Congressional Update

from Ntl Family Voices:

IN CONGRESS

Kavanaugh Hearings

The Senate Judiciary Committee held four days of hearings last week to consider the nomination of Judge Brett Kavanaugh to become an Associate Justice of the Supreme Court. He was questioned extensively regarding health care issues, particularly his positions on abortion rights and the Affordable Care Act. Since the Texas v. United Statescase challenging the constitutionality of the ACA (see above) could well wind up before the Supreme Court, his positions on issues raised in that case could determine the future of the law. As is the tradition among Supreme Court nominees, however, he refused to make any comments that would reveal how he might rule on specific issues.

 

The last day of the hearings was devoted to outside witnesses, among whom was Jackson Corbin, a 13-year-old with Noonan Syndrome, a disorder he shares with his brother and mother that affects multiple body systems. His moving written testimonywas about the importance to his family of having insurance coverage despite their significant pre-existing conditions. Another witness was Liz Weintraub, of the Association of University Centers on Disability, who testified about the rights of people with disabilities like herself.

 

Confirmation of Judge Kavanaugh will take only a simple majority of Senators, so if all 51 Republicans vote "YES," as currently expected, he will be confirmed. See Kavanaugh Hearings Didn't Alter Nominee's Supreme Court Trajectory (Washington Post, 9/9/18).

 

ACE Kids Act

Last week the Subcommittee on Health of the House Committee on Energy and Commerce held a hearing and approved a new version of the bipartisan ACE Kids Act, which would provide Medicaid reimbursement for states that choose to establish health homes for children with medically complex conditions, in order to better coordinate their care. The bill, sponsored by Rep. Joe Barton (R-TX) and Rep. Kathy Castor (D-FL), is a high priority for Rep. Barton, who is retiring from Congress at the end of the year. Family Voices and other children's health organizations have been providing input to committee staff with the aim of ensuring that families would have a choice about whether their children will participate in a health-home program, among other things. There is a similar companion bill in the Senate, which has been referred to the Finance Committee. An explanation of the bill can be found in the subcommittee background memo (p. 1-2). More information can be found on the website of the Children's Hospital Association, which has promoted the legislation.

 

EMPOWER Act

Last week the Subcommittee on Health of the House Committee on Energy and Commerce held a hearing and approved a revised version of the ''Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and Care Act'' or the ''EMPOWER Care Act." The bill would reauthorize the Medicaid "Money Follows the Person" program, which helps people transition from institutional to community-based care, and is strongly supported by the disabilities community. An explanation of the bill can be found in the subcommittee background memo (p. 2-3).

Opioid Legislation

Last week Senators worked out a deal on legislation to address the opioid epidemic, and the compromise bill is expected to come to a vote as early as this week. Once it passes, there will be a House-Senate conference committee to negotiate a compromise between the Senate bill (summary) and the bill that passed the House in June. One significant difference between the bills - the House measure would allow some Medicaid reimbursement for treating adults in "Institutions for Mental Disease" (IMDs), while the Senate bill would not. Specifically, the House bill would lift the current "IMD exclusion" for up to 30 days of treatment per year, until 2023. See The Health 202: Opioid Deal in Senate is Rare Bipartisan Win (Washington Post, 9/7/18).

 

ACA Repeal Legislation?

Former and now-again Senator Jon Kyl (R-AZ) was appointed by Arizona Governor Doug Ducey (R) to fill the vacancy left by the death of Senator John McCain. Senator Kyl has committed to holding the seat only until January 3, 2019 (the end of the current congressional session) but could hold the seat until a special election is held in 2020. In any case, he has said that he does not plan to run for reelection.

 

Unlike Senator McCain, Senator Kyl would be expected to vote in favor of legislation to repeal the Affordable Care Act (ACA). Since McCain cast the decisive third Republican "NO" vote to defeat earlier repeal legislation, Senator Kyl's appointment has raised the question of whether Senate leadership might again bring up a bill to repeal the ACA. Senate Majority Leader Mitch McConnell (R-KY) has indicated that he does not plan to bring up such legislation before the November elections, but has not ruled out the possibility of doing so during the "lame-duck" session, after the election and before the beginning of the next session of Congress. Even if he does so, however, the new Democratic Senator from Alabama, Doug Jones, who took a previously Republican seat in a December special election, would be expected to oppose an ACA repeal bill, meaning that such legislation again would fail to pass the Senate if all other Democratic Senators continue to oppose repeal, as expected. See McConnell: No Plan To Try Again On Obamacare Repeal Soon (The Hill, 9/5/18).