WHITE HOUSE:

The White House focused this week on the growth of small businesses, the 20 million Americans now covered by an Affordable Care Act plan, and a joint response with other countries to the Houthi attacks. One note of indirect interest:

• We often discuss the different Administration efforts related to student loans. This week, they announced a new set of student loan cancellations for those with less than $12,000 in student loan debt remaining. As there are many employees who may be covered by this, they might appreciate hearing about it from you.

CONGRESS:

With the agreement this past week by Congressional Leaders on top-line numbers, a path forward on a spending deal is starting to coalesce. Logistically, a short-term extension is likely to buy time for the many details that still need to be worked out. As to the bigger picture, many of the same folk that were upset at former Speaker McCarthy for negotiating with Democrats are unhappy with the new framework and are actively working against its passage. For now, Speaker Johnson remains firmly behind the agreement despite the conservative challenge. With the “short-term” extension likely to continue through March, it’s going to be a very contentious time for the Speaker as he navigates the tight Republican Majority. Elsewhere in the political world:

• An bipartisan tax deal is coming together that would tackle a wide range of business and other tax breaks. For our purposes, a key element of funding the bill would be ending the ERC program early.

• Speaking of the ERC, IRS Commissioner Danny Werfel briefed Congress on the program and efforts by the IRS to combat fraud.

• The House passed a resolution, that would block the NLRB’s new joint employer rule. The resolution, which utilizes a Congressional tool called the “Congressional Review Act” (PDF), will now go to the Senate for consideration.

• The State of Tennessee became the first to explore protecting artists from copyright infringement by AI. It’s legislation to monitor on the AI front.

• With yet another batch of Congressional retirements popped up as Congress came back from the Holidays, it’s important to note that overall the current number of Congressional retirements are in line with past sessions.

• With primary season around the corner, state GOP parties continue to struggle. Meanwhile, a look at the latest on redistricting and the impact it’s having on Congressional maps.

AGENCIES:

The Department of Labor issued a final rule on independent contractors. The final rule can be found at the Federal Register. The FAQ is here. A small business compliance guide can be found here. Please consult with your legal teams to understand the impact.

HHS issued a final rule on non-discrimination rules and religious conscience. The fact sheet guidance can be found here, while the full text can be found at the Federal Register. The rule is scheduled to go into effect on 3/11/24. The Hill has a summary.

CMS approved an extensive 1115 waiver from New York that would allow the state to use Medicaid to fund a wide variety of social initiatives. The Governor shared details of the waiver here. More in-depth summaries can be found here and here.

Oklahoma became the latest state to have their SNF life safety compliance audited by the OIG at HHS. The report in brief can be found here and the complete report here (both PDF).

The OIG at HHS also did an audit on the CDC’s NHSN Covid data reporting by SNF’s, finding that the process has been improved, but found that the CDC needs to continue to improve their reporting processes to make it easier. The full report can be found here (PDF).

ARPA-H, the federal agency tasked with innovation in healthcare, released their 3-year strategic plan. You can download the plan here (PDF).

MEDICARE ADVANTAGE:

Medpac, a non-partisan committee that advises Congress on Medicare issues, issued a new report on Medicare Advantage, finding that MA costs the government a staggering $88 billion more than traditional Medicare FFS. A link to the slides can be found here (PDF).

Another report, this time from Newsweek, found that more than half of seniors feel stuck in their MA plan.

FROM THE NOTEBOOK:

• An important study from Dr. Grabowski highlighting the need to build immigration pathways to grow the workforce. The study is available at Health Affairs (paid access required). Skilled Nursing News has a summary.

• KFF did a deep dive into SNF’s and understanding the trends from 2015 – 2023. They highlighted the many challenges that exist in building a stronger workforce and identify how to appropriately fund SNF care.

• KFF also released an analysis of the Medicaid Unwinding and underlying trends associated with disenrollment. This may be helpful in betting understanding Medicaid renewals and building better practices in protecting disenrollments.

• An interesting read from Fierce Healthcare on YouTube’s new set of health tools and resources, including, for example, a course on helping folks with no medical background learn CPR.

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