Chair, ACG National Affairs
Congress left for a seven-week recess on July 14 and will return after Labor Day, giving lawmakers limited time to act on a number of outstanding legislative priorities before the fall 2016 elections. The Senate is scheduled to be in session for 23 days between Labor Day and the November election, and the House for only 17 days. Many observers anticipate Congress will adjourn a week earlier than scheduled, leaving even fewer days for legislative work. The post-election period, or “Lame Duck session,” is scheduled to last approximately four weeks, from November 14 through December 16, with a week off for Thanksgiving. How long Congress stays in town and what gets done the remainder of this year is highly contingent on the election outcomes on November 8.
Among the Outstanding Issues ACG is Monitoring
FY 2017 Federal Budget: The Fiscal Year (FY) 2017 budget and appropriations process slowed amid disagreements over proposed amendments. The House passed five spending measures and the Senate passed just three, leaving Congress with unfinished appropriations work that will need to be addressed following the summer recess. None of the individual appropriations bills were sent to the President, and it is likely that a stop-gap (continuing resolution) or “omnibus” spending bill will be needed to fund the federal government past the end of the fiscal year on September 30.
Medicare and Chronic Conditions: The Senate Finance Committee is working separately to develop legislation to improve health outcomes for Medicare patients with multiple chronic conditions. Several Finance Committee Members have expressed interest in moving legislation by the fall. ACG is monitoring these developments and working with congressional staff on issues important to clinical GI.
MACRA: Congressional Committees are continuing their active oversight of physician payment reforms legislated under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. During a July 13 Senate Finance Committee hearing on MACRA implementation, CMS Acting Administrator Andy Slavitt suggested that federal officials are open to a possible delay of the timetable for implementing the proposed payment reforms. ACG has also urged CMS to delay MACRA in the College’s recent comment letter to the proposed rule.
Medicare Part B Drug Reimbursement: Congressional Committees have also held hearings on a CMS demonstration that implements value-based purchasing for Part B drugs. The final rule is expected to be released any time now. Click here to read ACG’s comments to the proposal.
Opioid Abuse: After several weeks of conference committee negotiations, both the House and Senate passed by large margins the Comprehensive Addiction and Recovery Act (S. 524), which authorizes $181 million in grants for opioid abuse prevention and treatment efforts. President Obama signed the bill into law on July 22. Democrats had threatened to oppose the measure over a lack of guaranteed funding. They may seek to appropriate the funds when the Senate is back in session.
Zika: Congress was also unable to pass a measure providing funds to fight the Zika virus after disagreements emerged in the Senate over the policy provisions and offsets included in the $1.1 billion House-passed package.
Mental Health Reform: On July 6, the House voted 422-2 to pass Rep. Tim Murphy’s (R-PA) mental health reform bill, the Helping Families in Mental Health Crisis Act (H.R. 2646). The latest iteration of the bill, which passed out of the House Energy and Commerce Committee in June, was significantly revised to strip out controversial provisions in order to win bipartisan support. The Senate’s major companion mental health legislation, the Mental Health Reform Act of 2016 (S. 2680), still awaits a floor vote after passing the Health, Education, Labor and Pensions (HELP) Committee in March.
Medical Innovation: This spring, the Senate HELP Committee approved a number of bills to promote medical innovation that may be considered by the full Senate as companion legislation to the House-passed 21st Century Cures Act (H.R. 6). Although medical innovation legislation has enjoyed bipartisan support, disagreements continue over offsets to cover the cost of the measure, as well as funding for the National Institutes of Health (NIH). House Energy and Commerce Committee Chairman Fred Upton (R-MI) has compiled a list of potential offsets that he plans to unveil after the summer recess, and Senate HELP Committee Chairman Lamar Alexander (R-TN) has indicated a desire to advance medical innovations legislation for consideration by the full Senate in September.
Medicaid: The House Energy and Commerce Committee Health Subcommittee held a hearing on July 7 to examine the latest discussion draft of the ACE Kids Act (H.R. 546), which aims to improve the delivery of care in Medicaid for children with complex medical conditions.
Whitfield L. Knapple, MD, FACG
Chair, ACG National Affairs Committee