D.C. Report: Short-Term Spending Bill Passed, Legislation to Repeal Medicare Board Introduced

Short-Term Spending Bill Passed. Once again, the Congress has approved a stopgap funding bill avoiding a government shutdown, this time until April 8. The continuing resolution (CR) signed by President Obama this morning, cuts $6 billion from the federal budget by reducing or eliminating 25 federal programs, including $276 million in pandemic influenza funding; and $75 million in State Health Access Grants for 13 states for purposes of expanding health coverage to uninsured individuals. Implementation funding for the Accountable Care Act and the Incentive Program are included in this CR.

The timeframe for an agreement for the remainer of the fiscal year is problematic for many reasons, including the fact that Congress is on recess for one of the three weeks. Further into the fiscal year means there are less so-called “easy cuts.” For example, a cut of $1.74 billion from the U.S. Census Bureau for the 2010 Census is no longer needed; and $48 million from the Commerce Department for an “emergency steel loan” program slated for a troubled time in the industry is also no longer needed.

Longer term efforts to pass funding for the remainder of the fiscal year are also made difficult by differing policy priorities in that Republicans have declared their intent to defund the health reform law and block federal funding for family planning. However, there is some reason to be optimistic in that both Republicans and Democrats agree that a government shutdown would be harmful to both sides. Also, some discussions are underway with staff from the White House, Senate Majority Leader and House Speaker holding a meeting this past Wednesday. Congress is now on recess, returning March 28.

Legislation to Repeal Medicare Board Introduced. The “Medicare Decisions Accountability Act of 2011” ( HR 452) introduced by Rep Phil Roe (R-TN) would repeal provisions of the Accountable Care Act (ACA) that established an Independent Payment Advisory Board (IPAB) to develop proposals to reduce the per capita rate of growth in Medicare spending and submit these to the President and Congress for consideration. Similar to the Base Realignment and Closures procedures, the IPAB recommendations would become final unless the Congress acted to nullify the entire package of recommendations. When this controversial provision was considered during the healthcare debate, concerns were expressed over Congress abrogating its responsibility and placing this authority in the hands of an unelected group of individuals. No hearings are planned, although the IPAB is a likely target in efforts to defund implementation of the ACA.

Health Affairs on the Effects of Health IT. A newly published study in the Journal Health Affairs by researchers at ONC provides a comprehensive and up-to-date review of studies showing the effects of health IT on key aspects of health care. The purpose of this new study was: (1) to provide an updated review of the evidence, especially as adoption has accelerated in recent years; and (2) to determine if benefits are accruing to providers outside of large integrated delivery systems. Among findings, authors identified 154 peer-reviewed studies from July 2007 to February 2010 on the effects of health IT on key measures of care delivery and provider and patient satisfaction. The authors also found more than 92 percent of the studies reached positive overall conclusions on the effects of health IT. Sixty-two percent of the articles had positive conclusions, and 30 percent had mixed but predominantly positive overall findings.