Congress adjourned for the August recess on the heels of a failed Senate effort to repeal the Affordable Care Act (ACA). Damaging the overall repeal effort were continuous reports from the Congressional Budget Office indicating that each proposal put forward would result in an almost immediate loss of health coverage for millions of Americans. Groups like the American Medical Association had opposed various proposals due in part to their emphasis on incentivizing non-utilization of healthcare services while patient organizations decried pricing individuals with pre-existing conditions out of the market. With no clear path forward on a single-party repeal and replace package, bipartisan working groups have formed to craft proposals to fix the ACA and stabilize the insurance markets.
While healthcare reform dominated the headlines, Congress worked quietly and diligently to advance the FY 2018 appropriations bills. To date, the House has marked up all twelve annual appropriations bills, including the Labor-HHS-Education (LHHS) bill, and even passed a “minibus” package of four spending bills (Defense, Energy, Legislative, and Veterans). The House LHHS bill provides a $1.1 billion increase for the National Institutes of Health, a $10 million increase for the CTSA program (and a significant increase for IDeA), and language blocking the administration from adjusting indirect costs.
The Senate has not moved as swiftly as the House on appropriations, but the chamber is working off of higher allocations which should make the annual spending bills more generous. When Congress reconvenes in September, the Senate will still need to mark up six bills, including the LHHS bill. With FY 2018 beginning on October 1st, Congress regularly misses this deadline and opts to pass a short-term Continuing Appropriations Resolution before finalizing the appropriations bills later in the year. This year will be more complicated though with imminent action also needed on a possible budget deal and raising the debt ceiling.