Re­newed ef­forts

GOP pushes ahead with deficit-re­duc­tion plans

Modern Healthcare - - The Week In Healthcare - Rich Daly and Jessica Zig­mond

En­er­gized af­ter a spring re­cess, House Repub­li­cans last week ap­proved more leg­is­la­tion to weaken the health­care re­form law. They also stood by their plan to make ma­jor changes for Medi­care and Med­i­caid as mem­bers from both po­lit­i­cal par­ties be­gan deficit-re­duc­tion plans with the White House.

Fed­eral dol­lars for health in­surance ex­changes and the con­struc­tion of school­based health cen­ters be­came the House GOP’s lat­est tar­gets, as the House passed bills to elim­i­nate fund­ing for them in last year’s Pa­tient and Pro­tec­tion and Affordable Care Act.

House GOP mem­bers also in­tro­duced a bill to re­peal the law’s re­quire­ment that states main- tain Med­i­caid el­i­gi­bil­ity lev­els un­til the in­surance ex­changes are in op­er­a­tion. Repub­li­cans say the main­te­nance-of-ef­fort pro­vi­sion is forc­ing states to make cuts to other pro­grams such as ed­uca- tion and law en­force­ment.

Sep­a­rately, the House ap­proved leg­is­la­tion to per­ma­nently pro­hibit the use of tax­payer dol­lars for abor­tions.

On May 3—Congress’ sec­ond day back af­ter a two-week break—the House voted 283-183 to elim­i­nate fed­eral fund­ing for states to es­tab­lish the in­surance ex­changes, even though Se­nate Health, Ed­u­ca­tion, La­bor & Pen­sions Com­mit­tee Chair­man Tom Harkin (D-Iowa) said the bill would be “dead on ar­rival” in the Se­nate and the White House promised a veto.

The next day, House mem­bers voted 235191 to elim­i­nate fund­ing for the con­struc­tion of school-based health cen­ters. Ac­cord­ing to the Na­tional Assem­bly on School-Based Health Care, more than 350 ap­pli­cants na­tion­wide are seek­ing fund­ing through the first round of com­pet­i­tive grants in the Affordable Care Act, which pro­vided $50 mil­lion a year for four years in one-time fund­ing for con­struc­tion, ren­o­va­tion and equip­ment.

The House also voted 251-175 to per­ma­nently pro­hibit the use of tax­payer dol­lars for abor­tions ex­cept in the cases of rape, in­cest and harm to the mother. That leg­is­la­tion builds on the Hyde amend­ment, a mea­sure Congress passed in 1976 that bars the use of fed­eral fund- Medi­care pro­gram and re­sult in a large num­ber of Medi­care ben­e­fi­cia­ries los­ing ac­cess to ser­vices. Ad­dress­ing the is­sue is on the com­mit­tee’s “short list of get­ting things done this sum­mer,” Up­ton said.

Amer­i­can Med­i­cal As­so­ci­a­tion Pres­i­dent Dr. Ce­cil Wil­son tes­ti­fied the SGR for­mula has called for pay­ment re­duc­tions since 2002, when pay­ments were cut by 5%. Since then, Congress has in­ter­vened a dozen items to pre­vent ad­di­tional cuts. And be­cause fund­ing wasn’t pro­vided to re­form the for­mula, the cur­rent Congress must ad­dress even steeper cuts.

Wil­son pre­sented a three-part so­lu­tion that sug­gests re­peal­ing the sus­tain­able growth-rate for­mula and im­ple­ment­ing a five-year pe­riod of sta­ble Medi­care pay­ments as pol­i­cy­mak­ers and stake­hold­ers de­velop a per­ma­nent so­lu­tion. The third el­e­ment calls for tran­si­tion­ing to a range of new pay­ment


Can­tor leaves a May 5 meet­ing on deficit re­duc­tions. House GOP mem­bers stand by

changes to Medi­care and Med­i­caid.

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