This week in Washington: The budget reconciliation saga continues.


Build Back Better Activity

On Oct. 27, House Speaker Nancy Pelosi (D-CA) wrote a “Dear Colleague” letter stating that the House was close to agreement on the priorities and budget of the Build Back Better Act.

The letter can be found here.

On Oct. 28, President Biden announced the updated Build Back Better framework. The framework includes $1.85 trillion in spending, a considerable decrease from the earlier $3.5 trillion proposed.

Healthcare measures in the framework include $150 billion for home- and community-based services, a decrease from the $400 billion originally support by President Biden. The bill includes an expansion of Affordable Care Act (ACA) tax credits through 2025. In addition, the bill would expand tax credits for people in Medicaid non-expansion states through 2025.

Healthcare provisions notably missing from the new framework include a $500 billion federal paid family and medical leave benefit. In addition, the proposed expansion of Medicare to cover vision, dental and hearing services has been limited to just hearing. The expanded child tax credit would be extended until 2023 and not made permanent. The outline also leaves out a proposal to lower prescription drugs by allowing Medicare to negotiate directly with pharmaceutical companies.

The Build Back Better framework can be found here.

The House Rules Committee met on Oct. 29 to determine the rules by which the Build Back Better Act would be debated on the House floor.

The bill text can be found here.


Senators Request Update on CMS Efforts to Streamline Prior Authorization Processes

On Oct. 28, a group of 29 senators led by Sens. Sherrod Brown (D-OH) and John Thune (R-SD) wrote to the Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure requesting an update on CMS efforts to streamline prior authorization protocols across programs, including Medicare Advantage (MA) plans. The letter cites the Improving Seniors’ Timely Access to Care Act as a balanced approach to prior authorization in the MA program that could be adopted by CMS.

The letter can be found here.

Read more on healthcare policy in McGuireWoods Consulting’s Washington Healthcare Update.