Overnight Healthcare: Budget Deal With Medicare Reforms Clears House
By Sarah Ferris and Peter Sullivan The Hill October 28, 2015
House lawmakers in both parties joined forces Wednesday to pass a sweeping budget deal that averts the 52-percent premium hikes that would have hit millions of Medicare recipients next year.
Final passage was 266 to 167, marking both a parting victory for outgoing Speaker John Boehner (R-Ohio) and a valedictory gift for his likely replacement, Rep. Paul Ryan (R-Wis.).
The legislation, which raises federal spending levels and expands the government’s borrowing authority, would push two of Congress’s fiercest fiscal fights well beyond next year’s elections, avoiding potential standoffs with President Obama and easing Ryan’s transition into the Speaker’s chair.
The two-year budget accord provides modest relief across a host of policy priorities, giving lawmakers some breathing room after years of lurching from deadline-driven crisis to deadline-driven crisis.
The deal also busts spending caps previously set by the sequester provision of the 2011 Budget Control Act, increasing funding by $80 billion through September 2017, split evenly between defense and non-defense programs. Busting the spending caps is a major win for Democrats, with every member of the party voting to support the deal. Read more here<http://thehill.com/homenews/house/258431-house-approves-budget-deal>.
SENATE EYING RECONCILIATION VOTE NEXT MONTH: The Senate is planning a budget vote to repeal major ObamaCare mandates and defund Planned Parenthood as early as November, the No. 2 Republican said Wednesday.
Senate Majority Whip John Cornyn (R-Texas) told reporters Wednesday that the chamber would hold a “vote-a-rama” on the massive budget bill, known as reconciliation, in the upcoming weeks.
Cornyn said he hopes it would take place in the week before Thanksgiving. That gives just three weeks for a so-called “Byrd bath” in the Senate – a close examination of budget bills by the chamber’s parliamentarian to ensure that each provision relates to the budget.
“My expectation is that it’d be sometime this fall,” Cornyn told reporters. “The week or so before Thanksgiving looks like a good opportunity.”
Using a vote-a-rama could help bolster support for the bill, which has become a flashpoint for debate among the Senate GOP’s right flank.
Three senators – presidential candidates Ted Cruz (Texas) and Marco Rubio (Fla.), as well as Mike Lee (Utah) – have vowed to oppose the bill because it does not fully repeal ObamaCare.
Meanwhile, moderate Republican senators, such as Sen. Susan Collins (Maine), have raised concerns<http://thehill.com/homenews/senate/256148-houses-planned-parenthood-fight-creates-headache-for-gop-senators> with the moratorium on Planned Parenthood funding. Read more here<http://thehill.com/policy/healthcare/258422-senate-plans-vote-on-partial-obamacare-repeal-before-thanksgiving>.
<http://thehill.com/policy/healthcare/258422-senate-plans-vote-on-partial-obamacare-repeal-before-thanksgiving>
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Budget Deal Includes Social Security, Medicare Reforms
By Sarah Ferris The Hill October 26, 2015
GOP leaders and the White House are pushing structural reforms to Social Security and Medicare that would avert the double-digit increases expected next year for many beneficiaries in both programs while saving billions in other areas.
A key piece of the budget deal – and one of its costliest provisions – staves off a 52 percent premium hike that would have hit 8 million Medicare Part B enrollees next year. That fix, which is the result of a glitch in federal benefits law, is estimated to cost nearly $8 billion.
The deal would also prevent a 20 percent across-the-board cut in Social Security disability benefits for 11 million people next year, which was the result of a quickly drying-up trust fund.
“We have extended the solvency of Social Security Disability Insurance and protected millions of seniors from a significant increase in their Medicare Part B premiums and deductibles next year,” House Minority Leader Nancy Pelosi (D-Calif.) wrote in a statement praising the deal Tuesday morning.
In addition to averting those increases, the deal would enact a series of changes to both the disability and Medicare programs – some of which could be tough for Democrats to stomach.
Several of Pelosi’s top allies, including Democratic Caucus Chairman Xavier Becerra (Calif.), have made it clear over the last week that they would oppose any deal that decreased benefits.
But one of the key pay-fors in the deal is the extension of the 2 percent cut in Medicare payments, which was first passed under the sequester.
One offset in the deal, described as healthcare delivery reform for hospitals, would lower some provider payments by evening out the reimbursements for doctors who work out of hospitals or other locations, such as ambulatory services providers.
The policy, known as site-neutral Medicare payments, is similar to one included in President Obama’s budget, which would also have gone into effect retroactively. It has been endorsed by Congress’s panel of outside Medicare experts, MedPac.
The White House and GOP have also struck a major deal on an ObamaCare provision that requires large employers to automatically enroll new employees in health plans and rollover current employees.
That measure, which has been twice delayed, has not yet gone into effect. It has already passed the House as part of its budget reconciliation measure earlier this month. That change alone was expected to save about $8 billion through 2025, according to the Congressional Budget Office.
In another win for Democrats, the budget deal incorporates a cost-saving strategy for Medicaid, in which generic drug-makers are required to pay additional rebates to state Medicaid programs when their drug costs increase faster than inflation.
The idea has been pushed by Sen. Bernie Sanders (I-Vt.), who is running for the Democratric presidential nomination, and Rep. Elijah Cummings (D-Md.), who say it would help save Medicaid about $500 million over 10 years.
House Speaker John Boehner (R-Ohio) and Senate Majority Leader Mitch McConnell (R-Ky.) had pushed for “structural entitlement reforms” during weeks of talks with the White House, according to a source familiar with the talks.
“This would be the first significant reform to Social Security since 1983 and would result in $168 billion long-term savings,” the source said.
The GOP had particularly pushed for reforms to Social Security Disability Insurance (SSDI), which would see stronger penalties for those charged with fraud and abuse, stronger oversight and reporting requirements.
The disability trust fund is facing a major budget shortfall early in 2016. This summer’s grim Social Security trustees report found that the fund would be depleted by the fourth quarter of 2016, meaning that the government could only pay out about 80 percent of what’s owed to beneficiaries.
Both parties have acknowledged problems with the 50-year-old program. Conservatives argue that the system is flawed because of outdated definitions of disability and instances of fraud and abuse, while Democrats have tried to protect beneficiaries from harsh work requirements or extra requirements.
The draft released late Monday shows that both parties made strides toward their goals without major losses for either.
Still, as the deal took shape Monday, talk of shrinking some Social Security benefits was generating strong outcry from liberal groups such as the Progressive Change Campaign Committee.
“The White House, every Democrat running for president, and every Democrat in Congress should make clear that any deal that cuts Social Security, Medicare, or Medicaid benefits would be unacceptable policy – and politically, would be wildly unpopular with voters,” Adam Green, co-founder of the progressive group, wrote in a statement late Monday
http://thehill.com/policy/healthcare/258165-gop-eying-social-security-reforms-in-budget-deal