With no clear “must-do” legislative priorities for health care in 2016, aside from annual appropriations, any legislation with potential of enactment must have strong bipartisan support and relatively little controversy. We should not expect massive policy reforms but more likely targeted fixes to address specific issues. We can also anticipate congressional hearings on topics of concern to constituents, which will provide a public focus on certain issues but may not be followed by legislative resolution.
Many “must-do” health care policies were addressed last year. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the perennial Sustainable Growth Rate (SGR) legislative vehicle as both an opportunity and a threat for health care concerns. The December 2015 “taxibus” combining tax provisions and omnibus appropriations for FY 2016 included a delay in the implementation of the so-called “Cadillac Tax” on certain health plans and a two year moratorium on the medical device excise tax. Additionally, there are no user fees—prescription drug, medical device, generic drug, or biosimilar—that need to be reauthorized until 2017.
Congress did provide a model for enacting narrow, bipartisan health care legislation in the closing hours of the first session of the 114th Congress, in the form of the Patient Access and Medicare Protection Act. The bill, which contained various targeted Medicare policies on which there was strong bipartisan agreement and little or no opposition, was introduced and passed both houses of Congress on December 18 and was signed into law by the President on December 28.
Congressional committees with jurisdiction over health care policy will likely continue their work on priority issues, and there is strong potential to move narrow bipartisan policy proposals from these larger efforts. For instance, the Senate Health, Education, Labor and Pensions Committee is expected to introduce its “Innovation for Healthier Americans” legislation to respond to the House Energy and Commerce’s work on the “21st Century Cures Act”. A bipartisan group of Senate Finance Committee members have delved into policy options for Americans managing chronic illnesses. Additionally, a broad hospital payment reform package is expected to be introduced by the House Ways and Means Committee. From these larger policy proposals, there is potential to derive some consensus provisions.
For topics on which there continues to be a strong public interest, such as prescription drug and heroin abuse, as well as the cost of prescription drugs, we can expect additional congressional hearings and investigations. However, enacting legislative solutions to such complex issues will not likely be able to meet the strong bipartisan/relatively little controversy test.
