Senate Won’t Vote on PPACA Repeal Legislation

Who doesn’t love a good to-do list? But when it comes to what Congress is looking to accomplish in September, let alone before the end of the year, the stakes are high and the to-do list is long.

With the end of the federal fiscal year rapidly approaching and limited legislative days to complete these tasks, the healthcare community is waiting with baited breath.

Congress took care of the Food and Drug Administration (FDA) user fee reauthorization before members left for summer recess; that was one key task. Then they look care of the disaster relief funding, raised the debt ceiling, and continued to fund the government through Dec. 8, essentially kicking the can down the road for another showdown in December.

We’ve already seen sizeable discrepancies in the funding levels for the 2018 fiscal year in the bills that were passed by the House versus what Senate appropriators agreed to in recent weeks. One example in the health IT world is the budget of the Office of the National Coordinator for Health IT, or ONC; the House wants to slash its budget by nearly 40 percent, while the Senate wants to maintain the 2017 level of about $60 million.

Congress has yet to pass a reauthorization of the Children’s Health Insurance Program (CHIP), which expires at the end of the month. Senate Finance Committee leadership, including Chairman Sen. Orrin Hatch (R-Utah) and Ranking Member Ron Wyden (D-Ore.) announced last week that they had agreed to a five-year extension, with the terms of the deal ultimately unveiled Monday afternoon. The House has not acted on a CHIP reauthorization proposal, promising their bill would be considered the last week of September.

In addition to the healthcare work, Congress has considered, and in varying capacities advanced, several telehealth proposals. The House Committee on Energy & Commerce advanced a telestroke bill (H.R. 1148), while the House Ways & Means Committee approved a bill that would expand telehealth in Medicare Advantage plans (H.R. 3727). The Senate’s Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, which includes many telehealth proposals, could pass before the end of the month. The CHRONIC Care Act would expand in-home tele-dialysis coverage, boost Medicare Advantage reimbursement for telehealth, increase the ability for Accountable Care Organizations (ACOs) to use telehealth, and grow telestroke coverage.

Add to that the discussions of data breaches and the patchwork of breach reporting laws that have emerged in the news once again with the massive Equifax breach, which has now grabbed headlines amid significant congressional attention. There’s an Oct. 3 hearing set on the Equifax breach, and calls for a national data breach law have been made by both members of Congress and administration officials.

Eyes are also on the Medicare extenders, the package of policies that get renewed at varying increments on several Medicare-related issues, most recently with the passage of the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015, now set to expire at the end of the year. Health policy professionals like myself are wondering if we may see additional policies addressing the Meaningful Use program, cybersecurity, or MACRA added to the extenders package.

There’s certainly not a shortage of action taking place here in D.C. these days, with very real implications for healthcare CIOs and the health IT world. Let’s all keep our fingers crossed that Congress can wrap up its to-do list in time!