CONGRESS (Washington Update, November 30, 2018)

Outlook for the Rest of the Year
A partial federal government “shut-down” is in the offing if Congress and the president have not reached an agreement on appropriations by the December 7 expiration date of a “continuing resolution” now funding seven federal departments. (In an unusual turn of events, the appropriations bill for the Departments of Labor, Health and Human Services, and Education has already been enacted.) The potential conflict is about whether Congress will provide funding for the “wall” that President Trump would like to build on the southwest border of the U.S.

Other bills that could come up before the end of the session include:

• The ACE Kids Act, which would provide Medicaid reimbursement for health homes for children with medically complex conditions in order to better coordinate their care. The bill was approved by the House Energy and Commerce Committee on September 13 so is now ready to be considered by the full House. It has not yet been taken up by the Senate Finance Committee. The website of the Children’s Hospital Association provides more information about the bill, which is supported by a number of child health organizations. Nevertheless, there has been no agreement on how to pay for the additional Medicaid costs (enhanced match) associated with the bill, and controversy about the substance of the legislation. See Health Homes for Chronically Ill Kids Spark Lame-Duck Battle (Modern Healthcare, 11/28/18).
• The EMPOWER Care Act, which would reauthorize the Medicaid “Money Follows the Person” program to help people transition from institutional to community-based care. The bill, which is strongly supported by the disabilities community, was approved by the House Energy and Commerce Committee on September 13 so can now be considered by the full House and then move to the Senate.

Next year (the 116^th Congress)
Every two years (in odd years) a new two-year (two-session) “Congress” begins. On January 3, the first session of the nation’s 116^th Congress commences. Democrats will have a majority in the House of Representatives so all of the committees will be chaired by Democrats and the committees’ “Ranking Members” will be the most senior Republican on each committee. Republicans will have a majority in the Senate, so all committee chairs will be Republican and Ranking Members will be Democrats. A key health committee in the House is the Energy & Commerce Committee, which has jurisdiction over numerous health agencies and programs, including Medicaid, CHIP, parts of the Affordable Care Act (ACA), the Family-to-Family Health Information Center program, the Maternal and Child Health Block Grant (Title V) program, a number of other programs in the Health Resources and Services Administration (HRSA), and the Indian Health Service. The new chairman of that committee will be Rep. Frank Pallone (D-NJ). The Ranking Republican is expected to be Rep. Greg Walden (R-OR), the current chairman. In the Senate, the Finance Committee has jurisdiction over the same programs, plus Social Security and others. The current chairman of the Finance Committee, Senator Orrin Hatch (R-UT) is retiring at the end of this Congress. He will be replaced by Senator Charles Grassley (R-IA), who chaired the committee before, including in 2006 when the Family Opportunity Act established federal grants for Family-to-Family Health Information Centers. The Ranking Democrat will continue to be Senator Ron Wyden (D-OR).