Congress Faces a Difficult Lame Duck Session in November
Congress was able to agree to and pass a temporary funding bill before October 1 that will avert a federal government shut-down, keep the government running until December 9, and allow Representatives and Senators to go home to their home districts and states to run for re-election. However, the Congress faces a very difficult “lame duck” session when it returns to Washington following the November elections.
Congress is scheduled to be in session between November 14 and December 16, and, during that time, it has set the following major legislative decisions on its agenda: a final spending bill, a major package of biomedical measures, emergency aid for floods and Zika, defense authorization, campaign finance fights, a criminal justice overhaul, an energy policy conference, LGBT rights, and confirmation (maybe) of a Supreme Court nominee.
Below is a summary of what the Endocrine Society will be watching when Congress returns:
Omnibus or Minibuses?
Congressional leaders and the White House will have to determine how to wrap up the 11 remaining fiscal 2017 appropriations bills, solve disputes that bogged down negotiations over the continuing resolution (CR) and merge the vastly different spending bills that emerged from the House and Senate committees.
Their first step, however, will not have to do with policy or spending decisions, but with how to package those leftover spending bills. Republican leaders are already staking their support for passing a series of so-called minibuses that would group appropriations bills together, while Democrats are leaning toward an omnibus bill that would include all the bills. From the Society’s perspective, it would be better to have an omnibus spending bill so that the controversial issues surrounding the Labor-HHS-Education bill do not hold up funding for the National Institutes of Health (NIH), the Centers for Disease Control and Prevention, and various diabetes-related initiatives.
The second step will be laying out and coming to agreement on the dozens of policy issues that separated the House and the Senate as well as the political parties throughout this year’s appropriations process. Hopefully, the fact that this will follow the elections and the corresponding partisan politics means the Congress will be able to reach agreement although the fundamental policy and spending issues that always divide Republicans and Democrats will remain the same.
During negotiations on the final spending bill or bills, we will continue to call for Congress to complete its work and pass a funding bill rather than a long-term CR, no sequestration cuts, and no “poison pill” policy riders as we advocate for at least $34 billion for NIH.
21st Century Cures
Republican leaders in the House and Senate indicated that they plan to prioritize passing a package of biomedical innovation bills known as 21st Century Cures (H.R. 6) during the lame duck session. 21st Century Cures was passed overwhelmingly by the House last year, but has faced a more difficult path in the Senate over disagreements including fights about mandatory funding for NIH.
Senate Majority Leader Mitch McConnell (R-KY) said getting the legislation passed would be one of his main goals in the lame-duck session. “My own personal priorities are funding the government and the 21st Century Cures bill, which I think could end up being the most significant piece of legislation we pass in the whole Congress,” he said.
House Speaker Paul D. Ryan (R-WI) made a similar statement. “When we return in November, I look forward to completing work on some very important key initiatives that just haven’t quite gotten over the finish line,” the Wisconsin Republican said, citing the Cures bill.
We will keep Endocrine Society members apprised of the discussions in Washington and hope you will join our advocacy campaigns. For more information, please visit our online advocacy center.
MACRA Website Offers New Tools to Aid in Transition
The American Medical Association (AMA) has released new online tools to help physicians through the upcoming Medicare payment and delivery changes and improve their chances of success under the new Medicare Access and Chip Reauthorization Act (MACRA). The tools include the AMA Payment Model Evaluator, to provide an initial assessment to physicians of how their practices will be impacted by MACRA, and AMA STEPS Forward, which is a collection of practice improvement strategies with MACRA-specific tools. The AMA has also launched a ReachMD podcast series titled Inside Medicare's New Payment System.
These tools are available on the AMA website and through the Endocrine Society's new MACRA webpage, which is dedicated to the helping our members understand the new system. Tools from the Centers for Medicare & Medicaid Services (CMS), AMA, American College of Physicians, as well as a recording of the MACRA overview offered at this year's Clinical Endocrinology Update are all available in one place. New resources are being added often, so you are encouraged to check back. If there are specific resources that you would like to see included, please contact Stephanie Kutler, Director of Quality Improvement at firstname.lastname@example.org.
Society Responds to Essential Health Benefits Proposal; Cites Concerns with Access to Obesity Treatment
The Department of Health and Human Services (HHS) released proposed regulations for benefit and payment parameters that outlines covered services for beneficiaries in 2018. The Society and its obesity coalition partners responded to the proposed rule citing concern with discriminatory benefit design practices which have denied patients access to evidence-based obesity treatment. The letter highlights U.S. Preventive Services Task Force recommendations on screening and management for obesity in adults and calls on HHS to review state health exchange essential health benefits to ensure that obesity services are properly covered. We will continue to work to ensure that patients have access to the full continuum of evidence-based obesity treatment options. To get involved in this important issue, take action now.
On October 7, the National Institutes of Health (NIH) announced procedures for NIH operations under the Continuing Resolution (CR) signed on September 29. Consistent with NIH practices under previous CRs, NIH will issue non-competing research grant awards up to 90% of the previously committed level in the Notice of Award, and adjust upward after FY 2017 appropriations are enacted. For more information, please see the full NIH Announcement.