House Introduces Temporary Stopgap Measure

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Earlier today, House Democrats unveiled the Continuing Appropriations Act, 2021 and Other Extensions Act, which would extend current federal funding levels through Dec. 11, 2020. The bill also includes a yearlong extension of surface transportation programs and the National Flood Insurance Program, as well as a short-term extension of health care extenders through Dec. 11. The bill does not include $30 billion in agricultural assistance requested by the White House for the Department of Agriculture’s Commodity Credit Corp. (CCC), a program designed to stabilize farm incomes.

The absence of agricultural aid, which generally enjoys bipartisan support, sets up a conflict on the Continuing Resolution (CR) between the Democratic-controlled House and the GOP-controlled Senate. Negotiations on the CR between House Speaker Nancy Pelosi (D-CA) and Treasury Secretary Steven Mnuchin fell apart late Friday. Democrats removed the agricultural aid requested by the White House as they continue to negotiate on the funding for COVID-19 food assistance and extra time for the U.S. Census Bureau to finish its count of the U.S. population.  

Government funding expires in less than nine days on Sept. 30. The House and the Senate have until then to reach a deal and avert a government shutdown.

Below is a summary of Divisions B and C of the House CR related to surface transportation and health extenders. A full section-by-section summary is attached.

Transportation Provisions 

The bill includes a yearlong extension of surface transportation programs set to expire on Sept. 30, 2020. In addition to plus-ups for nationally significant freight and highway projects and highway safety research and development, the bill transfers nearly $14 billion to the Highway Trust Fund—$10.4 billion to the Highway Account and $3.2 billion to the Mass Transit Account. Additionally, the Airport and Airway Trust Fund would receive $14 billion as well.

In response to the measure’s introduction, House Transportation and Infrastructure Committee leaders issued a press release applauding the effort. Committee Chair Peter DeFazio (D-OR) said with the “one-year extension in place, we can continue work on a long-term, transformational bill that significantly boosts investment in our surface transportation network and moves our transportation systems into the 21st century.” Additionally, Committee Ranking Member Sam Graves (R-MO) said the “full-year extension of expiring surface transportation programs will provide immediate, desperately needed certainty to state DOTs and transportation and construction industry workers across the country.”

Health Care Extenders 

The bill also extends many health care provisions set to expire on Nov. 30, 2020, through Dec. 11. The health care extenders provisions are outlined below.

DIVISION C – Health Extenders

Title I – Public Health Extenders and Miscellaneous

Section

Title

Summary

Sec. 2101

Community Health Centers, National Health Service Corps, and Teaching health centers that operate graduate medical education.

This provision extends funding for Community Health Centers, the National Health Service Corps and the Teaching Health Centers Graduate Medical Education Program through Dec. 11, 2020.

Sec. 2102

Diabetes Program

This provision extends funding for the Special Diabetes Program and the Special Diabetes Program for Indians through Dec. 11, 2020.

Sec. 2103

Personal Responsibility Education

This provision extends the the authorization of the Personal Responsibility Education Program (PREP) through Dec. 11, 2020. It is extended on a pro rata basis at the amount appropriated for fiscal year 2020.

Sec. 2104

Sexual Risk Avoidance Education

This provision extends the authorization of the Sexual Risk Avoidance Education (SRAE) program through Dec. 11, 2020. It is extended on a pro rata basis at the amount appropriated for fiscal year 2020.

Sec. 2105

Rare Pediatric Priority Review Voucher Extension

This provision extends the Rare Pediatric Priority Review Voucher (PRV) program through Dec. 11, 2020.

Sec. 21061

Authorization to Accumulate Excess Annual Leave

This provision extends, to 120 days, the amount of leave that can be accrued by U.S. Public Health Service (USPHS) Commissioned Corps members. This extension lasts until Sept. 30, 2023.

Sec. 2107

HHS Services and Supply Fund

This provision makes a technical change to clarify that the National Institutes of Health (NIH) and Office of the Secretary (OS) Service and Supply Fund can continue to provide other agencies with services.

Title II – Medicare Extenders

Sec. 2201

Extension of the Work Geographic Practice Cost Index Floor under the Medicare Program

This provision amends the Social Security Act to enable the work geographic practice index floor to remain at 1.0 through Dec. 11, 2020, for all localities that are currently less than 1.0.

Sec. 2202

Extension of Funding for Quality Measure Endorsement, Input and Selection

This provision extends funding for quality measure selection and support for the Department of Health and Human Services’ partnership with a consensus-based entity on quality measurement and performance improvement activities. It is extended through Dec. 11, 2020.

Sec. 2203

Extension of Funding Outreach and Assistance for Low-Income Programs

This provision extends funding for the low-income Medicare activities provided through State Health Insurance Assistance Programs, Area Agencies on Aging, Aging and Disability Resource Centers, and the National Center for Benefits and Outreach and Enrollment. It is extended through Dec. 11, 2020.

Title III – Medicaid Extenders

Sec. 2301

Extension of Money Follows the Person Rebalancing Demonstration

This provision extends funding of the Money Follows the Person Rebalancing Demonstration program through Dec. 11, 2020.

Sec. 2302

Extension of Spousal Impoverishment Protections

This provision extends protections against the impoverishment of individuals whose spouses receive home- and community-based services (HCBS) through Dec. 11, 2020.

Sec. 2303

Delay of DSH Reductions

This provision delays through Dec. 11, 2020, the implementation of scheduled allotment reductions for Medicaid disproportionate share hospitals.

Sec. 2304

Extension of Community Mental Health Services Demonstration Program

This provision extends through Dec. 11, 2020, the authorization for the certified community behavioral health clinics demonstration.

Title IV – Part B Premium Adjustment

Sec. 2401

2021 Medicare Part B Premium and Deductible

This provision freezes the Medicare Part B standard monthly premium at the 2020 amount. It imposes a fee equal to 25% of the difference between the 2020 amount and the preliminary monthly actuarial rate for 2021. Beneficiaries will pay a surcharge averaging $3 on the monthly premium until the supplemental Medical Insurance (SMI) Trust Fund is repaid for the Medicare Advance Payment program loans funded from the SMI during the COVID-19 pandemic. This provision also authorizes the transfer of funds from the Treasury Department to the SMI to cover the amount the SMI provided the Medicare Advance Payment program.

Title V – Improving the Accelerated and Advance Payment Programs

Sec. 2501

Modifying Accelerated and Advance Payment Programs Under Parts A and B of the Medicare Program During the COVID-19 Emergency

For payments made under the Medicare Accelerated and Advance Payment Programs between when the CARES Act was enacted and the end of the COVID-19 public health emergency, this provision: lowers the interest rate, reduces the recoupment percentage and extends the periods before repayment periods begin and before full repayment is required.

Title VI - Offsets

Sec. 2601

Inclusion in the Medicaid Drug Rebate Program of Covered Outpatient Drugs for Medication-Assisted Treatment

This provision makes a technical correction to clarify that drugs and biologicals used for medication-assisted treatment and covered by Medicaid from Oct. 1, 2020, onward will remain eligible for Medicaid program rebates.

Sec. 2602

Medicaid Improvement Fund

This provision increases funding for the Medicaid Improvement Fund to $3.4 billion.

Click here for a copy of the legislation.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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