The health care bills Congress left in limbo

Topics: Politics and Policy, Federal Government, Health Care Legislation, Health Care Spending, Public Health, Health Information Technology

By Heather Drost, senior editor

Members of Congress have begun their seven-week summer recess, leaving several health policy bills to linger until lawmakers' return in September. But with a packed congressional calendar and little time before the November elections, some experts are doubtful the measures will move forward even after Congress gavels back into session. 

Let's take a closer look at the pending measures.

HHS FY 2017 spending bill

One of the most pressing deadlines facing lawmakers when they return from recess will be the Sept. 30 end of the fiscal year. Unless lawmakers approve appropriations bills —including those for HHS and Veterans Affairs—or agree on a stopgap measure, the federal government will shut down on Oct. 1.

Both the House and Senate appropriations committees have released draft health care spending bills for FY 2017. The Senate draft bill would fund HHS at $76.9 billion in FY 2017, while the House draft allocates $73.2 billion. Both measures aim to bolster funding to combat opioid and prescription drug misuse, but provisions in the House bill to defund the Affordable Care Act (ACA) and Title X family planning programs are unlikely to garner support in the Senate, according to Morning Consult.

Further, according to Politico, the fact that no appropriations bills have been sent to President Obama so far this year suggests a continuing resolution "will almost certainly be necessary in September to stave off a shutdown."

According to Politico, House lawmakers are already discussing whether to draft a continuing resolution that would fund the government at current levels through December or a longer stopgap that would expire in March 2017.

Zika emergency response funding

Nearly six months after President Obama requested  $1.9 billion to combat the Zika virus in the United States, lawmakers adjourned for the summer without reaching an agreement on a spending bill (HR 2577) that would provide $1.1 billion to combat Zika in the United States.

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The bill, which resulted from congressional negotiations, would allocate about $400 million in new spending for Zika response efforts. The remaining funds would be redirected from other federal programs, including $107 million from Ebola-related efforts and $543 million from a program to help U.S. territories set up insurance marketplaces under the ACA.

Without that funding, HHS Secretary Sylvia Mathews Burwell said that existing funds for Zika response efforts could run out in late July or early August. According to Vox, this means many local health departments will have to combat the virus without additional help and that research into the disease's effects and potential vaccines will be delayed.

In an interview with The Atlantic, Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said he would continue to lobby lawmakers during the recess. However, he expressed concern that the congressional deadlock over spending bills may impede the fight against Zika. According to The Atlantic, Rep. Tom Cole (R-Okla.) said a "normal" continuing resolution would not contain a specific "line item" for Zika, meaning no additional funds would be approved for Zika.

21st Century Cures

The Senate also adjourned without acting on the Senate Health, Education, Labor and Pensions Committee's version of the House-approved 21st Century Cures Act (HR 6).

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The proposals aim to bolster medical research and innovation. But, according to Clinical Innovation & Technology, senators were unable to overcome differences on how to fund the Senate's version of the package. Sen. Patty Murray (D-Wash.) called for the bill's funding to be mandatory, while Republicans wanted to offset the costs through cuts in HHS. According to Politico's "Prescription Pulse," House Energy and Commerce Committee Chair Fred Upton (R-Mich.) has drafted a new list of ways to fund the proposal that is "pretty close" to resolving the funding issue, but no details have been released. 

In a statement, Senate HELP Committee Chair Lamar Alexander (R-Tenn.) urged lawmakers to take up the measure when they reconvene in September, saying that it "could be the most important legislation Congress passes this year."

However, not everyone is convinced the measure should be finalized right away. Paul Brown and Tracy Rupp of the National Center for Health Research, along with consumer advocate Steven Findlay, in a Health Affairs blog post called the legislation "flawed." They wrote, "Instead of hastily agreeing to it, Congress should postpone consideration until 2017 and attach the best of the 19 bills [approved by the HELP Committee] to must-pass legislation on FDA funding through industry user fees."

Mental health legislation

The House earlier this month in a near-unanimous vote passed a bill (HR 2646) that would overhaul the U.S. mental health care system. The far-reaching measure has gained support from both sides of the aisle, as well as from mental health advocates.

The full Senate has yet to vote on similar legislation. But some mental health advocates say they are optimistic the Senate could pass a similar bill later this year.

Linda Rosenberg, CEO of the National Council for Behavioral Health, told NBC News, "We certainly as advocates, along with our sister advocacy associations, are going to press for it. I think the champions and the senators that are the sponsors of that bill—they want very much to move it, so I'm hopeful."

Opioid misuse bill

But lawmakers didn't leave every issue hanging when they left Washington, D.C. last week: Before departing, Congress finalized legislation to address opioid misuse.

The Comprehensive Addiction and Recovery Act (CARA), which was sent to President Obama, would enable the federal government to issue grants to states to:

  • Create alternatives to incarceration for opioid misusers;
  • Examine ways to reduce illicit opioid distribution; and
  • Support efforts to train first responders about treating opioid-related overdoses.

However, the funding levels included in the bill have been criticized as inadequate by Democratic lawmakers and the White House. A group of 20 Senate Democrats last week sent a letter urging Senate Majority Leader Mitch McConnell (R-Ky.) to schedule a vote soon to consider additional funding.

The calls for more funding have gained some Republican support too, with Sen. Kelly Ayotte (R-N.H.), saying she will "continue to push the appropriations committee to [further] increase funding" to combat opioid misuse.

Looking ahead

The upcoming November elections mean that Congress will have little time to consider legislation when it returns. House Speaker Paul Ryan (R-Wis.) at a news conference Thursday said he was optimistic that annual spending measures ultimately would go forward: "I don't want to give up on the appropriations process," he said.