Congress completed action on its final “must pass” pieces of legislation in 2021, including a bill to raise the debt limit and the National Defense Authorization Act. Negotiations continued on the Build Back Better (BBB) Act. Senate Democrats continued to press for resolution before the end of the year, though by week’s end President Biden and Senate leaders acknowledged that the Senate would not take up the bill before January 2022.
Senate Committees Release BBB Text, as Negotiations and Meetings with Parliamentarian and Continue. This week, Congress completed action on its final “must pass” items of the year, including raising the debt limit and finalizing the annual defense authorization bill. At the same time, all eyes remained on the Senate to see whether Democrats would act on the Build Back Better (BBB) Act before the end of the year.
Since the House approved its version of BBB on November 19, Senate Democrats have been working with the Senate Parliamentarian on issues related to the so-called “Byrd Rule,” which dictates what types of provisions can advance in legislation considered under the budget reconciliation process. In addition, negotiations have been ongoing among the President, Democratic leaders and Senator Joe Manchin (D-WV) regarding his concerns with the size and scope of the legislation as well as particular provisions.
On December 11, key Senate committees unveiled their draft BBB texts, including the Finance Committee and Health, Education, Labor and Pensions (HELP) Committee (drafts found here and here, respectively). When compared with the House-passed bill there were notable health-related changes in the Finance and HELP drafts. Some highlights of health care changes include, but are not limited to:
It is important to note that the draft Senate text is subject to further changes before a BBB package reaches the Senate floor, given the aforementioned negotiations with Senator Manchin—or any other Democratic senators who raise concerns with particular provisions—along with forthcoming rulings from the Parliamentarian.
Negotiations are ongoing, though President Biden and Democratic leaders acknowledged on the evening of December 16 that the Senate would not act on BBB before the end of the year, following a ruling from the Parliamentarian that an immigration proposal in the package would violate the Byrd Rule. The Senate is scheduled to return to session on January 3, 2022, with the House not returning until January 10.
Updates on Challenges to Biden Administration’s Vaccine Mandates. On December 15, two federal courts issued orders that, together, significantly impact the Biden Administration’s authority to implement and enforce the COVID-19 vaccine mandate issued by the Centers for Medicare and Medicaid (CMS).
The first order, issued by the U.S. Court of Appeals for the Fifth Circuit, has the effect of allowing the federal government to proceed with its efforts to implement the COVID-19 vaccine mandate issued by CMS in over two dozen states. The second order, issued by a federal court in Texas, bars the federal government from implementing the CMS vaccine mandate in the state of Texas. The combined effect of yesterday’s orders, as well as recent actions by other federal courts, is that the Biden Administration is currently authorized to implement the CMS vaccine mandate in 25 states, but precluded from doing so in 25 states, creating a patchwork approach to the mandate.
It remains unclear how CMS will move forward with the mandate, especially given the original first compliance date of December 6. For more information, please see this Insight piece.
HHS Releases $9 Billion in Provider Relief Fund Payments. On December 14, HHS announced the distribution of approximately $9 billion in Provider Relief Fund (PRF) Phase 4 payments to health care providers who have experienced revenue losses and expenses related to the COVID-19 pandemic.
According to the agency’s press release, the average payment for small providers is $58,000, for medium providers is $289,000, and for large providers is $1.7 million. The Phase 4 payments—which are distributed through HHS’ Health Resources and Services Administration (HRSA)—were scheduled to begin on December 16 for more than 69,000 providers across all 50 states, Washington, DC, and eight territories (a state-by-state breakdown can be found here).
The remaining Phase 4 applications are being reviewed by HRSA and those payments will be made in 2022.
President Biden Issues Executive Order on Reducing Administrative Burden and Improving Customer Experience. On December 13, the President issued an Executive Order (EO) instructing federal agencies to take actions in six major categories to reduce administrative burden and improve the customer experience for organizations and the public.
Debbie Curtis, Meg Gilley, Amy Kelbick, and Rodney Whitlock gather to discuss the continuing work on the Build Back Better Act. We also take time to reflect on the most significant healthcare issues of 2021.Listen here
With the Senate and House expected to be in recess until January 3 and January 10, respectively, our Check-Up will be on a two-week holiday hiatus. Our next Check-Up is scheduled for publication on Friday, January 7. We wish you a happy and healthy holiday season!
For more information, contact Debra Curtis, Madeline Hodge, Kristen O’Brien or Erica Stocker.
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