess

Senate Majority Leader Mitch McConnell (R-KY) released a statement cancelling August Recess for the Senate so Senators can work on priority legislation, including appropriations and make progress on the president's nominees. Minority Leader Chuck Schumer (D-NY) is pushing the Majority Leader to include votes on healthcare legislation. 

Federal Mandatory Spending for Means-Tested Programs

Government spending on "means-tested" mandatory programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP) is expected to rise 4 percent annually over the next decade, according to a Congressional Budget Office (CBO) report. Spending on "non-means-tested" programs, like Medicare, Social Security and federal retirement plans, is expected to grow at a rate of 6 percent annually over a decade.

Administration Activities 

Affordable Care Act

The Trump administration announced that it will not defend the ACA against a group of lawsuits being led by Republican attorneys general who argue that the ACA is now unconstitutional. In a brief filed in a Texas federal court and an accompanying letter to the House and Senate leaders, the Justice Department agrees in large part with the 20 Republican-led states that brought the suit. The Trump administration argues that because the new tax law eliminates the penalty for not buying insurance, the Supreme Court's previous ruling permitting the mandate as a tax no longer applies. The Trump administration also believes that the provision of the ACA guaranteeing affordable rates to those with pre-existing conditions must be thrown out. A group of Democratic attorneys general has been granted permission to defend the ACA in this case. 

Federal Government Reorganization

The White House is preparing to release a plan for reorganizing the federal government that would include a significant consolidation of safety-net programs and the renaming of the Health and Human Services Department (HHS). The report is expected to be released in the coming weeks by the Office of Management Budget (OMB), and aims to move safety-net programs, like SNAP, under HHS oversight. The plan would also seek cuts to USAID and the State Department, as well.

Medicaid 

The Centers for Medicare & Medicaid Services (CMS) released Medicaid and Children’s Health Insurance Program (CHIP) Scorecards. The first version of the scorecard includes measures voluntarily reported by states, as well as federally reported measures in three areas: state health system performance; state administrative accountability; and federal administrative accountability. The metrics included in the first scorecard include well child visits, mental health conditions, children’s preventive dental services, and other chronic health conditions. The scorecard represents the first time that CMS is publishing state and federal administrative performance metrics, including measures like state/federal timeliness of managed care capitation rate reviews, time from submission to approval for Section 1115 demonstrations, and state/federal state plan amendment processing times. 

Opioid Treatment Grants

The Substance Abuse and Mental Health Services Administration (SAMHSA) is offering a new series of grants to states to help expand access to medication-assisted treatment for patients who use opioid painkillers and heroin, especially uninsured patients. SAMHSA identified the 35 eligible states as those most affected by the opioid crisis using the SAMHSA Treatment Episode Data Set. The notice includes language encouraging grantees “to collaborate and coordinate with RWHAP [Ryan White HIV/AIDS Program] grantees for the provision of HIV care and treatment services, including Hepatitis screening, testing, and vaccination for people living with HIV.” Applications are due July 9. 

Pediatric HIV Infection Guidelines

The HHS Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV has released an updated version of the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection.

2018 National STD Prevention Conference

The 2018 STD Prevention Conference will be held August 27-30, 2018 in Washington, DC. Registration for the conference is now open.

2018 National Ryan White Conference on HIV Care & Treatment

The 2018 Ryan White Conference on HIV Care & Treatment will be held December 11-14, 2018 in Washington, DC.Registration for the conference is now open. 

2019 National HIV Prevention Conference

The 2019 National HIV Prevention Conference (NHPC) will be held March 18-21, 2019 in Atlanta, Georgia. Check out the updated website for more information about tracks, session and abstract formats, and to view the tentative conference schedule. Abstracts will open May 21, 2018.

Resources

2018 340B Coalition Summer Conference: July 9-11

United States Conference on AIDS (USCA): September 6-9

AASLD - IDSA HCV Guidelines Update

Invasive Methicillin-Resistant Staphylococcus aureus Infections Among Persons Who Inject Drugs — Six Sites, 2005–2016

The Integrated HIV/AIDS Planning (IHAP) Technical Assistance Center (TAC) is hosting a webinar entitled Moving Integrated HIV Prevention and Care Planning into Action:  Integrated Funding for HIV Services on Wednesday, June 13, 2018 at 3:00 PM EDT. 

News Bulletin

HIV status disclosure in a digital age

“Social media can be important for providing information and support to those affected by HIV. The advent of gay dating apps in particular has provided opportunities to help normalize discussions about HIV and disclosure of HIV statuses that help to reduce stigma. Indeed, the gay dating and hook-up app Grindr encourages users to reveal their HIV status and has introduced opt-ins to provide testing reminders for the user. A major draw of these apps is the appearance of privacy and confidentiality they provide. However, recent events have cast doubt on the security of committing sensitive data to social media.”

Number of opioid prescriptions falls for fifth year in a row

“The number of opioid prescriptions issued nationwide has dropped by 22 percent between 2013 and 2017, which a doctors group touted as progress in fighting the epidemic of opioid addiction. The report from the American Medical Association (AMA) finds there were 55 million fewer prescriptions over that time period and the number of prescriptions has dropped for five years in a row.”

‘Paying Twice’: A Push for Affordable Prices for Taxpayer-Funded Drugs

“At the height of the AIDS crisis, federal health officials tried to impose “reasonable pricing” terms on drugs developed with N.I.H. technology, and their experience soured them on the idea. When the F.D.A. approved the first drug to treat AIDS in 1987, doctors and patients expressed alarm at the price, $8,000 to $10,000 a year for a patient. In 1989, the government added a clause that required “reasonable pricing” when it provided an exclusive license to a drug company to develop commercial products using N.I.H. technology.”

Biden & Frist: Now is not the time to cut off AIDS funding

“Last month marked the 15th anniversary of the President's Emergency Plan for AIDS Relief, or PEPFAR. The celebrations included an important announcement that didn't receive enough attention: Today, 14 million people who otherwise wouldn't have access to care are receiving lifesaving HIV treatment.”

Job Opportunities 

HIV and Hepatitis Prevention Program Manager

The Iowa Department of Public Health is seeking a HIV and Hepatitis Prevention Program Manager.