Lawmakers began work this week to reconcile differences between House and Senate tax reform legislation following the Senate’s early morning passage Saturday of its version of the House-passed Tax Cuts and Jobs Act.

With the Senate’s 52-48 vote on its tax bill, the process now moves to a House-Senate conference committee, which was expected to convene early this week after House Speaker Paul Ryan (R-WI) and Senate Majority Leader Mitch McConnell (R-KY) chose its members.

According to the Congressional Budget Office, the estimated $1.5 trillion in tax cuts proposed in the House and Senate tax reform bills would trigger the Office of Budget and Management (OMB) to issue an automatic sequestration to reduce spending in fiscal year 2018 by a total of $136 billion. If the sequester happens, about $25 billion of the $136 billion cut would come from Medicare annually. Republican congressional leaders have said they are committed to raising the budget caps to avoid sequestration but would need help from Democrats in passing such a bill.

Medicaid DSH and CHIP Bill Likely to Pass in Late December

A delay of Medicaid disproportionate share hospital (DSH) cuts most likely would come in a year-end health care extenders package, which also will include funding for the Children’s Health Insurance Program (CHIP). With current government funding set to run out Dec. 8, Congress is expected to pass a short-term continuing resolution by Dec. 22. Some states will begin alerting CHIP enrollees of their coverage loss this month so they can start planning for next year. Sen. Orrin Hatch (R-UT), chair of the Senate Committee on Finance, stated that CHIP reauthorization is his highest priority and that he is determined to resolve the issue before the end of the year.

Bill to Stop 340B Cuts Gains Cosponsors

In November, Reps. David McKinley (R-WV) and Mike Thompson (D-CA) introduced H.R. 4392, a bipartisan bill that would place a permanent moratorium on a new Medicare policy that cuts by 27 percent Part B payments for drugs purchased through the 340B Drug Pricing Program. The Centers for Medicare & Medicaid Services included the policy in the 2018 Outpatient Prospective Payment System rule, The bill’s sponsors this week said the legislation has more than 60 cosponsors.

The association supported the legislation with a statement and encouraged its members in an Action Alert to urge their House delegations to cosponsor the bill. America’s Essential Hospitals advocacy staff are meeting with key congressional leaders to determine if H.R. 4392 could be included in year-end legislation.

Committee Activity

The Senate Committee on Health, Education, Labor, and Pensions (HELP) will hold a hearing Dec. 7 on medical innovation in the 21st Century Cures Act. The HELP Committee also will hold a Dec. 13 hearing on mental health needs in the 21st Century Cures Act.