Summary
The House and Senate are both in session today as the President releases his Fiscal Year (FY) 2025 budget request. The budget request kicks off the start of the FY 2025 budget process, just days after six of the 12 FY 2024 appropriations bills were finally enacted. Included with the first six appropriations bills that was enacted was a long awaited, but slimmed down, healthcare package (IHPP summary). The largest of the FY 2024 bills, including the Labor-HHS and Department of Defense bills are still on a continuing resolution until March 22.
The FY 2025 budget request is expected to prioritize several health care issues that the President highlighted in his State of the Union speech last Thursday (IHPP summary) including lower prescription drug costs in Medicare and private health insurance, making permanent expanded premium tax credits for Marketplace coverage, a $12 billion investment in women’s health research, expanded Medicaid coverage, mental health care, and several other priorities. The White House released a fact sheet of health policy proposals ahead of the State of the Union address. Impact Health Policy Partners will send out a summary of the full budget request later today.
Hearings and Markups
Senate Budget Committee: On Tuesday the Senate Budget Committee will hold a hearing to examine the President’s proposed budget request for FY 2025 with the Office of Management and Budget (OMB) Director Shalanda Young.
Senate Banking, Housing and Urban Affairs Committee: On Tuesday the Senate Banking, Housing, and Urban Affairs Committee will hold a hearing to examine proposals to address housing affordability, availability, and other community needs.
House Ways and Means Committee: Also on Tuesday, the House Ways and Means Committee will hold a hearing to examine opportunities and challenges in enhancing access to care in patients’ homes and modernizing care in rural and underserved communities
House Energy & Commerce Committee: On Tuesday, the House Energy & Commerce Subcommittee on Health will hold a markup of 19 health related bills. Among the bills being marked up are H.R. 620, the Alzheimer’s Accountability and Investment Act, H.R. 7218, Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act of 2024, and H.R. 7153, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act.
Senate Finance Committee: On Thursday the Senate Finance Committee will hold a hearing to examine the President’s proposed budget request for FY 2025 for the Department of Health and Human Services (HHS) with the HHS Secretary Xavier Becerra.
Regulatory Update
The Office of Management and Budget (OMB) is reviewing the following rules:
Medicare
- Alternative Payment Models – The proposed rule would implement a new Medicare payment model titled, Increasing Organ Transplant Access (IOTA) Model (was set for December 2023).
- Payment Update – The proposed rules would make policy payment updates for acute care hospitals inpatient and long-term care hospitals, hospice, inpatient psychiatric facilities, skilled nursing facilities, and inpatient rehabilitation facilities (April 2024).
- Nursing Homes – The final rule would establish minimum staffing standards for long-term care facilities and establish Medicaid institutional payment transparency reporting requirements (September 2026).
Medicaid
- Disproportionate Share Hospital Program – The final rule would implement requirements under section 203 of the Consolidated Appropriations Act, 2021 (CAA), which relate to Medicaid shortfall and third-party payments (February 2024).
- Eligibility and Enrollment – The final rule would implement changes to align enrollment and renewal requirements for most individuals in Medicaid and promote maintenance of coverage (February 2024).
- Access to Care – A pair of final rule intended to access to care and quality outcomes for Medicaid and CHIP beneficiaries enrolled in managed care delivery systems and fee-for-service Medicaid (April 2024).
Commercial Insurance
- ACA Marketplace – The final rule would make changes to regulations governing Affordable Care Act (ACA) Marketplace plans, insurance standards, and the risk adjustment program for plan year 2025 (not specified but likely April 2024).
- Short-Term Plans – The final rule would modify definitions to ensure short-term, limited duration insurance and fixed indemnity benefits coverage do not undermine consumer protections and requirements under the Affordable Care Act (April 2024).
Other Topics:
- Healthcare System Resiliency and Modernization – The proposed rule would revise and update national emergency preparedness requirements for Medicare- and Medicaid-participating providers and suppliers (was set for December 2023).
- Reproductive Health Care Privacy – The final rule would modify the HIPAA Privacy Rule to support reproductive health care privacy (March 20240.
- Health IT – The proposed rule would advance interoperability through proposals for: standards adoption; public health IT certification; expanded uses of certified application programming interfaces (APIs), such as for electronic prior authorization, patient engagement, care management, and care coordination; and information sharing under the information blocking regulations (was set for November 2023).