Health Center Federal Policy

Around the Horn Hill Download

By Joseph Miller, Federal Affairs Intern

As the summer heats up here in DC, so has the debate around the Affordable Care Act (ACA) – again— along with a number of other health issues.  Here’s the roundup on health news as we move toward the August Recess.

Parties Continue to Battle It Out Over ACA

On July 2nd, the Treasury Department released a statement saying that the Administration plans to delay the Employer Mandate one year, citing concerns that employers need more time to effectively implement the mandate.  Republican Members of the House responded by introducing legislation delaying both the employer and individual mandates, making the case that if the employer mandate was delayed, the individual mandate should be as well.  On July 17th, with the help of 22 Democrats, the House passed H.R. 2667, the Authority for Mandate Delay Act and H.R. 2668, the Fairness for American Families Act, which delay both mandates for one year.  Moving forward, the delay of the employer mandate will continue to be a hot topic on Capitol Hill as several House Committees plan to hold hearings on the subject in the coming weeks.

Meanwhile, Democrats from the President to the Hill continue to publicly press their case for the ACA. On July 18th, President Obama spoke about the ACA in the East Room of the White House, highlighting benefits of health reform and stressing the importance of the October 1st start date for individuals purchasing health insurance through new online marketplaces known as Exchanges.  House Democrats, led by the House Energy and Commerce Committee Ranking Member Henry Waxman also released district-by-district fact sheets that they said highlighted the benefits of the law’s Medicare and private insurance reforms.

Lest you think the Senate was not in the mix: a number of Republican Senators have signed a letter stating they will not support any bill funding the Federal government that also includes funding for implementation or enforcement of the ACA – thereby potentially shutting down the Federal government.  In addition, more than 60 Republican House Members have signed a letter to House Speaker John Boehner (OH) pressing him to not bring legislation to the floor unless it would specifically defund the ACA.

We’ll be watching how these debates progress, but as of now, without further legislative or Administrative action, the insurance marketplaces are set to be ready and open for enrollment on October 1st and the individual mandate will go into effect January 1st, 2014.

In Other Important News… the Medicare Sustainable Growth Rate (SGR), on the Way to a Fix? 

Also of note,  the House Energy and Commerce Committee has begun markup on a bipartisan bill, sponsored by Michael Burgess (R-Texas), Fred Upton (R-MI), Henry Waxman (D-CA), Joe Pitts (R-PA), and John Dingell (D-MI),  that would reform the Medicare sustainable growth rate (SGR).  Every year in recent memory Congress has enacted a so-called “doc fix,” overriding the SGR- the payment system for physicians billing fee-for-service Medicare and preventing significant cuts to physician reimbursement.

The bill now under discussion attempts to end the need to pass a short-term fix every single year by increasing the current reimbursement schedule and putting Medicare on a path to an updated system that will be based largely on quality of care, yet also leaves room for significant flexibility to develop alternative reimbursement models that can be mutually agreed upon.  So far, the Health Subcommittee has conducted multiple hearings and involved numerous stakeholders in a very transparent process to produce this 70-page bill that permanently repeals the SGR.  It would not affect how Health Centers bill Medicare, but we are tracking it closely to see how it changes during the Committee process and as it moves to the House floor.