AANP Federal Legislative Update
New Year's Agreement Shifts Fiscal Cliff to March Contentious negotiations led a lame duck Congress to rare New Year’s Day votes last week to approve legislation blocking increases in tax rates and cuts in spending and Medicare payment. But the 11th-hour agreement sets the stage for another fiscal showdown by delaying across-the-board spending cuts until March, when the government will also risk defaulting on the national debt and funding to operate federal programs will expire. Leaders in both parties are demanding that major changes in the tax code and entitlement programs including Medicare and Medicaid must be part of the debt limit negotiations.
A majority of Republicans in the House of Representatives opposed the fiscal cliff deal negotiated by the Obama administration and Senate Republicans, but support from Democrats allowed the “American Taxpayer Relief Act” (H.R. 8) to pass by a margin of 257 to 167 on New Year’s Day. In addition to delaying the sequestration spending cuts for 60 days, the agreement extends tax cuts for families earning less than $450,000 and funding for unemployment benefits. It also prevents a 27 percent cut in Medicare fee schedule payments by extending current fees for a year. Despite the efforts of AANP and congressional sponsors, the bill does not include language to enable nurse practitioners to certify home health services.
Members of 113th Congress Take Office Senators and Representatives elected by voters last November officially took their oaths of office last Thursday, marking the beginning of the two-year 113th Congress. Rep. John Boehner (R-OH) was reelected as Speaker of the House by a smaller margin than expected as some Republicans demonstrated their dissatisfaction with the 2012 election campaign and recent negotiations with the Obama administration.
The 113th Congress opens with a smaller Republican majority in the House, a slightly larger Democratic majority in the Senate, and a record number of 101 women members of Congress. The leadership of most of the committees with jurisdiction over policies important to nurse practitioners will remain the same, although Senator Barbara Mikulski (D-MD) succeeds the late Senator Daniel Inouye (D-HI) as Chair of the Senate Appropriations Committee and Rep. Jack Kingston (R-GA) assumes the Chair of the House Labor-HHS-Education Appropriations Subcommittee. Rep. Kevin Brady (R-TX) will chair the House Ways and Means Health Subcommittee, while Rep. Jim McDermott (D-WA) will be the ranking Democrat on that subcommittee.
HHS Approves More Exchanges, Issues New Guidance The Department of Health and Human Services approved seven more state health insurance exchanges last Thursday, including marketplaces designed by California, Hawaii, Idaho, Nevada, New Mexico, Utah, and Vermont. The agency cited ongoing disagreements among state officials as holding up approval of Mississippi’s application for a state-based exchange. To assist states that may want to convert partnerships with the federal government into state-operated exchanges by 2015, the department also released additional guidance and gave states until mid-November to submit their plans.
HHS will host a conference call this Wednesday, January 9, at 2 pm Eastern time, to update clinicians, hospitals, and other providers on how recent regulations and guidance to states will affect their practices. Gary Cohen, Director of the Center for Consumer Information and Insurance Oversight, and other senior HHS officials with discuss the new policies and respond to providers’ questions. Nurse practitioners can participate in the briefing by calling 1-888-455-2963 and entering the passcode 2954962.