Health Care Checkup: August 5, 2022

Health Care Checkup

August 5, 2022

THE BIG PICTURE

The Senate made significant progress this week toward finalizing its reconciliation package, the Inflation Reduction Act of 2022, and setting it up procedurally for a vote. Late Thursday, Senator Kyrsten Sinema (D-AZ) indicated she would support the legislation, which Democrats have been negotiating on for over a year. Sinema’s support will likely give Democrats the 50 votes they need to pass the package.

On Wednesday, the Congressional Budget Office (CBO) released the estimated budgetary effects of the reconciliation legislation. CBO estimates that the legislation would result in a net decrease of $102 billion in the deficit over a ten-year period. Part of the deficit decrease comes from the provision that would allow Medicare to negotiate the cost of certain prescription drugs, which CBO estimates would save approximately $102 billion dollars. Additionally, eliminating former President Donald Trump’s limitations on prescription drug rebates would generate around $122 billion.

On Thursday, the U.S. Department of Health and Human Services Secretary Xavier Becerra declared the spread of the monkeypox virus in the U.S. a Public Health Emergency (PHE). As of this writing, there have been 7,102 total confirmed monkeypox cases in the U.S. HHS has allocated 1.1 million doses of the JYNNEOS monkeypox vaccine to states and jurisdictions and is making more doses available as jurisdictions use their current supply. Additional information can be found here.

Earlier in the week, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for inpatient and long-term care hospitals for fiscal year (FY) 2023. Under the rule, CMS expects payments in FY 23 to increase by approximately 2.4%. For acute care hospitals paid under the Inpatient Prospective Payment System (IPPS) that participate in the Hospital Inpatient Quality Reporting (IQR) Program, the final rule will result in a 4.3% increase in operating payment rates.

A new report released by the Department of Health and Human Services (HHS) found that the nation’s uninsured rate reached an all-time low of 8% in the first quarter of 2022. Since 2020, approximately 4.1 million adults ages 18-64 and 1 million children ages 0-17 gained health insurance coverage. HHS attributes these gains in coverage to the American Rescue Plan’s enhanced Marketplace subsidies, which have made plans more affordable for many individuals and families.

The Senate Homeland Security & Governmental Affairs Subcommittee on Emerging Threats and Spending Oversight held a hearing titled, “Revisiting Gain of Function Research: What the Pandemic Taught Us and Where Do We Go from Here.” Mehlman Castagnetti’s summary of the hearing can be found here.

What to Expect Next Week: The Senate is slated to convene on Saturday to vote on the motion to proceed with H.R. 5376, the Inflation Reduction Act of 2022. At some point late Saturday or Sunday, it is expected the Senate will begin a vote-a-rama. On Monday or Tuesday, it is anticipated that the Senate will move to pass the reconciliation bill. The House is currently out on August recess, but it is expected to convene on Friday, August 12th, to consider the legislation.

DEEP DIVE

Democrats move Forward with Health, Tax, Environmental Reconciliation Package, As CBO Issues New Analysis

The Senate made significant progress this week toward finalizing its reconciliation package and setting it up procedurally for a vote. Late Thursday, Senator Kyrsten Sinema (D-AZ) indicated she would support the legislation, which Democrats have been negotiating on for over a year. Sinema’s support will likely give Democrats the 50 votes they need to pass the package. On Wednesday, the Congressional Budget Office (CBO) released the estimated budgetary effects of H.R. 5376, the Inflation Reduction Act of 2022. CBO estimates that the legislation would result in a net decrease of $102 billion in the deficit over a ten-year period. Part of the deficit decrease comes from the provision that would allow Medicare to negotiate the cost of certain prescription drugs, which CBO estimates would save approximately $102 billion dollars. Additionally, eliminating former President Donald Trump’s limitations on prescription drug rebates would generate around $122 billion. The Senate is slated to convene on Saturday to vote on the motion to proceed with H.R. 5376, the Inflation Reduction Act of 2022. At some point late Saturday or Sunday, it is expected the Senate will begin a vote-a-rama. On Monday or Tuesday, it is anticipated that the Senate will move to pass the reconciliation bill. The House is currently out on August recess, but it is expected to convene on Friday, August 12th, to consider the legislation.

Biden Administration Declares Monkeypox a Public Health Emergency

CMS Issues Inpatient and Long-Term Care Hospital Final Rule for FY 23

On Monday, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for inpatient and long-term care hospitals for fiscal year (FY) 2023. Under the rule, CMS expects payments in FY 23 to increase by approximately 2.4%. For acute care hospitals paid under the Inpatient Prospective Payment System (IPPS) that participate in the Hospital Inpatient Quality Reporting (IQR) Program, the final rule will result in a 4.3% increase in operating payment rates. The rule also includes equity-focused measures for the IQR Program. These measures include creating a new hospital designation to identify hospitals as “birthing friendly.” CMS will award this new designation to hospitals that participate in a statewide or national perinatal quality improvement program and implement recommendations from the program. A fact sheet on the final rule can be found here and a fact sheet on the health equity measures can be found here.

CMS Releases Guidance to Help States Connect Children with Complex Medical Conditions to Medicaid Services

CMS released guidance for states on a new Medicaid health home benefit for children with medically complex conditions. Children with medically complex conditions, such as cerebral palsy, and cystic fibrosis, will now be able to receive health home services. These new at-home services will be especially helpful for families who currently need to travel out-of-state for care. Beginning October 1, 2022, states will be able to offer the new health home services for children with medically complex conditions. The services will include pediatric specialty and subspecialty medical services. More on this guidance can be found here.

HHS Report Finds that the National Uninsured Rate Reached an All-Time Low in 2022

President Biden Signs Executive Order to Protect Access to Reproductive Rights

On Wednesday, President Joe Biden signed an executive order to make abortion care more accessible for women in states where restrictive laws have been placed on the medical procedure. Specifically, President Biden is calling on the Secretary of Health and Human Services (HHS), Xavier Becerra, to consider actions that would support patients traveling out of state for medical care, including Medicaid patients. He is also directing the HHS Secretary to ensure health care providers comply with Federal non-discrimination law, and promote agency research and data collection on maternal health outcomes. As a reminder, last month, President Biden signed an executive order to protect access to medication abortion and contraception, and ensure that women receive emergency medical care for reproductive emergencies, as afforded under the law.