Friday, February 9, 2018

Legislative Update

Congress
from National FV:

IN CONGRESS
 
The Continuing Saga - Funding the Federal Government (and Family-to-Family Health Information Centers)
Federal fiscal year 2017 began on October 1, 2017, but Congress has not passed the appropriations bills needed to fund the departments, agencies, and discretionary programs of the government (as opposed to mandatory programs like Social Security, Medicare, and Medicaid, which are not funded through appropriations). Instead, several temporary funding measures ("continuing resolutions," or CRs) were enacted. Most recently...
 
January 22: A CR was enacted to keep the government running through February 8. The significant things about that agreement:
  • It included a six-year extension of CHIP funding.
  • In order to get the Democratic support needed to pass the bill, Senate Majority Leader Mitch McConnell (R-KY) promised that the Senate would openly debate and hold a vote on legislation -- referred to as DACA (for Deferred Action on Childhood Arrivals) -- to address the situation of "DREAMers" (youth brought into this country illegally as children), if the Democrats would agree to another CR if necessary.
February 6: The House passed another CR which would, among other things:
  • Fund the Defense Department for the remainder of the fiscal year;
  • Fund the other agencies through March 23;
  • Fund community health centers for two more years;
AND
  • Fund Family-to-Family Health Information Centers through FY 2019 at an increased level ($6 million, up from $5 million), and create F2Fs for territories and Indian tribes.
February 9: Congress passed and the president signed a bill which will:
  • Increase spending caps for both defense and non-defense programs over the next two years, meaning there will not need to be significant cuts in many of programs important to children, families, and people with disabilities.
  • Fund all agencies through March 23, at which point there should be a bill to fund agencies for the remaining 6 months of the fiscal year;
  • As in the House bill, fund Family-to-Family Health Information Centers for two more years (through FY 2019) at an increased level ($6 million, up from $5 million), and create F2Fs for territories and Indian tribes;
  • Fund CHIP for an additional four years, for a total of 10 more years of funding, through 2027.
  • Fund community health centers for two more years;
  • Fund the Maternal, Infant, and Early Childhood Home Visiting program for five more years;
  • Fund disaster relief efforts for Puerto Rico, the U.S. Virgin Islands, Florida, and Texas, including almost $5 billion to increase Medicaid caps for Puerto Rico and U.S. Virgin Islands for two years;
  • Provide $6 billion over two years to address opioid addiction;
  • Provide $2 billion in funding over two years for the National Institutes of Health;
  • Provide $5.8 billion for child care over two years; and
  • Lift the debt limit through March 1, 2019.
In addition, the bill includes the "Family First Prevention Services Act," intended to improve the child welfare system and reduce the need for foster-care placements.

Many fiscally conservative Republicans (and some Democrats) opposed the bill because it increases the deficit significantly. See The House Staring Contest: Pelosi and Ryan (Roll Call, 2/7/18). The legislation does include some "pay-fors," however, including a cut to the Prevention and Public Health Fund, which is likely to reduce funding for the Centers for Disease Control and Prevention (CDC), and some changes in third-party liability for Medicaid that could hurt providers.

DREAMers and DACA/Border Security. Notably, the new law does NOT include "DACA" (Deferred Action on Childhood Arrivals) legislation to address the future of young people brought to this country illegally as children ("DREAMers"). House Minority leader Nancy Pelosi (D-CA), among others, opposed the bill because House Speaker Paul Ryan (R-WI) did not explicitly promise to hold a House vote on some version of bipartisan DACA legislation. See House Democrats Divided on Backing Budget Deal Without DACA (Roll Call, 2/7/18). Nor did the bill include any measures to address other immigration policy or border security, which the president wanted. Pursuant to the promise he made in January, though, Senator Majority Leader Mitch McConnell has scheduled open debate on this issue on the Senate Floor next week.
 
More information:
The ADA Education and Reform Act of 2017
Next week the House is expected to take up the "ADA Education and Reform Act of 2017" (H.R. 620). Although the bill is bipartisan, it is opposed by many disability advocates because it would weaken the Americans with Disabilities Act (ADA). The bill would eliminate the requirement that businesses and other entities be accessible unless a complaint is filed against them, make the complaint process more burdensome, and give businesses more time to address ADA violations. The Judiciary Committee's report on the bill (House Report 115-539) includes dissenting views (pp. 17-27) which discuss these concerns.

 
''Right to Try" Legislation
In his recent State of the Union speech, the president stated his support for "Right-to-Try" legislation, which would permit terminally ill patients to try treatments not yet approved by the Food and Drug Administration (FDA). On February 6, forty patient advocacy groups sent a letter to the Hill expressing their opposition to the particular legislation under consideration. This legislation was approved by the Senate, and a modified version of it may be taken up fairly soon in the House. See 40 Patient Advocacy Groups Oppose 'Right To Try' Drug Bill (The Hill, 2/6/18).
 
Drug Pricing Legislation
On February 6, 44 groups which generally have diverging interests, signed a joint letterto congressional leaders to urge passage of the bipartisan "Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act (S. 974/H.R. 2212). The legislation is intended to lower prescription drug prices by preventing manufacturers of brand-name drugs from taking measures to delay marketing of equivalent generic drugs. See Coalition of 44 groups calls for passage of drug pricing bill (The Hill, 2/6/18)

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