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January 2019

Shutdown Enters New Year

The federal government entered a partial shutdown on December 21, 2018, after President Trump and Congress failed to reach an agreement on funding for a border wall. A partial shutdown is expected to furlough 380,000 federal employees and leave 420,000 to work without pay.

A bipartisan agreement appeared to emerge to provide funding for several major federal agencies through February 8, 2019. The package passed the Senate by voice vote. The House of Representatives was expected to act on the measure, until the President’s abrupt announcement that he would not sign a stop gap spending bill without $5 billion for a wall. The House passed its own continuing resolution (CR) late on Thursday, rather than taking up the Senate version. The House package passed by a vote of 217-185, with eight Republicans joining Democrats in opposition to the bill. It meets the President’s demand of $5 billion for a border wall. After discussions between Senate leadership, Vice President Pence and others, the Senate announced that it would not have additional votes until they had more time to continue working on a funding package.

While the U.S. Department of Health and Human Services (HHS) is already funded, the Food and Drug Administration (FDA) receives its annual appropriations through one of the spending bills that would have been addressed by the CR. The agency will continue vital activities during the shutdown but will stop routine inspections of pharmaceutical and food manufacturing plants. Work funded by user fees is generally expected to continue. Approximately 40 percent of the agency’s employees will be placed on unpaid leave of absence.

Congress returned on December 27, and no votes were taken. The new 116th Congress began on January 3, 2019. The House passed spending measures to reopen the remaining closed government agencies till the end of the fiscal year and provide funds for the Department of Homeland Security until February 8, in order to finish negotiations on its funding and border security concerns. The Senate has not yet taken the bill up and the President has threatened to veto any measure that does not include at least $5 billion for a border wall.


Texas Judge Declares ACA Unconstitutional

A federal judge in Texas struck down the Affordable Care Act (ACA) on Friday, one day before the deadline to enroll in coverage for 2019. The case was brought by 20 GOP-led states that sought to overturn the law’s protections for pre-existing conditions. The Trump administration declined to defend the law in court. Judge Reed O’Conner ruled that the law’s individual mandate is unconstitutional, and that the mandate cannot be separated from the rest of the law – therefore, the rest of the law is invalid.

Judge O’Conner found that the Supreme Court upheld the individual mandate as a tax. When Congress repealed the fine for failing to comply with the mandate, the penalty was no longer a tax and the mandate was therefore unconstitutional. He also characterized the mandate as essential to the rest of the ACA, arguing that Congress effectively invalidated the entire law when it repealed the individual mandate.

The ruling will be appealed, during which time the ACA will remain in effect. O’Conner did not issue an injunction to stop federal officials from enforcing the law in the meantime.


 HELP Committee Chairman Lamar Alexander to Retire in 2020

Sen. Lamar Alexander (R-Tenn.), Chairman of the HELP Committee, announced that he will not run for reelection in 2020. He is the first senator up for re-election in 2020 to announce that he will not be running.


McSally to Replace Jon Kyl in Senate

Arizona Governor Doug Ducey (R) has announced his appointment of Representative Martha McSally (R-AZ) to the Senate. McSally will replace Jon Kyl (R), who was previously picked to fill the seat of late GOP Sen. John McCain. She will serve out the remaining two years of McCain’s term, which expires in January 2021.


Health and Human Services Releases Policy Priorities for 116th Congress

Health and Human Services released a report, Reforming America’s Healthcare System Through Choice and Competition, detailing a wish list for developing a better functioning health care market. The report identifies government regulations that act as barriers to market competition and stifle innovation, lead to higher prices, and fail to incentivize improvements in quality. It includes over 50 recommendations for action by either the administration, Congress, or state governments, arguing for the expanded use of Health Savings Accounts (HSAs), increased price transparency, and a lifting of restrictions on physician-owned hospitals.

The report also recommends broadening providers’ scope of practice, expanding access to telehealth, and funding graduate medical education (GME) through single grant that rewards the training of residents in priority specialties or programs. The recommendations outline the administration’s health policy priorities for the second half of the President’s first term.