Health Center Federal Policy

House Committees Approve Reconciliation Recommendations: Energy & Commerce Proposal Targets Health Spending

| by Alexandra Sange

As we blogged last week, per the reconciliation instructions in the recently passed FY2013 House budget resolution, several House committees including Energy and Commerce have now considered and passed recommendations to further reduce federal spending over the next decade.  To recap: each of six House committees were given instructions in the House FY2013 budget resolution to find savings by last Friday, April 27thin order to eliminate the need for the scheduled across-the-board sequester that would go into effect next January as agreed to in the Budget Control Act (BCA).  The Energy and Commerce Committee – which has jurisdiction over many health programs including health centers and Medicaid – was instructed to find approximately $97 billion in savings from programs within their jurisdiction.  Last week, they completed this task, identifying $113.4 billion in deficit reduction over the next ten years as estimated by the Congressional Budget Office, with all of the savings coming from health accounts.  Last week’s blog previewed some of the proposals that the committee considered in their markup, but here is an outline of the full package as passed by the committee last Wednesday:

Title I (approved by a vote of 30-22; no amendments accepted)

  • Repeal Prevention and Public Health Fund, rescinding unobligated funds.
  • Repeal state Exchange Authority, striking direct appropriations for grants to states to facilitate exchanges and rescinding unobligated funds.
  • Defund the “Consumer Operated and Oriented Plan” (CO-OP) program, rescinding unobligated funds.

Title II (approved by a vote of 30-20; 1 amendment accepted)

  • Repeal the Medicaid Maintenance of Effort (MOE) on states, allowing states flexibility to lower their eligibility standards for Medicaid and CHIP.
  • Rebase the Disproportionate Share Hospital (DSH) allotment in Fiscal Year 2022.
  • Repeal the increased Federal Medicaid match rate and funding cap for territories, rolling the federal Medicaid match back down to 55% and eliminating the bump in the funding cap.
  • Adjust the provider tax threshold down to 5.5 percent from 6%.
  • Repeal of bonus payments for states for increasing their Medicaid enrollment (amendment approved during the markup).

Title III (approved by a vote of 29-22; no amendments accepted)

  • Implement medical liability reform, limiting medical malpractice litigation in state and federal courts.

The next step in the process is for the Budget Committee to introduce the combined reconciliation bill for consideration by the full chamber.  However, Senate Democrats  have signaled they will not be pursuing reconciliation, leaving many to speculate that the fate of the sequester, both whether to undo it and how to pay for it if so, will be left to the lame-duck session after the election, along with many other issues.  More information on the Energy and Commerce markup including recordings and the full text of all amendments is available on the Committee majority and minority websites.