Budget deal sets back key healthcare bills

Congress’s two-year budget deal is throwing up hurdles for a pair of healthcare bills, taking away almost $13 billion in offsets that had been proposed to pay for the legislation.

Both bills have already passed the House and are expected to reach the Senate sometime before 2016. One of those — the 21st Century Cures Act — passed with nearly 350 votes as lawmakers rallied behind the push for streamlined drug approvals and a boost in medical research funding.

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The cures bill was slated to use a total of $5.4 billion from sales of U.S. petroleum reserves. But congressional leaders took the idea for their budget deal, generating about $5 billion between 2018 and 2025 by selling about 58 million barrels of oil from the Strategic Petroleum Reserve (SPR).

Policy staffers for the House Energy and Commerce Committee, which spent more than a year carefully drafting the cures bill, are now headed back to the drawing board.     

The measure contains about $7 billion in other offsets, created mostly through payment changes or delays in Medicare and Medicaid. But the strategic petroleum reserve represented a large chunk of savings put together by Energy and Commerce Committee Chairman Fred Upton (R-Mich.) and Rep. Diana DeGette (D-Col.). The offsets were the bill's biggest obstacle and took months to negotiate.

While the House bill would still have to be merged with a still-to-be-written Senate version, staffers are dreading a new fight over how to pay for it.

Still, a GOP spokesman for the committee said some funding could still be used. After subtracting the budget deal's offsets, the 21st Century Cures bill has about $350 million in funding provisions left.

"Based on our conversations with [the Congressional Budget Office], resources would still be available via the SPR,” the spokesman said, though he declined to give a figure. “We are proud of our work passing a fully paid for 21st Century Cures Act. We look forward to the Senate completing its work and finalizing a bill in conference, with pay-fors, that will truly make a difference in the lives of countless Americans."

The biggest offset in the budget deal from the healthcare sector comes from the repeal of an ObamaCare provision known as the employer auto-enrollment requirement. Ending the mandate is projected to save the government a total $7.9 billion, according to the Congressional Budget Office.

Those savings had been included in the House’s recently passed bill to repeal pieces of ObamaCare as part of the budget reconciliation process.

Although President Obama plans to veto that bill, the Restoring Americans' Healthcare Freedom Reconciliation Act, GOP leaders have made it a priority to officially send the legislation to his desk.

That effort could be derailed, however, if the House and Senate aren’t able to meet the strict rules of reconciliation. As part of the process, several committees instructed told to draft one section, and each must cut the deficit by $1 billion. The repeal of ObamaCare’s auto-enrollment had been used by the House Education and the Workforce Committee.

The savings from the auto-enrollment provision had also been eyed for other health bills — including the Senate version of the 21st Century Cures bill.