Health-Care Debate ‘Sucking the Life’ Out of Other Initiatives


If Republicans can’t come to agreement on overhauling Obamacare in coming weeks, they’ll be forced to deal with several must-pass health bills while their signature health legislation waits in limbo.

Bills allowing the FDA to collect user fees, fund medical research, and ward off cuts to Medicare are being delayed by the health-care reform debate, lobbyists and former Hill staffers warn. Some worry lawmakers may miss crucial deadlines to pass some of this legislation if the debate lingers to the end of July, when Congress leaves for the monthlong August recess.

All the attention on Affordable Care Act reform is “really sucking all the life out of other initiatives, including appropriations,” a former House appropriations staffer who asked not to be identified told Bloomberg me recently.

Congress broke for the July 4 recess with Senate Republicans divided over a proposed repeal bill (H.R. 1628). According to Senate aides, with Congress back July 10, Republican leaders hope adding new money for opioid programs to the legislation and making tax credits for insurance more generous for some will win over some reluctant lawmakers.

The scramble by Republicans to pass a replacement health-care bill comes with just a little more than a dozen working days left before the August recess. Meanwhile, another important health-care bill, the user fee legislation (S. 934), must pass Congress before the current agreement expires Sept. 30. If there's no action by the end of July, the Food and Drug Administration will have to begin the process of furloughing roughly 5,000 employees.

User fees are negotiated rates that makers of drug, device, and biologic products agree to pay to help fund the FDA's operations.

Another looming congressional deadline involves the repeal of IPAB, an independent board meant to address rising Medicare costs.

Health-care provider groups that represent doctors and hospitals are growing increasingly concerned Congress will miss the Aug. 15 deadline to repeal the Independent Payment Advisory Board (IPAB) without fear of a filibuster, Mary Grealy, president of the Healthcare Leadership Council, a coalition of health executives, told me recently. Grealy has spearheaded a lobbying effort to repeal the IPAB in coming weeks.

The ACA allows Congress to repeal the IPAB with a simple majority vote before Aug. 15, Grealy said. That means lawmakers have to act before the August recess, at the same time Republicans want to pass their ACA overhaul, she said.

“This is a one-time no-filibuster opportunity to repeal this,” Grealy said.

A lack of clarity on the ACA front is also impacting the debate on domestic discretionary funding and funding for the public health insurance program for poor children, the Children's Health Insurance Program (CHIP), which expires in the fall.

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