WHITE HOUSE:

The White House focused this week on the release of their initial blueprint to target online harassment, their push to help with voting rights, and new efforts to create cleaner manufacturing. One item of practical interest for us, before we break down the President’s budget:

• They highlighted the practical real-world impact of several of the Administration’s recent efforts, such as capping monthly insulin payments. It’s a good lesson in how the political activities of government play out in the private sector.

PRESIDENTIAL BUDGET:

The big ticket item was the release of the President’s budget. It’s important to remember that presidential budgets never pass as introduced. They are simply a guide to the Administration’s moral priorities and a baseline recommendation to Congress, who is the ultimate arbiter of the federal budget. Nevertheless, as it’s the official start of the formal federal budget process, here is more about the sections and overall process that are relevant to SNF’s:

• An overview of the key fiscal Congressional deadlines in the coming months.

• A general overview of the entire budget.

• The approach to Medicare and the $150 billion for HCBS. The President also penned an op-ed for the NY Times outlining more specifics for his plan for Medicare.

• Cost-savings through crackdown on excessive payments to MCO’s and other wasteful spending.

• Provisions that will directly impact the middle class and American consumer.

• Efforts to create more affordable housing.

• Finally, a good explainer of the federal budget process and what comes next is available from the Congressional Research Service (CRS Report – PDF).

CONGRESS:

With the President unveiling his budget, Congressional response from the GOP was predictably opposed. Of course, the GOP hasn’t yet offered a formal budget alternative, although the House Freedom Caucus (HFC) released their proposal, which doesn’t have full party support. Although the HFC proposal doesn’t touch Medicare, it represents, for now, posturing in the ongoing battle over the debt limit. While the actual date that the US will hit the debt ceiling remains a moving target (dependent on a whole slew of other factors, such as tax collection), a new report this week predicted the date as mid-August. In short, don’t expect a resolution on the budget till the US is right up against that debt ceiling. Elsewhere on the Congressional front:

• The immigration discussions in DC are not going well.

• The House unanimously approved a bill that would require the federal government to declassify all information related to Covid-19 origins, sending the bill to the President for signature.

• In a break from their oversight agenda, the GOP announced that their first major legislative push will be a new energy bill.

• We’ve mentioned a few times about the elderly folk on the Democratic side. With Senator McConnell hospitalized this week following a fall, the GOP is asking itselfthe same questions.

• On the 2024 outlook, some insight into alternate GOP candidates, whether Ron DeSantis is becoming more appealing to the base, and the national outlook in DeSantis’ state of the state address.

• While polling has taken a bad rap over the last few elections, 538 did a deep dive into just how accurate the 2022 polling actually was. They also released some early 2024 presidential favorability numbers.

• The Congressional health insurance program suffered a significant data breach this week. Practically, this could have an impact on federal healthcare cybersecurity policy.

• Finally, an interesting look at how the Democratic governor of Kentucky is favored to win reelection in a red state.

One interesting CRS report from this week. Although unrelated to SNF’s, several of our readers are involved in some way with marijuana companies. The CRS provided an updated guide on the gap between federal and state policy related to marijuana policy. You can download a copy here (PDF).

AGENCIES:

HHS’ Administration for Strategic Preparedness and Response (ASPR) released a new cybersecurity guide for healthcare providers. The central resource page is here. The full cybersecurity guide to health care providers is accessible here (PDF).

HHS created a central resource page for all healthcare related elements of the President’s budget. The executive summary can be found here. The full “budget-in-brief”, clocking in at a svelte 169 pages, is available here (PDF).

One CMS item from last week: they updated their dashboards that have information related to spending on prescription drugs in federal programs (including Medicare Part B, Medicare Part D, and Medicaid) with the 2021 data.

FROM THE NOTEBOOK:

• A group of the largest insurance companies in the nation are joining together to help with Medicaid unwinding.

• In a good example of how an association can use data to show the effectiveness of long-term care providers, the Florida Health Care Association, in collaboration with Zimmet Health Care Services and our very own z-INTEL, released a public dashboard highlighting the quality of long term care provided in the state.

• Ohio had the first session in the Governor’s new task force on SNF’s.

• Following up on legislation from South Dakota that we referenced two weeks ago, the South Dakota Senate rejected a bill that would have funded SNF’s at 100%. While they recognize the need to fund SNF’s, they objected, ideologically, to legislation that would have forced the state to automatically fund a specific provider in a way that didn’t involve the legislature.

• A look at the fight taking place between NYC unions and their members over a plan by the union to switch their members from traditional Medicare to Medicare Advantage.

• Politico did a deep dive on what happens when different federal policies clash through the prism of the DEA and their battle on opioids. This has repercussions for regulatory arguments like funding vs. enforcement.

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