With the new Congress and Administration in place, ASCO has been on Capitol Hill monitoring the issues that affect the cancer care community, and educating lawmakers on how best to serve Americans with cancer. In particular, ASCO is closely tracking efforts to repeal and replace the Affordable Care Act (ACA), the discussion on the future of Medicaid, and relevant cabinet appointments.
Repealing and Replacing the Affordable Care Act
House Budget, Ways and Means, and Energy and Commerce committee hearings have begun discussions on repealing and replacing the ACA, but Congress has yet to coalesce around a plan. A few of the proposals under consideration include Sen. Rand Paul’s (R-KY) plan that would repeal and replace the ACA in one day, and House Energy and Commerce Chairman, Rep. Greg Walden’s (R-OR) bill which would ensure that individuals with pre-existing conditions have access to affordable health insurance. Sens. Susan Collins (R-MA) and Bill Cassidy (R-LA) also introduced legislation that would give states the discretion to implement a partial ACA replacement, and Speaker Paul Ryan (R-WI) and Rep. Tom Price (R-GA) previously introduced broad ACA replacement proposals in the House.
President Trump also signed an executive order giving federal agencies discretion not to enforce ACA’s individual mandate, which could complicate repeal efforts. If the U.S. Department of Health and Human Services (HHS) issues formal guidance on implementing the order, the Congressional Budget Office will have to factor that into their scoring of replacement legislation, which could undermine Congress’ ability to offset the cost of replacement legislation.
On Feb. 1, the House Energy and Commerce Committee held a hearing to discuss the future of the Medicaid expansion program implemented under the ACA, and three bills that would increase scrutiny of Medicaid beneficiaries. While House Republicans have yet to agree on the future of Medicaid, many have expressed support for a repeal of Medicaid expansion, stronger enforcement of anti-fraud measures, and converting Medicaid into a block-grant, per-capita caps system. However, several state Governors have expressed concerns that turning Medicaid into a block-grant program would shift the cost of Medicaid onto the states.
HHS Nominee Moves Closer to Confirmation; Collins to Remain Head of NIH
As President Trump’s cabinet takes shape, Rep. Tom Price (R-GA), the HHS Secretary nominee, may receive full Senate consideration as early as this week. Additionally, Francis Collins, MD, PhD, will temporarily stay on as the Director of the National Institutes of Health. Appointed by the Obama Administration in 2009, Dr. Collins has been largely popular among both Democrats and Republicans in Congress, but it remains unclear how long Dr. Collins will remain at the post.
ASCO is ready to work with Congress and the Administration so that any healthcare reform proposals meet the needs of patients facing a cancer diagnosis. Stay tuned to ASCO in Action as for the latest cancer policy and healthcare reform news.