Week in Washington 072822

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Week in Washington: Reconciliation Bill Lives

7/28/2022

The big news this week was the resurrection of a potential reconciliation bill. The bill could have massive implications for the health care industry. The new bill is being referred to as the Inflation Reduction Act of 2022. (Note this bill is different from Build Back Better). You can read the full bill here.

What Health Care Provisions are in it?

• Allows Medicare to negotiate certain prescription drugs and make changes to Part D (benefit redesign). The provisions would reduce the federal deficit by $288 billion over 10 years, which is a big deal. KFF has a good summary of the prior version of the bill and when certain things phase in (implementation of negotiated prices starts in 2026, but there are other changes starting in 2023). I would also recommend looking at CBO’s estimates.
• ARP level (enhanced) and ACA subsidies are extended through 2025 ($64 billion worth of subsidies).
• There are no direct provisions on Medicaid and there is nothing that affects sequestration.

What else is in it?

• Changes to corporate minimum taxes, IRS tax enforcement, carrier interest loophole, and spending on energy security and climate change.
• Overall, $739 billion in revenue, $433 billion in spending, $300 billion in deficit reduction.

Is it going to pass and if so when?

• Given tonight’s announcement, there’s a very good chance this bill will pass (more likely than not).
• The goal will be to pass it in August. It must be passed by September 30th for technical reasons (i.e., if it’s going to happen, it’ll happen in the next 2 months.

Telehealth Legislation

The other piece of legislation in the news this week was the House passed legislation that would extend the telehealth rules that are in place until the end of 2024. Currently, as a result of the public health emergency, telehealth requirements in Medicare and for mental health are relaxed. If the PHE were to end these flexibilities, they would revert back to pre-pandemic requirements. This bill would keep the telehealth flexibilities in place, regardless of the PHE, until the end of 2024. There is no timetable for a vote in the Senate.  

Other News of Note

• HHS released a proposed rule that would provide greater protections based on sexual orientation, gender identity, and those seeking reproductive health care.
• A federal judge in Texas heard oral arguments that could end preventative services requirements as required by the ACA. While the ruling is likely to be appealed, and if an eventual ruling goes against the government, approximately 167.5 million Americans would be impacted.
• HHS released 2 new datasets.
  • 2023 proposed rate data for the individual and small group markets were released. You can find it here.
  • AHRQ released a new data set on the social determinants of health. You can find it here.

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