Week in Washington 102121

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Week in Washington


Congress- Reconciliation Bill Status

This week there was significant progress towards finalizing the reconciliation bill (Build Back Better).  The revised bill appears to be a scaled back version of what was passed in the House (as opposed to a $3.5 trillion bill, the revised bill will likely be around $1.9 trillion). In terms of health care items, here is the latest on each:

  • ACA – If a bill does pass, it is almost assured that some form of extending ARP level subsidies will be included. There is some discussions of extending ARP subsidies for a limited time (3 years) rather than in-perpetuity.

  • Medicaid – On the other end of the spectrum, Medicaid expansion for states that have not expanded Medicaid appears to be in a more tenuous position. The Hill reported that it might take the form of on-Exchange coverage for those in the Medicaid coverage gap.

  • Medicare – There are also discussions about downsizing the Medicare benefit expansions for covering hearing, vision, and dental. Some reports think that the final bill may have the expansion only including hearing and vision and dental care covered by vouchers.


  • CBO released its estimates of the impact of the original reconciliation bill. The bill would increase Medicaid enrollment by 4 million and non-group enrollment by about 2.6 million. The full write up is here.

HHS/CMS Happenings


The Public Health Emergency (PHE) was officially renewed (October 18) for another 90 days.  The HHS Secretary cannot renew the PHE for longer than 90 days at a time.

Final Rule Delay

CMS today released an announcement that would grant them authority to delay finalizing the Policy and Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, etc., programs for Years 2020 and 2021 until November 1, 2022.  The proposed rule, if finalized, would have given the Secretary the authority to revise the MA RADV program (for example, not apply an FFS adjuster to offset RADV payment penalties).

You can read the announcement here


Previous editions: 

10/14/2021: Week in Washington

10/07/2021: Week in Washington

09/30/2021: Week in Washington

09/23/2021: Week in Washington



09/09/2021: Week in Washington

9/02/2021: Week in Washington

8/26/2021: Week in Washington

8/19/2021: Week in Washington


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