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On the Hill: Work Continues on FY 2020 Federal Funding, DSH Cuts

Lawmakers have three weeks to agree on federal government funding through the end of fiscal year (FY) 2020 and funding extensions for various health care programs, including Medicaid disproportionate share hospital (DSH) payments.

President Trump last month signed a continuing resolution (CR) to extend FY 2019 funding levels for federal operations through Dec. 20, which staved off a scheduled $4 billion cut to Medicaid DSH payments. Without further congressional action, the cuts will start Dec. 21.

Meanwhile, congressional leaders remain focused on using legislation to lower out-of-pocket health care costs, including prescription drug prices, to pay for the health care “extenders” and Medicaid DSH relief.

Drug Pricing Legislation Update

The House this month is expected to vote on Speaker Nancy Pelosi’s (D-CA) drug pricing bill, the Lower Drug Costs Now Act of 2019 (H.R. 3). The comprehensive legislation seeks to lower the cost of prescription drugs, in part by authorizing the Medicare program to negotiate the price it pays for up to 250 of the costliest prescription drugs that have no generic or biosimilar alternative.

In October, the Congressional Budget Office (CBO) released a preliminary analysis of Pelosi’s bill that estimated the price negotiation provisions (Title I) would generate $345 billion in savings for the federal budget and result in up to 15 fewer drugs released in the marketplace over the next 10 years. The House is expected to pass the legislation, but the Senate is unlikely to vote on it.

Bipartisan leaders of the Senate Committee on Finance — Sens. Chuck Grassley (R-IA) and Ron Wyden (D-OR) — continue work to advance their prescription drug legislation, the Prescription Drug Pricing Reduction Act (S. 2543). The Grassley-Wyden bill would cap seniors’ out-of-pocket costs and require drug manufactures to pay a rebate to the Medicare program if they raise prices higher than the rate of inflation. According to a Finance Committee release, a preliminary CBO estimate indicates the bill would save more than $100 billion over a 10-year budget window.

Impeachment Investigation

The House this week resumes its impeachment investigation, as the Permanent Select Committee on Intelligence wraps up its work. The select committee will submit a report summarizing its findings to the House Committee on the Judiciary.

On Wednesday, the Judiciary Committee will hold a public hearing to examine the constitutional basis for the impeachment inquiry.  The committee also will review the select committee’s report as part of its due diligence to determine whether articles of impeachment are necessary.

The Judiciary Committee must approve articles of impeachment before they can be considered by the full House of Representatives.

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About the Author

Erin Delaney is the legislative affairs associate at America's Essential Hospitals.

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