This edition of our AASM election news coverage will focus on the health care legislation the 114th Congress is expected to consider before the end of the year.
Every year, Labor Day marks the start of Congress’ scramble to pass a budget resolution and 12 appropriations bills for next federal fiscal year (FY), which begins on October 1, 2016. Partisan and ideological differences between the Senate and the House of Representatives as well as the political parties can create a deadlock preventing the adoption of the necessary appropriations bills which may lead to a government shutdown. To prevent the government from shutting down, Congress has generally passed a Continuing Resolution (CR) to operate the Federal Government at the appropriations levels as the previous fiscal year (or with minor modifications) for a set amount of time. As of September 27, the main points of contention on the proposed CR were centered on funding for Louisiana flood victims, the Flint, Michigan water crisis, and how funding to combat the spread of the Zika virus would be spent, specifically, which agencies and non-profit organizations would be authorized to receive funding.
Should Congress complete the funding to operate the Federal Government in time, Congressional observers expect legislators to consider several pieces of health care legislation prior to the start of the 115th Congress in 2017.
H.R. 4207, the Fair Drug Pricing Act
On September 15, Senator John McCain of Arizona, Senator Tammy Baldwin of Wisconsin and Representative Jan Schakowsky of Illinois introduced H.R. 4207, the FAIR Drug Pricing Act in both Chambers. This legislation would require manufacturers of certain drugs submit a report detailing manufacturing, research and development costs, net profits and how much they spend on advertising on a particular medicine 30 days before any price increase in excess of 10 percent. It is unlikely to be considered by either Chamber before the 114th Congress adjourns. However, the FAIR Drug Pricing Act will likely be reintroduced early in 2017 for detailed consideration.
H.R. 2646, the Helping Families in Mental Health Crisis Act of 2015
The Senate is expected to consider H.R. 2646 to address the stigma of mental illness directly by instituting significant reforms across federal departments and agencies ensuring evidence-based approaches to care of individuals with mental illness and/or substance use disorders. In addition, the bill provides more psychiatric hospital beds, improves the use of health information technology in mental health care, provides resources for suicide prevention, and contains provisions designed to improve data collection and outcomes measurement and expand the availability of evidence-based services. Passed by the House of Representatives on July 6, 2016, H.R. 2646 was referred to the United States Senate for consideration before the end of the 114th Congress. In early September, Senator John Cornyn of Texas acknowledged the Senate would not vote on mental health legislation until after the November 8 election because the spending bills are taking a priority.
H.R. 6, 21st Century Cures Act
The Senate needs to act on the 21st Century Cures Act (H.R. 6), which, among other things, will streamline clinical trials, reduce the regulatory burden for new antibiotic approvals, prioritize limited use pathways, implement changes to the U.S. Food and Drug Administration approval process, and includes more than $9 billion in mandatory funding for the National Institutes of Health (NIH) over the next five years. A version was overwhelmingly passed by the House but is still being debated in the Senate. Senate Democrats are looking to add mandatory spending to the bill to avoid federal spending limits. However, Senate Republicans would offset the flow of mandatory spending by including budget cuts. Senate members are also exploring the idea of creating a NIH Innovation Fund capable of providing a surge in one-time NIH funding for close-ended priorities like Cancer Moonshot and the Precision Medicine Initiative.
Funding for Public Law 114-198, The Comprehensive Addiction and Recovery Act (CARA) of 2016
One bill lawmakers passed before adjourning for recess in August was S. 524, The Comprehensive Addiction and Recovery Act (CARA), designed to address opioid misuse. On July 22, 2016, President Obama signed S. 524 into federal law. CARA would enable the federal government to issue grants to states to (1) Create alternatives to incarceration for opioid misusers; (2) Examine ways to reduce illicit opioid distribution; and (3) Support efforts to train first responders about treating opioid-related overdoses. However, Congress adjourned without actually funding the law. President Obama has asked for $1.1 billion to implement the law, much of would have gone to state and local prevention and treatment programs. Republicans, who control both chambers of Congress, authorized only 16 percent of the requested funding — $181 million. Recently, a group of 20 Senate Democrats sent a letter urging Senate Majority Leader Mitch McConnell (R-Ky.) to schedule a vote soon to consider additional funding.
The 114th Congress is in its waning days. Both Chambers are scheduled to adjourn by October 7 in order to allow incumbents to campaign for reelection. Shortly after the election is held, the 114th Congress will reconvene for a scheduled four weeks of a ‘lame duck’ session to complete their legislative work and begin the transition to a new Congress and a new Presidential Administration. During this lame duck session, Congress is expected to take up the final Spending Bills required to fully fund the Federal Government for the next fiscal year, including the Labor/HHS appropriations bill, mental health care reform, and discussions about the Trans Pacific Partnership trade agreement.