United States: Capitol Hill Healthcare Update - January 30, 2017

At GOP retreat, consensus on healthcare elusive

House and Senate Republicans emerged from a policy retreat last week in Philadelphia with no agreement on next steps in their plan to repeal and replace the Affordable Care Act (ACA).

Most congressional leaders, including House Energy and Commerce Committee Chairman Greg Walden (R-Ore.), urged rank-and-file lawmakers to proceed cautiously, given the policy intricacies and political dynamics of changing health insurance for more than 20 million people. Walden recently has talked up his plans to "repair" the ACA, which represents a shift from the party's previously stated position of wiping the law from the statutes.

Conservative lawmakers in the House – including members of the House Freedom Caucus – are pressing leaders to identify an ACA replacement plan by March. Conservatives also want a rapid transition to whatever replaces the health law, while moderate Republicans are calling for a longer runway to smooth out any disruptions during the transition.

While Republicans didn't emerge from their retreat with a concrete plan to go forward, all signs point to a February or early March vote repealing key provisions of the ACA using a special procedure known as budget reconciliation, which Senate Democrats can't block with a filibuster. Republicans hope to attach some ACA replacement language to the reconciliation bill, too.

Walden said Congress will then take up a series of stand-alone health bills that GOP leaders hope to approve over the coming months. Those bills would be subject to filibuster in the Senate, so Republicans will need at least some Democratic support to approve them.

Price's HHS nomination to advance

The Senate Finance Committee on Tuesday is scheduled to vote on – and likely approve – the nomination of Rep. Tom Price (R-Ga.) as secretary of the U.S. Department of Health and Human Services (HHS).

Price survived two hearings this month as Democrats sharply criticized the orthopedic surgeon for his personal ethics and his support for dismantling the ACA.

The committee's vote will send Price's nomination to the full Senate, where he is expected to win confirmation. Republicans in Congress and the White House are eager to see Price at HHS so they can get guidance on what ACA provisions HHS could roll back through rulemakings and what legislation lawmakers would need to approve.

Committee Chairman Orrin Hatch, (R-Utah) praised Price in a statement Sunday, saying, "There's no question Dr. Price has the experience, fortitude and judgment needed to lead HHS."

House panel to consider insurance market bills

A key House health panel this week will consider a series of bills Republicans hope will foster stable insurance markets as the party plans to replace the ACA.

The Energy and Commerce Health Subcommittee on Thursday will consider four bills, including one that would reduce from five to three the number of age-rating bands that prevent insurers from charging older people much more than younger people. Other legislation would require verification before a patient signs up for a plan outside of the standard open enrollment period.

Subcommittee Chairman Michael Burgess (R-Texas) said the bills are designed to ensure the individual and group insurance markets are stable and health insurance premiums don't rise dramatically during the ACA transition.

Democrats have sharply criticized Republicans' plans with Rep. Frank Pallone (D-N.J.), the top Democrat on the committee, saying the GOP's dismantling of the health law will prompt chaos among insurers, providers and patients nationwide.

Trump's hiring freeze could impact FDA

Stakeholders were weighing how President Trump's executive order last week creating a government-wide hiring freeze may impact key federal health agencies like FDA.

Trump's order is in place until the White House's Office of Management and Budget implements a comprehensive plan for reducing the federal workforce. How it impacts FDA is a moving target, including unfilled FDA jobs based on user fee funding, not money appropriated by Congress. It's also not immediately clear whether FDA falls under the "public safety" exemption of the executive order.

OMB is expected, perhaps as soon as this week, to provide agencies with guidance on how to implement the order. The federal Office of Personnel Management also may announce additional guidance.

Incoming HHS Secretary Tom Price would be able to grant exemptions from the order for vacancies that are related to national security or public safety. FDA personnel who work on bioterrorism research may fall under those exceptions, but it's not clear if staff reviewing drug or device applications would be exempt.

The chairmen of the House and Senate Veterans' Affairs committees – Rep. Phil Roe (R-Tenn.) and Sen. Johnny Isakson (R-Ga.), respectively – wrote to Trump last week asking for explicit guidance that filling of positions for VA direct care providers would be exempt from the president's hiring freeze.

House hearing probes Medicaid oversight

A House oversight panel on Tuesday will examine recent government reports on duplication, inefficiency and fraud in Medicaid.

The Government Accountability Office (GAO) said in a report that the Centers for Medicare and Medicaid Services won't be able to rule whether eligibility determinations are being properly met for state Medicaid programs expanded under the ACA.

Witnesses scheduled for the Energy and Commerce oversight subcommittee hearing include Carolyn Yocom, director of GAO's healthcare group; Ann Maxwell, an assistant inspector general at HHS; Paul Howard of the Manhattan Institute; Josh Archambault of the Foundation for Government Accountability; and Timothy Westmoreland, a health law professor at Georgetown University.

Trump rule nixes FDA Hill briefing

FDA last week canceled a congressional staff briefing on the new pharmaceutical and medical device user fee agreements following a Trump administration directive temporarily restricting agencies' external communications.

There was some indication last week that agencies like FDA were interpreting the order more broadly than intended by the White House, which had meant only to freeze agency rulemaking and formal guidance, not routine interaction with Congress or stakeholders.

Pharma companies contacted congressional offices last week seeking assistance in understanding the directive. Staff on Capitol Hill said they were urging the Trump White House to clarify agency latitude on external communications.

Walden to introduce bill on pre-existing conditions

House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) said he will introduce legislation this week that would require health plans to cover patients with pre-existing conditions.

Republicans oppose the individual mandate, and Walden didn't say how he would maintain the pre-existing coverage requirement without roiling insurance markets.

Last summer Republicans outlined their healthcare plan in broad strokes. Their plan, called "A Better Way," would guarantee people who maintain continuous insurance coverage the ability to purchase coverage at favorable rates regardless of pre-existing conditions. Those who failed to obtain or maintain coverage would be eligible for basic coverage but with higher premiums in state high-risk pools.

Walden didn't say how he would structure his bill or whether it would include federal subsidies to offset the higher premiums for coverage in the high-risk pools. Too small a subsidy would make coverage unaffordable for the sick, but too generous a subsidy would incentivize people to seek insurance only after they become sick.

Senate committee to examine individual insurance markets

The Senate HELP Committee on Wednesday will hold a hearing on the individual insurance markets and policies Congress may consider to stabilize them during the transition from the ACA.

Marilyn Tavenner of America's Health Insurance Plans and Janet Trautwein of the National Association of Health Underwriters are among the witnesses scheduled to testify.

Also testifying before the committee, which is chaired by Sen. Lamar Alexander (R-Tenn.), will be Kentucky Gov. Steve Beshear (R-Ky.) and Julie Mix McPeak, commissioner of the Tennessee Department of Commerce and Insurance.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

In association with
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Check to state you have read and
agree to our Terms and Conditions

Terms & Conditions and Privacy Statement

Mondaq.com (the Website) is owned and managed by Mondaq Ltd and as a user you are granted a non-exclusive, revocable license to access the Website under its terms and conditions of use. Your use of the Website constitutes your agreement to the following terms and conditions of use. Mondaq Ltd may terminate your use of the Website if you are in breach of these terms and conditions or if Mondaq Ltd decides to terminate your license of use for whatever reason.

Use of www.mondaq.com

You may use the Website but are required to register as a user if you wish to read the full text of the content and articles available (the Content). You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these terms & conditions or with the prior written consent of Mondaq Ltd. You may not use electronic or other means to extract details or information about Mondaq.com’s content, users or contributors in order to offer them any services or products which compete directly or indirectly with Mondaq Ltd’s services and products.


Mondaq Ltd and/or its respective suppliers make no representations about the suitability of the information contained in the documents and related graphics published on this server for any purpose. All such documents and related graphics are provided "as is" without warranty of any kind. Mondaq Ltd and/or its respective suppliers hereby disclaim all warranties and conditions with regard to this information, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. In no event shall Mondaq Ltd and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use or performance of information available from this server.

The documents and related graphics published on this server could include technical inaccuracies or typographical errors. Changes are periodically added to the information herein. Mondaq Ltd and/or its respective suppliers may make improvements and/or changes in the product(s) and/or the program(s) described herein at any time.


Mondaq Ltd requires you to register and provide information that personally identifies you, including what sort of information you are interested in, for three primary purposes:

  • To allow you to personalize the Mondaq websites you are visiting.
  • To enable features such as password reminder, newsletter alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our information providers who provide information free for your use.

Mondaq (and its affiliate sites) do not sell or provide your details to third parties other than information providers. The reason we provide our information providers with this information is so that they can measure the response their articles are receiving and provide you with information about their products and services.

If you do not want us to provide your name and email address you may opt out by clicking here .

If you do not wish to receive any future announcements of products and services offered by Mondaq by clicking here .

Information Collection and Use

We require site users to register with Mondaq (and its affiliate sites) to view the free information on the site. We also collect information from our users at several different points on the websites: this is so that we can customise the sites according to individual usage, provide 'session-aware' functionality, and ensure that content is acquired and developed appropriately. This gives us an overall picture of our user profiles, which in turn shows to our Editorial Contributors the type of person they are reaching by posting articles on Mondaq (and its affiliate sites) – meaning more free content for registered users.

We are only able to provide the material on the Mondaq (and its affiliate sites) site free to site visitors because we can pass on information about the pages that users are viewing and the personal information users provide to us (e.g. email addresses) to reputable contributing firms such as law firms who author those pages. We do not sell or rent information to anyone else other than the authors of those pages, who may change from time to time. Should you wish us not to disclose your details to any of these parties, please tick the box above or tick the box marked "Opt out of Registration Information Disclosure" on the Your Profile page. We and our author organisations may only contact you via email or other means if you allow us to do so. Users can opt out of contact when they register on the site, or send an email to unsubscribe@mondaq.com with “no disclosure” in the subject heading

Mondaq News Alerts

In order to receive Mondaq News Alerts, users have to complete a separate registration form. This is a personalised service where users choose regions and topics of interest and we send it only to those users who have requested it. Users can stop receiving these Alerts by going to the Mondaq News Alerts page and deselecting all interest areas. In the same way users can amend their personal preferences to add or remove subject areas.


A cookie is a small text file written to a user’s hard drive that contains an identifying user number. The cookies do not contain any personal information about users. We use the cookie so users do not have to log in every time they use the service and the cookie will automatically expire if you do not visit the Mondaq website (or its affiliate sites) for 12 months. We also use the cookie to personalise a user's experience of the site (for example to show information specific to a user's region). As the Mondaq sites are fully personalised and cookies are essential to its core technology the site will function unpredictably with browsers that do not support cookies - or where cookies are disabled (in these circumstances we advise you to attempt to locate the information you require elsewhere on the web). However if you are concerned about the presence of a Mondaq cookie on your machine you can also choose to expire the cookie immediately (remove it) by selecting the 'Log Off' menu option as the last thing you do when you use the site.

Some of our business partners may use cookies on our site (for example, advertisers). However, we have no access to or control over these cookies and we are not aware of any at present that do so.

Log Files

We use IP addresses to analyse trends, administer the site, track movement, and gather broad demographic information for aggregate use. IP addresses are not linked to personally identifiable information.


This web site contains links to other sites. Please be aware that Mondaq (or its affiliate sites) are not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of these third party sites. This privacy statement applies solely to information collected by this Web site.

Surveys & Contests

From time-to-time our site requests information from users via surveys or contests. Participation in these surveys or contests is completely voluntary and the user therefore has a choice whether or not to disclose any information requested. Information requested may include contact information (such as name and delivery address), and demographic information (such as postcode, age level). Contact information will be used to notify the winners and award prizes. Survey information will be used for purposes of monitoring or improving the functionality of the site.


If a user elects to use our referral service for informing a friend about our site, we ask them for the friend’s name and email address. Mondaq stores this information and may contact the friend to invite them to register with Mondaq, but they will not be contacted more than once. The friend may contact Mondaq to request the removal of this information from our database.


This website takes every reasonable precaution to protect our users’ information. When users submit sensitive information via the website, your information is protected using firewalls and other security technology. If you have any questions about the security at our website, you can send an email to webmaster@mondaq.com.

Correcting/Updating Personal Information

If a user’s personally identifiable information changes (such as postcode), or if a user no longer desires our service, we will endeavour to provide a way to correct, update or remove that user’s personal data provided to us. This can usually be done at the “Your Profile” page or by sending an email to EditorialAdvisor@mondaq.com.

Notification of Changes

If we decide to change our Terms & Conditions or Privacy Policy, we will post those changes on our site so our users are always aware of what information we collect, how we use it, and under what circumstances, if any, we disclose it. If at any point we decide to use personally identifiable information in a manner different from that stated at the time it was collected, we will notify users by way of an email. Users will have a choice as to whether or not we use their information in this different manner. We will use information in accordance with the privacy policy under which the information was collected.

How to contact Mondaq

You can contact us with comments or queries at enquiries@mondaq.com.

If for some reason you believe Mondaq Ltd. has not adhered to these principles, please notify us by e-mail at problems@mondaq.com and we will use commercially reasonable efforts to determine and correct the problem promptly.