The growing list of critical and timely legislative items along with the lack of an overarching budget and spending deal for fiscal year (FY) 2018 contributed to a brief government shutdown in mid-January. Lawmakers reopened the government by passing another short-term continuing resolution (CR) that kept federal programs operating at their FY 2017 levels and will last until February 9, 2018. Legislators used the CR as a vehicle to address some of their most pressing issues by including in the overarching measure a 6-year extension of the Children’s Health Insurance Program (CHIP) and a 2-year extension of the moratorium on the medical device tax.
While congressional negotiators have made recent progress, there remains no deal on spending caps for FY 2018 appropriations, which will necessitate the passage of another short-term CR as an agreement is finalized. There are building expectations though that lawmakers will once again use the CR to address other pressing items, such as an extension of the authority and funding for community health centers. Following the precedent set by the CHIP extension, various communities have also begun advocating for legislators to address parochial CMS items through the CR given the litany of Medicare and Medicaid policy decisions before Congress this year (and the limited time on the legislative calendar before members of Congress begin campaigning for the mid-term elections).
Lawmakers appear close to a budget deal that would add funding to both defense and non-defense programs and facilitate enactment of the pending FY 2018 appropriations measures. Such action would result in funding increases for medical research and patient care programs while also eliminating the ability to address policy matters through passage of short-term CRs. Lawmakers also appear to be making meaningful progress in negotiations over healthcare. It has been widely-reported that majority leaders in Congress will not continue to seek to “repeal and replace” the Affordable Care Act. In this regard, the Senate is taking the lead on advancing a narrower series of modest adjustments to shore-up and stabilize insurance markets and bring down the cost of monthly health insurance premiums.
The Senate has also sought to make progress on health policy by confirming Alex Azar as the new Secretary of the Department of Health and Human Services (HHS). Following the high-profile departure of the previous Secretary, Mr. Azar made ethics a core part of his leadership pledge to lawmakers. Coinciding with Mr. Azar’s confirmation was the departure of the Director of the Centers for Disease Control and Prevention who, while being a well-respected public health official, had been fending off a series of ethical questions. It remains to be seen how Secretary Azar’s tenure will impact ongoing HHS activities, including efforts at CMS.