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With a Rescission Package on the Way, Fiscal Uncertainty Persists in Washington

Having approved a two-year budget agreement in February and the bipartisan Consolidated Appropriations Act of 2018 in March, Congressional appropriators would, in most years, move on to crafting the next fiscal year's...more

New 2019 ACA Payment Policies for Individual and Small Group Markets

On April 9, the Department of Health and Human Services (HHS) released the long-anticipated final Notice of Benefits and Payment Parameters (NBPP) for plan year 2019, providing standards for health insurers and the health...more

New ACA Regulation: HHS Proposes Expanded Access to Short-Term Insurance

On February 20, 2018, the Departments of Treasury, Labor, and Health and Human Services (HHS) issued a proposed rule to expand the availability of Short-Term, Limited Duration Insurance (STLDI). Building on President Trump's...more

President's Budget on Health Care: Entitlement Reform, Opioid Funding, and Cuts to Health Programs

Note: All fiscal estimates cited over a ten-year budget window refer to the Fiscal Year 2019-2028 budget window. The President's fiscal year 2019 (FY19) budget proposal for the Department of Health and Human Services (HHS)...more

White House Unveils Long-Awaited Infrastructure Proposal

On Monday, February 12, as part of the President's FY19 budget proposal, the Trump Administration lifted the curtain on a $1.5 trillion infrastructure package that would focus on public private partnerships and increased...more

Trump Administration Releases Fiscal Year 2019 Budget Proposal

On February 12, 2018, the White House released the President's Fiscal Year 2019 (FY19) budget, outlining a $4.4 trillion federal budget proposal that prioritizes substantially higher spending on the military and on border...more

Challenges for the Affordable Care Act Remain in 2018

After repeated attempts to repeal failed in 2017, overarching federal reform of the Affordable Care Act (ACA) appears unlikely in 2018. However, ongoing uncertainty and turmoil in the individual insurance market will ensure...more

Trump Administration Asserts New Vision for Medicaid

In 2018, Congress may revisit proposals to enact either per capita caps or a block grant for Medicaid and offer broader flexibility on Medicaid expansion rules. However, major structural reform to Medicaid remains unlikely...more

Congress Passes Government Funding Measures

On December 21, Congress passed a bill to continue funding the government through January 19, 2018, averting a potential government shutdown ahead of the December 22, 2017, deadline for the previous funding measure. The House...more

Republicans Release Final Tax Bill Agreement

On Friday, December 15, Republican House and Senate negotiators announced they had come to an agreement on a final tax bill that they expect to vote on this week and that may potentially be signed into law by President Trump...more

With December Deadlines Approaching, Congress Considers Another Continuing Resolution

With less than a month remaining before the December 8 deadline for adopting an appropriations deal and the December 15 deadline to lift the debt ceiling, it is increasingly likely that Congress will once again pass a...more

Affordable Care Act Initially Fades from Spotlight; Reemerges in Senate Republicans' Latest Tax Proposal

After dominating the agenda for most of 2017, the Affordable Care Act (ACA) seemed to take a backseat at first as Republicans shifted their focus to enacting tax legislation. The initial momentum behind the bipartisan...more

Alexander, Murray Announce Bipartisan Proposal on Market Stabilization

On October 17, the Senate Health, Education, Labor and Pensions Committee Chair Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) announced they had agreed on a proposal for a narrow, short-term individual market...more

President Trump Issues Far-Reaching Changes to the Affordable Care Act

On October 12, the Trump Administration announced that it would immediately terminate payments for Cost-Sharing Reductions (CSRs), which subsidize health coverage for low-income enrollees in the Affordable Care Act's (ACA)...more

Trump Administration Broadens Employer Exemption from ACA's Contraceptive Coverage Requirements

On October 6, the Trump Administration issued two new interim final rules that significantly expand exemptions for employers to the ACA's requirements to provide free contraceptive coverage. The new regulations, effective...more

Trump Executive Order Expected to Expand Association Health Plans and Short-Term Coverage

President Trump is expected to issue an executive order in the coming days that would direct federal agencies to expand access to association health plans (AHPs), which would be exempt from the ACA's coverage requirements and...more

White House Reaches Deal with Congressional Democrats to Keep Government Open and Suspend Debt Limit Until December

President Trump came to an agreement with congressional Democrats to extend FY17 federal appropriations and suspend the debt limit until December 8. The deal, which took congressional Republicans by surprise, was paired with...more

Graham-Cassidy Falters; Bipartisan Talks Restart on Market Stabilization

Following defections from Senators Rand Paul (R-KY), John McCain (R-AZ), and Susan Collins (R-ME), Senate Republican leaders announced on September 26 that they did not have the votes for the Graham-Cassidy plan – the last...more

Lawmakers Approve a Six-Month Extension of FAA Authorization

On September 28, Congress approved a six-month extension to the Federal Aviation Administration (FAA) authorization, heading off a partial shutdown of the FAA. Expect negotiations over House Transportation and Infrastructure...more

Fate of Last-Minute Affordable Care Act Initiatives Uncertain

This week, the debate over the Affordable Care Act (ACA) gained new momentum in two separate, but connected channels. As the fiscal year (FY) budget reconciliation window enabling expedited passage of an ACA repeal draws to a...more

Next Steps on Tax Reform Expected Later this Fall

Long a priority of House and Senate Republicans and the White House, expect tax reform to take center stage this fall. Originally, the White House was expected to drive the discussion over tax reform and promised to release a...more

Congress and the White House Remain Divided over Fiscal Year 2018 Appropriations

With the October 1 start of fiscal year 2018 coming closer, the White House, Senate and House remain far apart on the 12 regular appropriations bills that collectively fund the federal government. At this time, all parties...more

Debt Ceiling Expected to be Breached at the End of September

According to Treasury Secretary Steve Mnuchin, the U.S. will hit its debt limit at some point in late September. Congress has until then to raise the federal debt ceiling before the Department of the Treasury's so-called...more

Federal Aviation Administration Authorization Set to Expire September 30

At the end of the month, the Federal Aviation Administration (FAA) authorization is set to expire. If not reauthorized, authority to fund the FAA and the nation's airway system will cease. As has been previously reported, in...more

NAFTA Renegotiations Have Begun – Expect Them to Continue Through the Fall

In May, President Trump initiated the renegotiation process for the North American Free Trade Agreement (NAFTA), the landmark 1994 trade agreement between the U.S., Canada and Mexico. Direct talks, which began in August,...more

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