Policy Corner: October 27, 2023
Categories: Policy Corner Archives
House Republicans Elect New Speaker of the House
On Wednesday, the Republican Conference elected the 56th Speaker of the House of Representatives, Rep. Mike Johnson (R-La.). Rep. Johnson was the party’s fourth nominee for Speaker after Rep. Kevin McCarthy (R-Calif.) was voted out of the Speaker’s office Oct. 4. The House has been unable to conduct business since that time. Rep. Johnson, who is relatively new to Congress, was first elected in 2017 and has not held any leadership positions. In his new job, he faces a potential government shutdown as fiscal year (FY) 2024 appropriation bills need to pass by Nov. 17, when current government funding expires. The House had only passed four of the twelve bills before this week. Rep. Johnson has indicated that a stopgap measure may be needed to extend funding until January or April to avoid a shutdown, although he is wanting to pass individual appropriation bills.
His first order of business was passing a resolution denouncing Hamas and supporting Israel following the attack on Israel on Oct. 7. The President has submitted a supplemental request for military assistance to Israel and Ukraine and for humanitarian aid across Israel, Ukraine, Gaza and elsewhere in the world as necessary, which will need to be considered by both the House and Senate. In his first speech following his election as Speaker, Rep. Johnson called for the creation of a bi-partisan debt commission to address the national debt. This commission could address such social programs as Social Security, Medicare, Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and other critical human needs programs. He has proposed that the House take up the farm bill in December and begin negotiations with the Senate. The farm bill expires every five years and expired Sept. 30. The bill authorizes funding for SNAP, known as food stamps. As Speaker, Rep. Johnson will play a major role in influencing the federal budget which funds education, research, health care, and programs and services that are critical to individuals with disabilities, including brain injury.
House and Senate Move on FY 2024 Appropriation Bills
On Thursday, the House of Representatives passed H.R. 4394, the Energy and Water Development and Related Agencies Appropriations Act, which funds energy and water development and related agencies for the fiscal year ending September 30, 2024. The bill cuts more than $5 billion in spending that was part of previously passed legislation signed by the President last year to address climate change, tax, and health care. House Republicans are planning to pass the last seven full-year funding bills by mid-November. But Republican leadership has not come to an agreement as to the topline number for the party’s overall proposed government spending for fiscal year 2024, although that was set in the debt ceiling bill passed earlier this year.
Meanwhile, Senator Patty Murray (D-Wash.), Chair of the Senate Appropriations Committee, announced a bipartisan agreement to proceed with amendment votes and final passage of the Senate appropriations “minibus” that is comprised of the appropriations bills for Military and Military Construction-Veteran Affairs, Agriculture-Food and Drug Administration (FDA), and Transportation-Housing and Urban Development (HUD). Senators will vote on 40 amendments before final passage of the nearly $280 billion package. The Senate started voting on the measure Sept. 12, but have been negotiating on amendments since.
House Energy and Commerce Committee Holds Hearing on LTSS Rule
On Wednesday, the Health Subcommittee of the House Energy and Commerce Committee, Chaired Cathy McMorris Rodgers (R-Wash.) held a hearing on long-term services and supports (LTSS) for people with disabilities or who are aging relating to the workforce for such services. In her remarks, Rep. Rodgers criticized new regulations from the Biden Administration, including the the “Medicaid Access Rule” which would require home health agencies to pass through a minimum of 80 percent of all reimbursements directly to the direct care workforce. Health Subcommittee Chair, Brett Guthrie (R-Ky.) believes his bill, H.R. 468, the Building America’s Healthcare Workforce Act, is one solution for addressing this staffing problems. The proposed legislation would permit temporary nurse aides to work in eligible Medicaid or Medicare long-term care facilities while they work to become certified nurse assistants.
Ranking Member Frank Pallone, Jr. (D-N.J.), in his opening remarks, said he was pleased that the Biden Administration has taken steps to help address staffing issues in both nursing homes and home and community-based settings to improve the quality-of-care people receive in LTSS facilities. He noted that the proposed rule already includes flexibility for certain facilities by allowing an exception for facilities in areas with workforce shortages if they are, making a good faith effort to hire additional staff, and do not have a history of safety violations. The Administration is also proposing to phase-in the rule’s requirements gradually, with additional time for rural nursing homes.
The Biden Administration has proposed two regulations aimed at addressing the perceived issues facing the LTSS workforce. The first, “Medicaid Program; Ensuring Access to Medicaid Services” (or the Access Rule) (88 FR 27960), which, among other provisions, would require a minimum of 80 percent of all Medicaid reimbursements for home and community-based services (HCBS) care to be directly spent on the compensation of the workforce and would limit no more than 20 percent of reimbursements to be applied to administrative and overhead costs (commonly referred to as the 80/20 Rule). The second, the “Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payments Transparency Reporting” (or the Minimum Staffing Rule) (88 FR 61352) would set minimum staffing standards for the registered nurses (RNs) and nurse aides (NAs) that must be onsite in a nursing home in any given week.
White House Schedules November Public Engagement Calls with Aging and Disability Communities
The White House Office of Public Engagement hosts monthly Aging and Disability Communities calls and the next call scheduled is Thursday, Nov. 2 at 2:00 p.m. (ET). Pre-registration is required. Through outreach, communication, public events, and official announcements from the Administration and the various departments of the Executive Office, the Office of Public Engagement strives to remove obstacles and barriers and creates opportunities to improve public awareness and involvement in the work of the Biden-Harris administration. Register here.