Yesterday, House Majority Leader Eric Cantor released the 2014 House of Representatives calendar. The House of Representatives is scheduled to be in session 113 days next year. The rest of the calendar is devoted to district work periods where lawmakers are back home working with constituents. The number of calendar days in Washington, DC is on par with those of recent years. In what is typical for an election year, the House will look to finish up its work around October 2, 2014 and then be back home until after the election. Start scheduling those Hill days, fly-ins, and 2014 vacations…but the calendar, of course, is always subject to change.
The Word: Boehner Rule
Definition: The “Boehner Rule” is not a formal rule of the House of Representatives, but rather a procedural technique used by the Speaker of the House to bring legislation to the floor for a vote.
History: The “Hastert Rule,” named for former Speaker of the House Dennis Hastert, is a procedural technique that Republicans have used to bring legislation to floor only if it has the support of the majority of House Republicans. The current Speaker of the House, John Boehner, has at times abandoned the Hastert Rule in order to pass legislation that a majority of his Republican caucus would not support. On at least three occasions (2012 fiscal cliff vote, Hurricane Sandy Relief bill, and the Violence Against Women Act), Speaker Boehner has used a new procedural technique that has been dubbed the “Boehner Rule” which basically allows the Senate to pass their bill first. Once the bill is passed by the Senate, Speaker Boehner calls the bill up for a vote in the House. Usually this technique can muster up the needed votes by both House Democrats and Republicans to pass the measure.
Used in a Sentence: “Mainly, what they seem to want is solved by the `Boehner Rule’ that involves having the Senate act first on most things.” From “Hastert Rule/Boehner Rule,” by Jonathan Bernstein, Washington Post, April 11, 2013.
Why It’s Relevant: With the continued fraction within the House Republican Caucus Speaker Boehner may have to use the “Boehner Rule” to pass a clean continuing resolution (CR) to end the government shutdown and/or to raise the debt ceiling set to expire on October 17th.
**The Boehner Rule may also refer to Speaker Boehner’s insistence of “at least one dollar in spending cuts for every dollar of debt increase”: “As Boehner put it, from now on `any increase debt limit has to be accompanied by spending reductions that meet or exceed it.’ It became known as the Boehner Rule.” From “Why did the GOP surrender the spending fight?” by Marc A. Thiessen, Washington Post, October 7, 2013.
Term: Hastert Rule
Definition: An informal governing principle used by Republican Speakers of the House of Representatives since the 1990s to only allow bills to come up for a vote on the House floor that have support from the “the majority of the majority” of Members of Congress. In practice, if Speaker Boehner follows the Hastert Rule it would mean that he would not bring legislation for a vote unless it would have the support of the majority of the current House majority party, the Republicans.
Used In a Sentence: “That’s what the Hastert rule is really about, Feehery, now a lobbyist and consultant, told me recently — political survival. It’s just common sense: The speaker is elected by a majority vote of his caucus; if he does things a majority of his caucus doesn’t like, they can vote him out.” From “Even the Aide Who Coined the Hastert Rule Says the Hastert Rule Isn’t Working,” by Molly Ball, The Atlantic, July 21, 2013
History: According to John Feehery, the staffer who coined the phrase, former Speaker Dennis Hastert is often credited with inventing the rule but Newt Gingrich, who preceded him as Speaker, followed it as well.
Why It’s Relevant: Following the Hastert Rule makes it is very difficult to have legislative successes if the majority caucus is divided. Speaker Boehner has invoked the Hastert Rule during the recent fiscal debates leading up to the current government shutdown. Some suggest that the House of Representatives could pass clean (no added legislative language or provisions) legislation to reopen the government or raise the debt ceiling because most of the Democrats and 20 or so of the Republicans would vote for it, giving it enough votes to pass. However, bringing that legislation up would violate the Hastert Rule since at this point it would not have the support of the majority of the Republicans (the majority party).
Earlier this week the House appeared poised to move swiftly to consideration and passage of H.J. Res. 59, the FY 2014 continuing resolution (or C.R.), which would keep the functions of the government operating between the upcoming start of the new federal fiscal year (October 1st) through December 15, 2013. Unlike traditional appropriations measures, which can be hundreds of pages long, this draft stop-gap measure clocks in on the Government Printing Office (GPO) website at a mere 16 pages.
Generally the C.R. maintains virtually everything “at a rate for operations as provided in the applicable appropriations Acts for fiscal year 2013.” In plain English, this means that Congress basically is keeping the lights on for the federal government at the same funding levels as the previous year. However, the bill does contain a number of “anomalies,” which are a means through which Congress can adjust funding levels for specific programs in a C.R. to be higher or lower than the previous year’s funding level. For example, the bill includes two specific line-item appropriations additional funding for both the Department of Interior’s Wildland Fire Management program and the Department of Agriculture’s Forest Service Wildland Fire Management “for urgent wildland fire suppression activities” to help address fires in the west, including Yosemite.
House Republican leaders introduced the funding measure on Tuesday, with plans to bring the measure to the House floor today for a vote. To address requests from a bloc of their members, the House GOP leadership had planned to link the stopgap funding measure to language that would defund implementation of the Affordable Care Act (a.k.a. ACA, health care reform or ObamaCare) in the coming year. The original plan was to have two sequential votes – one on the funding measure itself and a second on a separate resolution eliminating the funding for the ACA; following House passage, both measures would be sent to the Senate for consideration. However, a number of House Republicans have expressed significant concern that such a strategy would allow the Senate to ignore the ACA-related measure, given the chamber is in Democratic control. Given growing concern and opposition within the House Republican ranks, the leadership decided to delay today’s votes and take more time to build support for the legislative and procedural approach. As such, earlier today, House Majority Whip Eric Cantor announced to his members that the previously scheduled recess period for the week of September 23 could turn into a Washington work week as a C.R. must be passed by both chambers and sent to the President for enactment on or before September 30, otherwise the government will shut down. To follow the House legislative activity and calendar, visit: http://www.house.gov/legislative/.
This week Congress returns to Washington, DC following their August recess and are jumping right back into legislative matters. Listed below are a few health-related hearings scheduled for this week.
Each Monday Capitol Health Record will be providing health-related highlights for the coming week.
Tuesday, September 10, 2013
“PPACA Pulse Check: Part Two”
House Energy and Commerce Subcommittee on Health Hearing
2322 Rayburn House Office Building
Wednesday, September 11, 2013
“The Threat to Americans’ Personal Information: A Look into the Security and Reliability of the Health Exchange Data Hub”
House Homeland Security Subcommittee on Cybersecurity, Infrastructure Protection, and Security Technologies Hearing
311 Cannon House Office Building
Thursday, September 12, 2013
“Dental Crisis in America: The Need to Address Cost”
Senate Health, Education, Labor, and Pensions Subcommittee on Primary Health and Aging Hearing
430 Dirksen Senate Office Building
Thursday, September 12, 2013 and Friday, September 13, 2013
In addition to the above Congressional hearings, the Medicare Payment Advisory Commission (MedPAC) will be meeting in Washington, DC on Thursday and Friday to discuss recommendations regarding Medicare payment policies. MedPAC will meet at the Ronald Reagan Building and International Trade Center (1300 Pennsylvania Avenue, NW) from 9:30 a.m. to 5:15 p.m. on Thursday and 9:00 a.m. to 12:00 p.m. on Friday (agenda).
On Thursday, July 18, 2013, the House Energy and Commerce Committee released an updated draft of their “legislative framework” to repeal and replace the sustainable growth formula (SGR). More information from the Committee is available here and the latest draft of the legislative framework is available here. Background information on the SGR is available here and information on the previous iterations of the legislative framework is available here.
The Congressional Budget Office (CBO) estimates that a ten year freeze to physician payments would cost $139.1 billion. More information on the CBO score is available here.
Unless Congress acts by the end of the year, physicians who treat Medicare beneficiaries will face an estimated 24.4 percent reduction in their reimbursement. The exact amount of the reduction will be announced when the Centers for Medicare & Medicaid Services (CMS) releases the Medicare Physician Fee Schedule final rule, which is expected in November 2013. More information on the proposed rule is available here.
As with similar proposals, the latest draft of the legislative framework would repeal the SGR and replace it with a stable 0.5 percent payment update during the period 2014-2018. At the end of this period, Medicare would implement an enhanced Physician Quality Reporting System (PQRS) system, under which provider reimbursement would be linked to the quality of the care they provide.
Alternatively, providers can choose to participate in an alternative payment model (e.g., patient-centered medical home, bundled episodes of care, etc.). These new alternative payment models will encourage high value and high quality health care.
The latest draft legislative framework is authored by Rep. Mike Burgess (R-TX), Energy and Commerce Health Subcommittee Chairman Joseph Pitts (R-PA), Energy and Commerce Health Subcommittee Ranking Member Frank Pallone (D-NJ), Energy and Commerce Committee Chairman Fred Upton (R-MI), Energy and Commerce Ranking Member Henry Waxman (D-CA), and Rep. John Dingell (D-MI). The revised framework does not include any pay-fors.
The Committee plans to markup the legislation on Monday, July 22nd and Tuesday, July 23rd. A link to the background memo prepared by the Committee can be found here.