WASHINGTON -- Despite the sometimes tempestuous relationship between Democrats and Republicans on Capitol Hill, several healthcare bills are likely to be put into play when Congress reconvenes next month, according to House and Senate congressional aides.
"This fall is shaping up to be a busy and productive one in healthcare," a senior House Republican aide said at a briefing sponsored by the and , a public relations firm. The briefing was given "on background" with the condition that speakers not be quoted by name.
"There are a couple of things that there is strong bipartisan support for," one of which is the reauthorization of the Children's Health Insurance Program (CHIP), he continued. "We had a good hearing in late June to talk about different policy choices." Considered along with the CHIP extension is the extension of funding for federally qualified health centers (FQHCs), he said. "The substance of the hearing was very bipartisan for extending those programs."
Some senators have mentioned a "clean" CHIP reauthorization -- that is, without a lot of other provisions attached to the bill -- but "from a timing perspective, FQHC funding expires at the end of fiscal year, so it would make sense to put those with CHIP," the aide told 鶹ý. "When you think about orders of magnitude, CHIP and FQHCs are multiple billions of dollars -- not insignificant," while some other programs such as the National Health Service Corps "are not unimportant, but they're much smaller, so it's a little easier to think about plugging them in and offsetting them; that's less tricky than some of the bigger costs. I expect we'll do more conversations with members and stakeholders, [but] there tends to be a lot of support from members for those types of [programs]."
Another area of bipartisan support has been Medicare "extenders" -- parts of the Medicare program that expire unless they're renewed, such as add-on payments for hospitals that have low Medicare patient volumes -- but they don't have to be authorized until year's end, so there is less urgency to work on them, the aide said.
Funding for opioid addiction treatment is another issue members are concerned about, he continued. Part of that is making sure that the Comprehensive Addiction and Recovery Act (CARA) "is being implemented effectively and efficiently. Obviously, one bill doesn't solve all the problems; the epidemic is systemic and challenging. We are hearing from a lot of members on that [issue]."
A senior House Democratic aide noted that in the House, "in some ways, healthcare is a subtext to taxes, appropriations ... and the debt ceiling," she said. "On a global basis, [House members] will continue on with smaller Medicare member-related bills." The aide said her committee is looking for Medicare extenders that can be passed on a bipartisan basis, but the challenge is how to offset any new spending that is called for.
One bill that is of interest is , a measure sponsored by Rep. Sander Levin (D-Mich.) to add dental, hearing, and vision coverage to Medicare, she continued. "Anybody who knows someone over 65, they've got one of those issues."
Issues related to drug treatment and pricing also are on the radar, according to a senior Senate Democratic aide. "The House has legislation from Sen. [Ron] Johnson [R-Wisc.] on expanded access to treatment [that has already passed the Senate] ... and the drug pricing conversation will continue," the aide said, adding that there is interest in the latter issue among both Democrats and Republicans. "I think that will play itself out in the fall."
And of course there is the gorilla in the room -- fixing the problems with the Affordable Care Act (ACA). The Senate Health, Education, Labor, and Pension (HELP) Committee will begin in September to on proposals to stabilize the ACA's health insurance exchanges; ideas under consideration include guaranteeing payment of the cost-sharing reductions used by insurers to help low-income enrollees pay their copayments and deductibles, and "re-insuring" insurance companies that have to pay for the care of high-cost patients.
"Trying to put something together with bipartisan support in September is a reasonable goal," said a senior Senate Democratic aide. "We are working to move this as quickly in September as we can." There has been no word from the Trump administration on whether it would consider extending the late-September deadline for insurers to sign contracts indicating what premiums they will charge on the exchanges in 2018, the aide said.