House Passes Reconciliation Bill

On October 23, the House moved forward a reconciliation bill that repeals major provisions of the Affordable Care Act (“ACA”) and defunds Planned Parenthood for one year.  Reconciliation, which is a complicated budget procedure that allows the Senate to pass legislation with a simple majority, repeals the individual and employer mandates as well as the Cadillac and medical device taxes.  However, the House dropped its effort to repeal the Independent Payment Advisory Board after a ruling from the Senate parliamentarian.

The Senate will look to take up the House-passed reconciliation package in the coming weeks.  One issue may be conservative Republicans not voting for the package because it does not fully repeal the ACA.  The White House has issued a veto threat on the House reconciliation package.

CMS Extends Physician Pay Comment Period

Late last week, CMS announced it will give stakeholders an extra 15 days to comment on the new physician pay system that CMS is implementing over the coming years.  CMS extended the deadline to November 17, 2015 after a number of physician groups expressed frustration over the original 30-day comment period.  CMS had asked physicians to weigh in on close to 150 questions, and details have been sparse about how the agency plans to design and implement the new formula.

Congress replaced the now defunct Sustainable Growth Rate formula with a system that aims to pay doctors on the value of care they provide and encourages them to participate in alternative pay models like Accountable Care Organizations.  As a result of the recently signed law, physician pay rates will increase annually starting in 2026 by 0.75 percent for those participating in an alternative pay model.  Physicians not in an alternative pay model will get a 0.25 percent pay increase annually.

Paul Ryan Moves Closer to Becoming House Speaker

Current Ways and Means Chairman Paul Ryan (R-WI) appears set to become the next Speaker of the House.  Ryan is a noted policy wonk who chairs the Ways and Means and was formerly chairman of the House Budget Committee.  In 2013, he authored the House-Senate Budget accord that addressed the sequester spending cuts.  With Ryan’s ascent to Speaker, the chairmanship of the House Ways and Means Committee becomes open.  The two top candidates for the chairmanship are Reps. Pat Tiberi (R-OH) and current Health Subcommittee Chairman Kevin Brady (R-TX).

Health Bills Introduced This Week

On October 21, Rep. Steve King (R-IA) introduced a bill (H.R. 3780) to eliminate meaningful use penalties in CMS’s electronic health records incentive programs.

Next Week in Congress

Congress is 12 days from reaching its authorized debt limit, which the Congressional Budget Office announced was November 3.  House Republicans are unlikely to take major action on the debt ceiling before Paul Ryan’s expected ascension to the speaker’s chair is complete.  Any legislative action on the debt limit must originate in the House.

The Senate HELP Committee will hold a hearing on Thursday on mental health care reform.  The committee is looking at a number of mental health bills, including S. 1945 and S. 1983.  The hearing will focus on efforts to consolidate the legislation.