Other contentious issues that will arise at Thursday's full committee vote include votes related to the administration's July 2 delay in the requirement that large employers provide qualifying health insurance to their employees or face tax penalties. Sen. Jerry Moran (R-Kan.) plans to offer amendments to delay for a year both the employer mandate and the requirement that individuals obtain qualifying coverage.
The individual mandate enforcement funding for the IRS was cut Wednesday from the House Financial Services appropriations bill. That makes it likely House and Senate conferees will wrestle with that issue when they try to reconcile their must-pass spending bills.
The two chambers also are likely to battle over the HHS' overall funding levels, since the Senate bill ignored the fiscal impacts of the Budget Control Act, which required nearly $1 trillion in 9-year cuts from across the federal government. The law's so-called sequester required 2% cuts to Medicare providers and up to 8% in cuts each year in the budgets of most federal departments.
The Senate panel's HHS “funding levels will be achieved only if Congress and the administration can agree on a balanced plan that eliminates the damaging spending caps imposed by sequestration, and if Congress works in a bipartisan manner to approve the Labor-HHS bill through regular order as quickly as possible,” Dr. Darrell Kirch, president and CEO of the Association of American Medical Colleges, said in in a written statement.
Hospitals were pleased that the Senate measure restored $179 million in children's hospital graduate medical education funding that was cut under Obama's budget. Without the funding that is used to train about half of the nation's pediatricians each year, children's hospitals would likely have to cut some of those training slots, said Jim Kaufman, vice president for public policy at the Children's Hospital Association.
Other funding watched by hospitals included the money provided for the National Institutes of Health. The Senate bill would provide $30.9 billion to NIH, or $147 million less than the administration requested.
Both the NIH and children's hospital GME funding have broad bipartisan support.
The Senate committee matched the $1 billion administration request for the Prevention and Public Health Fund authorized by the Patient Protection and Affordable Care Act. In addition, the subcommittee added $79 million for a preventive health block grant, which the administration did not request. Harkin is a strong advocate for public and preventive health efforts.
Harkin has battled the White House over previous cuts in prevention funding, including briefly blocking the confirmation of Marilyn Tavenner as CMS administrator earlier this year as a way to underscore his concerns.
Among the major initiatives in the bill is doubling the funding for Medicare and Medicaid anti-fraud enforcement sought by the administration, to $640 million.
“We know that every dollar we spend on combating fraud and abuse in Medicare and Medicaid generates $7.90 in savings,” Harkin said. “At that rate, this bill will return about $5 billion to the U.S. Treasury.”