Congress (Washington Update, January 9, 2019)

The New Congress
The 116^th Congress of the United States convened on January 3, 2019, and will exist for two years–divided into the first and second “sessions.” It is the most racially and ethnically diverse Congress in history, and the most female. Among the new members are Native American women, Muslim women, and bisexual women, and a number of first-from-their-state women, people of color, or LGBTQ members. See Meet the New Freshmen in Congress (New York Times, 1/3/19). The House freshmen also include several health care professionals (physicians, a dentist and a nurse).

The most significant change from the last Congress is the fact that Democrats now hold the majority in the House of Representatives, meaning that all committee chairs are Democrats. (The Senate majority continues to be Republican.) Rep. Nancy Pelosi (D-CA) has been elected to serve as the Speaker of the House (her second stint), giving her control over which measures are taken up by the full House. Reps. Steny Hoyer (D-MD) and Kevin McCarthy (R-CA) return as the Democratic and Republican Majority Leaders, respectively.

Rep. Frank Pallone (D-NJ) will chair the Energy & Commerce Committee, which has jurisdiction over Medicaid, the Health Resources and Services Administration (HRSA), and the Indian Health Service, among other programs and agencies. Former committee chairman Greg Walden (R-OR) will be the Ranking Member. The Appropriations Committee will be chaired by Nita Lowey (D-NY), and the Subcommittee on Labor, Health and Human Services, and Education Appropriations will be chaired by Rep. Rosa DeLauro (D-CT). Rep. Richard Neal (D-MA) will chair the Committee on Ways & Means, which has jurisdiction over the Supplemental Security Income (SSI) program, taxes, Medicare, and other issues.

In the Senate, the Finance Committee will have a new chairman – Senator Chuck Grassley (R-IA) – due to the retirement of former chairman Orrin Hatch (R-UT). Senator Grassley served as Finance chairman previously, including when the committee passed the Family Opportunity Act of 2005, which created the federal grant program for Family-to-Family Health Information Centers. Senator Ron Wyden (D-OR), will continue to serve as the committee’s ranking Democrat. There will be three new Republicans on the committee — Senators James Lankford (R-OK), Steve Daines (R-MT), and Todd Young (R-IN) – and two new Democrats — Maggie Hassan (D-NH) and Catherine Cortez Masto (D-NV).

Connecting With New and Returning Members of Congress
The beginning of a new Congress presents a great opportunity to establish contact with new Representatives and Senators and their staffers, and to reconnect with returning Members, who often have new staffers after an election. Family-to-Family Health Information Centers (F2Fs) can let congressional caseworkers (usually in the local office) know that their F2F is available to help constituents whose children have special health care needs. F2Fs can also let DC and local health staffers know that they can serve as a source of information about the needs of CYSHCN and their families in their state. You can find your two Senators at www.senate.gov, and your (one) Representative by entering your zip code at www.house.gov.

Status of Legislation
In the waning days of the last Congress, there were several bills of interest that were under consideration.

Not passed:
The Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act (IMPROVE Act, H.R. 7217; text) incorporated several Medicaid measures, including scaled-back versions of the ACE Kids Act, which would allow states to receive Medicaid reimbursement for “health homes” to better coordinate care for children with medically complex conditions, and the EMPOWER Care Act, which would extend for three months the Medicaid “Money Follows the Person” program to help people transition from institutional to community-based care. The bill passed the House by a vote of 400-11 but was not taken up in the Senate before the end of the session. Some Senators opposed the temporary increase in the federal Medicaid matching rate that the ACE Kids Act would have provided to states that took up the health-home option.

Note: On January 4, 2019, Rep. Frank Pallone (D-NJ) introduced the Medicaid Extenders Act of 2019 (H.R. 259), which would extend for three months the Money Follows the Person (MFP) demonstration program and spousal impoverishment protections for Home- and Community-Based Services (HCBS) recipients.

The Emergency Medical Services for Children (EMSC) Program Reauthorization Act (S. 3482), had been passed by “unanimous consent” in the Senate, but was not taken up by the House before the end of the session. The EMSC program, administered by the Maternal and Child Health Bureau, provides grants to states and territories to improve their response to pediatric emergencies.

Signed by the president:
The Prematurity Research Expansion and Education for Mothers who deliver Infants Early (“PREEMIE”) Reauthorization Act of 2018 (S. 3029) was signed by the president on December 18, becoming Public Law 115-328. The law reauthorizes for five years programs at the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) to collect data about and improve the treatment and outcomes of premature infants.

The Improving Access to Maternity Care Act (H.R. 315), which requires HRSA to assign providers to areas with a shortage of maternity care health professionals, was signed by the president on December 17, becoming Public Law 115-320.

The Preventing Maternal Deaths Act of 2017 (H.R. 1318), which will provide funding to states and tribes to establish and improve maternal mortality review committees, was signed into law by the president on December 21, becoming Public Law 115-344.

The Traumatic Brain Injury Program Reauthorization Act (H.R. 6615), to reauthorize the Traumatic Brain Injury program, was signed by the president on December 21, becoming Public Law 115-377.

Upcoming Hearings
On January 3, House Energy and Commerce Committee Chairman Frank Pallone (D-NJ) announced the first three hearings to be held by the committee. The first hearing will be about climate change; the second will be about the impact of the federal district court decision that the Affordable Care Act is unconstitutional (see “Courts” section, below); the third hearing will be about the administration’s former policy of separating immigrant families at the border and how the Administration is currently keeping immigrant children safe under the care of the Department of Health and Human Services.