The 115th Congress continues to work on a number of important legislative issues with plans to advance for consideration prior to the end of the year. A brief summary includes:

Budget Resolution

The House passed the Senate version of the budget resolution last week which establishes a unified budget with reconciliation protection for tax reform.

As a reminder, the Senate version contained the following “key points”:

  • Allows for $1.5 trillion in increase deficit spending to pay for a tax overhaul.
  • Does not contain $203 billion in cut to entitlement programs in order to move forward with tax reform.

Tax Reform

The Republican tax plan that was scheduled to be released today, has been delayed until later this week or early next week. However, House Republican leaders remain confident that the legislation will be positively received and are confident of the odds of passage. Especially given that they only need 50 votes in the Senate and the flexibility of having $1.5 trillion extra to spend on tax cuts courtesy of the budget resolution passed by the Senate.

We will continue to work with our national partners to closely monitor issues related to state taxes and local deductibility, mortgage deductions, and non-for-profit charitable tax-exempt status.

CHIP Reauthorization/Medicare Extenders

The Children Health Insurance Plan (CHIP) Reauthorization legislation could be on the floor of the House later this week for a vote.  It is expected to pass. This is the partisan CHIP extension that passed the House Energy and Commerce Committee amongst party lines and includes delays of Medicaid DSH cuts until 2020.

As a reminder, the CHIP Reauthorization needs to have 60 votes in the Senate. It is still unclear if CHIP and the Medicare Extenders will move forward as free standing, or be attached to an anticipated disaster relief package that could be voted on by Thanksgiving or they may be attached to a year-end December 8 or December 15 package that would include funding for government.

Final Rules

Three final rules are anticipated to be finalized this week. They included; the Outpatient Rule, Physician Fee Schedule, and the Home Health Groupings Model (HHGM). The Outpatient Rule has the 340B cut in it and the Physician Fee Schedule has the reduction in payment to non-grandfathered, so new build outpatient facility from 50% OPPS fee schedule to 25%. The HHGM would drastically alter how home health is paid for by Medicare. Once these rules are released, we will share detailed analysis and recommended next steps.

Open Enrollment

The Open Enrollment for the Insurance Market place begins today and continues through December 15th. SDAHO has joined with the Community Healthcare Associations of the Dakotas (CHAD) to raise the level of awareness and promote assistance from various groups. Click here to read the joint op-ed article.