Summary
Budget Reconciliation
This morning, Sen. Bernie Sanders (I-VT), Chairman of the Senate Budget Committee, introduced the fiscal year (FY) 2022 budget resolution, which includes $3.5 trillion in reconciliation instructions. The Senate is expected to consider the budget resolution after passage of the bipartisan Infrastructure Investment and Jobs Act, which could happen as soon as early Tuesday. House Speaker Nancy Pelosi (D-CA) has said that the House will not vote on the roughly $1 trillion bipartisan infrastructure bill until the Senate passes a budget reconciliation package, which is not likely to happen until the late fall. Highlights of the budget reconciliation instructions:
- Finance Committee – At least $1 billion in deficit reduction for FYs 2022 through 2031 to “provide the Committee with flexibility to make investment, revenue and offset decisions consistent with the policy recommendations.” The Finance Committee is instructed to use “health care savings,” which entail “lowering the price of prescription drugs,” and tax reforms to offset investments. They include:
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- Extending the temporary increase to Affordable Care Act (ACA) premium subsidies;
- Addressing the Medicaid expansion coverage gap;
- Expanding Medicare to include dental, vision, and hearing benefits, and lowering the eligibility age;
- Addressing health care provider shortages (graduate medical education);
- Home and community-based services;
- Health equity (maternal, behavioral, and racial justice health investments); and
- Other investments for paid family and medical leave; child tax credit; clean energy, manufacturing, and transportation incentives; pro-worker incentives and worker support; housing incentives; and SALT cap relief.
- Health, Education, Labor and Pensions Committee – $726 billion for:
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- Investments in primary care, including Community Health Centers, the National Health Service Corps, the Nurse Corps, and Teaching Health Center Graduate Medical Education
- Health equity (maternal, behavioral, and racial equity health investments);
- Pandemic preparedness;
- Workforce development and job training;
- Labor enforcement and penalties; and
- Other investments for universal Pre-K; child care for working families; financial support for schools and students; and school infrastructure.
- Committee on Agriculture, Nutrition, and Forestry – $135 billion for child nutrition, agriculture conservation programs, rural development, and a civilian climate corps.
Regulatory Update
The latest Spring Update to the Unified Agenda identified August 2021 as the timeframe for release of a number of rules. We outline the rules below on which we may see movement in the coming weeks.
- Medicaid: CMS is slated to release a final rule on changes to the continuous enrollment requirements for the temporary 6.2 percentage point Federal Medical Assistance Percentage (FMAP) increase under the Families First Coronavirus Response Act (P.L. 116-127).
- Tobacco: The Food and Drug Agency (FDA) is slated to release a proposed rule that would ban characterizing flavors in all cigars. This new tobacco product standard would build on FDA’s ban on flavored cigarettes (more details here).
- Technology: The Centers for Medicare & Medicaid Services (CMS) is slated to propose new standards to support both health care claims and prior authorization transactions, and standards for electronic signatures to be used in conjunction with health care attachments transactions.
- Administrative Improvements: The U.S. Department of Health and Human Services (HHS) is slated to propose a new rule to rescind regulations governing HHS release and maintenance of guidance documents.
- Housing: The U.S. Department of Housing and Urban Development (HUD) is slated to propose a rule to change the procedures for affirmatively furthering fair housing to focus on advancing equity and providing access to opportunity more effectively.
Please note that the target dates included in the Unified Agendas are subject to wide variability and that, as a result, the release of the aforementioned rules may be delayed.