“Everything was discussed,” [Rep. Buddy] Carter told reporters Tuesday, adding that members are “still in the process of just throwing mud up against the wall to see what sticks.” – Inside Health Policy
The Rundown
- Reconciliation process is underway: What is it? How could it impact healthcare?
- House Energy & Commerce Committee finalizes membership and gets to work
- What’s up NC delegation?
- From our desks
- Join the Duke Health Advocacy Network!
Federal Updates
Reconciling with Reconciliation
“Everything was discussed,” Carter told reporters Tuesday, adding that members are “still in the process of just throwing mud up against the wall to see what sticks.” – Inside Health Policy
That was a statement from House Energy & Commerce Health Subcommittee Chairman Rep. Buddy Carter (R-GA) regarding the Committee holding a closed-door meeting Tuesday to discuss health policies and reconciliation. Last week, House Republicans were considering a list of potential healthcare policy changes that could serve as cost savings for other priorities in the upcoming spending debates. Included on the broader list were so-called site neutral cuts and changes to Medicaid, such as moving to a per capita cap, lowering the Federal Medical Assistance Percentage (FMAP) floor, and limiting Medicaid provider taxes.
You may recall discussions about reconciliation from 2021 and 2022, but like us, you may need a refresher. Reconciliation is a powerful tool when both houses of Congress are controlled by the same party, as “reconciliation allows for expedited consideration of certain tax, spending, and debt limit legislation.” Reconciliation bills cannot be filibustered in the Senate and only require a simple majority vote, which is why they are a favored tool to move policies quickly. In this case, House and Senate Republicans are planning for reconciliation to try and move several of President-Elect Trump’s policy proposals, particularly with their majorities in both chambers.
However, there are limits to how a reconciliation bill can be used for policy change. According to the Center on Budget and Policy Priorities, reconciliation is only for legislation that changes spending, revenues, and/or the federal debt limit. On the spending side, reconciliation can be used to address most “mandatory” or entitlement spending, which includes programs such as Medicare and Medicaid.
The process starts with a budget resolution that will include directions to the committees of jurisdiction to change spending, revenues, deficits, and/or the debt limit by a specific amount. Each committee of jurisdiction will write its bill, and then Congress will move to pass one larger reconciliation bill. The process is more nuanced than this, but we don’t want to lose your attention. If you want to learn more about the process, please contact us and we can direct you to additional resources.
Our office continues to prepare for this bill and potential offsets and is working strategically to ensure we share the impact of legislation on the Duke Health community and patients.
Getting down to business
Earlier this week, the House Energy and Commerce Committee released its rosters of Republican and Democratic members. As we reported to you last week, Rep. Richard Hudson (R-NC-09) will serve as Chairman of the Subcommittee on Communications and Technology.
On Wednesday, the Committee held its organizational meeting adopting its rules for business. In his opening statement, new Committee Chair Brett Guthrie (R-KY) discussed the energy, technology, and healthcare priorities for the Committee including lowering the cost of health care, providing price transparency to consumers and businesses, supporting innovation, and restoring trust in public health. He said they will closely examine the Medicare and Medicaid programs to ensure they work efficiently and serve the individuals they were designed to assist. Chair Guthrie said they will also work to address the opioid epidemic and advance policies to help individuals avoid fentanyl poisoning while also giving hope to families and individuals struggling with substance use disorder.
Rep. Frank Pallone (D-NJ), who is returning as the Committee’s Ranking Member this Congress, spoke kindly about his work with Chairman Guthrie but noted his concerns with President-elect Trump’s policies and that Democrats will fight any efforts to gut healthcare or environmental or consumer protections. He specifically noted opposing efforts to cut Medicaid funding.
What’s up NC delegation?
With a new Congress comes new members and new committee assignments. Below are some of the recent announcements for members of the NC delegation. We anticipate more announcements in the coming days as the committees finalize their organization.
- Rep. Deborah Ross (D-NC-02) will again serve on the House Judiciary Committee and the House Science, Space, and Technology Committee. On the House Judiciary Committee, she will again serve on the Subcommittee on Immigration Integrity, Security, and Enforcement and the Subcommittee on Courts, Intellectual Property, Artificial Intelligence, and the Internet.
- Rep. Greg Murphy (R-NC-03) will serve as Vice Chair of the House Veterans' Affairs Subcommittee on Health.
- Rep. Valerie Foushee (D-NC-04) was elected by her Democratic colleagues to the leadership position of Regional Whip. In this role, she will assist Democratic Whip Katherine Clark (D-MA) in coordinating the votes of Democratic representatives from North Carolina, Louisiana, Tennessee, Mississippi, Alabama, South Carolina, and the Virgin Islands.
- Rep. Virginia Foxx (R-NC-05) was appointed by Speaker Mike Johnson (R-LA) to serve as chair of the House Rules Committee.
- In addition to being appointed to the House Judiciary Committee and the House Agriculture Committee, Rep. Mark Harris (R-NC-08) was appointed to the House Education and Workforce Committee.
- Rep. Chuck Edwards (R-NC-11) will again serve on the House Appropriations Committee and the House Budget Committee. Within the House Appropriations Committee, he was selected as Vice Chairman for the National Security, Department of State, and Related Programs Subcommittee.
From our desks
This week, our office participated in the monthly meeting of the Gun Violence Prevention roundtable and an event hosted by the Hill entitled “Trust in Science: The High-Stakes Game for U.S. Public Health.”
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