House Speaker Kevin McCarthy (R-CA) released the Limit, Save, Grow Act of 2023, which proposes to increase the nation’s debt limit and reduce government spending. The proposal would increase the debt limit by $1.5 trillion, through May 2024, and provide more than $4.5 trillion in savings. To achieve these savings, the legislation would “claw back billions of dollars in unspent COVID money that has sat for 2 years.” The proposal also calls for stricter work requirements in health care and economic assistance programs such as Medicaid and the Supplemental Nutrition Assistance Program (SNAP). Unless action on the debt limit is taken, the Congressional Budget Office predicts that the government’s ability to cover expenses using extraordinary measures will be “exhausted between July and September 2023.” The House Rules Committee is slated to take up the legislation next Tuesday, April 25, with the expectation of a House floor vote sometime later next week.

Also this week, the Centers for Medicare and Medicaid Services (CMS) issued the 2024 Notice of Benefit and Payment Parameters Final Rule, which aims to expand access to health care, simplify the plan selection process, and make it easier to enroll in coverage. The press release can be found here and the fact sheet can be found here.

Senate Finance Committee Chair Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) released a bipartisan framework that the committee will use to “pursue legislative solutions to modernize and enhance federal prescription drug programs, with the goal of reducing drug costs for patients and taxpayers.” The framework outlines four challenges facing prescription drug programs: misaligned incentives that increase prices, inadequate transparency, barriers to pharmacy access, and behind-the-scenes practices that inhibit competition and increase costs.

President Joe Biden issued an Executive Order (EO) to support caregivers and improve job quality for care workers. The EO aims to make child care and long-term care more accessible and affordable for families, increase access to home-based care for veterans, enhance job quality for long-term care workers, and provide better support to family caregivers. The EO can be found here and the fact sheet can be found here.

HHS announced that it will release ownership data for all Medicare-certified hospice and home health agencies. For the first time, the public will now be able to review details on the ownership of more than 6,000 hospices and 11,000 home health agencies that participate in the Medicare program.

HHS approved an Illinois proposal to expand school-based health services. The state’s newly approved state plan amendment (SPA) will allow for schools in Illinois to receive additional Medicaid funding for all children with Medicaid, rather than only those with an Individualized Education Program (IEP).

House Speaker Kevin McCarthy (R-CA) released the Limit, Save, Grow Act of 2023, which proposes to increase the nation’s debt limit and reduce government spending. The proposal would lift the debt limit by $1.5 trillion through May 2024, and provide more than $4.5 trillion in savings. To achieve these savings, the bill would “claw back billions of dollars in unspent COVID money that has sat for 2 years.” The proposal also calls for stricter work requirements in programs that assist lower-income Americans such as Medicaid and the Supplemental Nutrition Assistance Program (SNAP). Additionally, it would cap federal budget increases to 1% per year, scrap President Biden’s student loan forgiveness program, repeal various green tax credits from the Inflation Reduction Act, rescind $80 million in additional IRS funding, and implement the GOP’s energy bill, the "Lower Energy Costs Act" (H.R. 1).

 

In remarks on the House Floor, McCarthy urged President Biden to “come to the table to negotiate.” Unless action on the debt limit is taken, the Congressional Budget Office predicts that the government’s ability to cover expenses using extraordinary measures will be “exhausted between July and September 2023.” The Biden Administration and Congressional Democratic leaders have pushed back forcefully against the proposal, which GOP leaders hope will at least kick start negotiations between the parties to reach an ultimate debt limit agreement. President Joe Biden said, “MAGA Republicans in Congress are threatening to default on the national debt, the debt that took 230 years to accumulate overall, unless we do what they say.” However, Senator Joe Manchin (D-WV) praised the proposal. Manchin stated that he "applaud[s] Speaker McCarthy for putting forward a proposal that would prevent default and rein in federal spending." 

On Monday, the Centers for Medicare and Medicaid Services (CMS) issued the 2024 Notice of Benefit and Payment Parameters Final Rule, which aims to expand access to health care, simplify the plan selection process, and make it easier to enroll in coverage. To improve access to care, CMS revised the network adequacy and essential community provider (ECP) standards to provide that all individual market qualified health plans (QHPs) use a network of providers that complies with the standards. The revision also removed the exception that certain sections of the standards do not apply to plans that do not use a provider network. The rule also adds Substance Use Disorder Treatment Centers and Mental Health Facilities to the essential community provider (ECP) categories. In addition, the rule gives Marketplaces the option to implement a new rule for the special enrollment period for people losing Medicaid or Children’s Health Insurance Program (CHIP) coverage. The option would give consumers up to 90 days after their loss of Medicaid or CHIP coverage to select a Marketplace plan. The press release can be found here and the fact sheet can be found here.

Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH), co-chairs of the Senate Diabetes Caucus, introduced the Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2023. This legislation would reduce out-of-pocket insulin costs for diabetes patients by "ensuring that group and individual market health plans must waive any deductible and limit cost-sharing to no more than $35 or 25% of list price per month." It would also require PBMs to pass through 100% of insulin rebates from manufacturers to plan sponsors. Additionally, it aims to promote generic and biosimilar competition to lower prices.

Senate Finance Committee Chair Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) released a bipartisan framework that the committee will use to “pursue legislative solutions to modernize and enhance federal prescription drug programs, with the goal of reducing drug costs for patients and taxpayers.” The framework outlines four challenges facing prescription drug programs: misaligned incentives that increase prices, inadequate transparency, barriers to pharmacy access, and behind-the-scenes practices that inhibit competition and increase costs. The framework can be found here and the press release can be found here. The Senate Health, Education, Labor, and Pensions (HELP) Committee is expected to mark up legislation later this month that also would include PBM reforms. Senate Majority Leader Chuck Schumer (D-NY) has indicated that he hopes to take up legislation later this year on the Senate floor that would include a number of drug pricing reforms as well as legislation based on the Shaheen-Collins insulin cap legislation that was just introduced this week, as well.

This week, President Joe Biden issued an Executive Order (EO) to support caregivers and improve job quality for care workers. The EO aims to make child care and long-term care more accessible and affordable for families, increase access to home-based care for veterans, enhance job quality for long-term care workers, and provide better support to family caregivers. The EO directs HHS to consider issuing regulations and guidance to “improve the quality of home care jobs, including by leveraging Medicaid funding to ensure there are enough home care workers to provide care to seniors and people with disabilities enrolled in Medicaid.” Additionally, it directs HHS to test a new dementia care model that will “include support for respite care and make it easier for family caregivers to access Medicare beneficiary information.” The EO can be found here and the fact sheet can be found here.

The Department of Health and Human Services (HHS) approved an Illinois proposal to expand school-based health services. The state’s newly approved state plan amendment (SPA) will allow for schools in Illinois to receive additional Medicaid funding for all children with Medicaid, rather than only those with an Individualized Education Program (IEP). 11 other states have already expanded Medicaid payment for school provided health care. These states include Arizona, California, Colorado, Connecticut, Georgia, Kentucky, Louisiana, Massachusetts, Michigan, Nevada, and North Carolina. Additional information can be found here.

HHS announced that it will release ownership data for all Medicare-certified hospice and home health agencies. For the first time, the public will now be able to review details on the ownership of more than 6,000 hospices and 11,000 home health agencies that participate in the Medicare program. The data includes enrollment information; detailed information about each owner; and a numerical associate ID for each owner. The press release can be found here. 

The House Energy and Commerce Subcommittee on Health announced that it will hold a hearing on Wednesday, April 26 at 10:00 AM ET entitled “Lowering Unaffordable Costs: Legislative Solutions to Increase Transparency and Competition in Health Care.” CMS Administrator Chiquita Brooks-LaSure will testify at the hearing. This will be a legislative hearing that will focus on the below bills:

House Committee on Veterans' Affairs - Hearing

Subcommittee on Technology Modernization (Committee on Veterans' Affairs) Hearing: Electronic Health Record Modernization Deep Dive: Pharmacy

Tuesday, April 25 at 3:00 PM ET

House Committee on Education and the Workforce - Hearing

Subcommittee on Health, Employment, Labor, and Pensions (Committee on Education and the Workforce) Hearing: Reducing Health Care Costs for Working Americans and Their Families.

Wednesday, April 26 at 10:15 AM ET

House Ways and Means - Hearing

Tax-Exempt Hospitals and the Community Benefit Standard

Wednesday, April 26 at 2:00 PM ET

House Select Subcommittee on the Coronavirus Pandemic - Hearing

Select Subcommittee on the Coronavirus Pandemic Hearing: "The Consequences of School Closures, Part 2: The President of the American Federation of Teachers, Ms. Randi Weingarten"

Wednesday, April 26 at 2:00 PM ET

House Energy and Commerce - Hearing

Subcommittee on Innovation, Data, and Commerce Hearing: "Addressing America's Data Privacy Shortfalls: How a National Standard Fills Gaps to Protect Americans' Personal Information.” 

Thursday, April 27 at 2:00 PM ET

House Energy and Commerce – Hearing

Subcommittee on Oversight and Investigations Hearing: “Antimicrobial Resistance: Taking on the Next Emerging Public Health Threat.”

Friday, April 28, 2023, at 9:00 AM ET