Brownstein Client Alert, September 22, 2020
Earlier this evening, the House passed the Continuing Appropriations Act, 2021 and Other Extensions Act (H.R.8337) with broad bipartisan support 359-57, extending current federal funding levels through Dec. 11, 2020.
House Democrats previously released a version of the bill on Sept. 22. However, due to the absence of agricultural assistance requested by the White House, it was rejected by Republicans. The White House and Democrats reached an agreement earlier today, shortly before the vote. This version of the bill includes $30 billion in agricultural assistance to replenish the Commodity Credit Corporation (CCC), though Democrats secured a provision that would restrict CCC payments to fossil fuel companies. Democrats were also able to secure $8 billion for COVID-19 food assistance, including a year-long extension of the Pandemic Electronic Benefit Transfer (P-EBT), waivers for the National School Lunch Program, and the Supplemental Nutrition Program for Women, Infants and Children (WIC).
The bill heads now to the Senate and is expected to pass.
Below is a summary of Divisions B and C of the House CR related to surface transportation and health extenders.
The bill includes a yearlong extension of surface transportation programs set to expire on Sept. 30, 2020. In addition to plus-ups for nationally significant freight and highway projects and highway safety research and development, the bill transfers nearly $14 billion to the Highway Trust Fund—$10.4 billion to the Highway Account and $3.2 billion to the Mass Transit Account. Additionally, the Airport and Airway Trust Fund would receive $14 billion as well.
In response to the measure’s introduction, House Transportation and Infrastructure Committee leaders issued a press release applauding the effort. Committee Chair Peter DeFazio (D-OR) said with the “one-year extension in place, we can continue work on a long-term, transformational bill that significantly boosts investment in our surface transportation network and moves our transportation systems into the 21st century.” Additionally, Committee Ranking Member Sam Graves (R-MO) said the “full-year extension of expiring surface transportation programs will provide immediate, desperately needed certainty to state DOTs and transportation and construction industry workers across the country.”
Health Care Extenders
The bill also extends many health care provisions set to expire on Nov. 30, 2020, through Dec. 11. The health care extenders provisions are outlined below.
|DIVISION C – Health Extenders
|Title I – Public Health Extenders and Miscellaneous
||Community Health Centers, National Health Service Corps, and Teaching health centers that operate graduate medical education.
||This provision extends funding for Community Health Centers, the National Health Service Corps and the Teaching Health Centers Graduate Medical Education Program through Dec. 11, 2020.
||This provision extends funding for the Special Diabetes Program and the Special Diabetes Program for Indians through Dec. 11, 2020.
||Personal Responsibility Education
||This provision extends the authorization of the Personal Responsibility Education Program (PREP) through Dec. 11, 2020. It is extended on a pro rata basis at the amount appropriated for fiscal year 2020.
||Sexual Risk Avoidance Education
||This provision extends the authorization of the Sexual Risk Avoidance Education (SRAE) program through Dec. 11, 2020. It is extended on a pro rata basis at the amount appropriated for fiscal year 2020.
||Rare Pediatric Priority Review Voucher Extension
||This provision extends the Rare Pediatric Priority Review Voucher (PRV) program through Dec. 11, 2020.
||Authorization to Accumulate Excess Annual Leave
||This provision extends, to 120 days, the amount of leave that can be accrued by U.S. Public Health Service (USPHS) Commissioned Corps members. This extension lasts until Sept. 30, 2023.
||HHS Services and Supply Fund
||This provision makes a technical change to clarify that the National Institutes of Health (NIH) and Office of the Secretary (OS) Service and Supply Fund can continue to provide other agencies with services.
|Title II – Medicare Extenders
||Extension of the Work Geographic Practice Cost Index Floor under the Medicare Program
||This provision amends the Social Security Act to enable the work geographic practice index floor to remain at 1.0 through Dec. 11, 2020, for all localities that are currently less than 1.0.
||Extension of Funding for Quality Measure Endorsement, Input and Selection
||This provision extends funding for quality measure selection and support for the Department of Health and Human Services’ partnership with a consensus-based entity on quality measurement and performance improvement activities. It is extended through Dec. 11, 2020.
||Extension of Funding Outreach and Assistance for Low-Income Programs
||This provision extends funding for the low-income Medicare activities provided through State Health Insurance Assistance Programs, Area Agencies on Aging, Aging and Disability Resource Centers, and the National Center for Benefits and Outreach and Enrollment. It is extended through Dec. 11, 2020.
|Title III – Medicaid Extenders
||Extension of Money Follows the Person Rebalancing Demonstration
||This provision extends funding of the Money Follows the Person Rebalancing Demonstration program through Dec. 11, 2020.
||Extension of Spousal Impoverishment Protections
||This provision extends protections against the impoverishment of individuals whose spouses receive home- and community-based services (HCBS) through Dec. 11, 2020.
||Delay of DSH Reductions
||This provision delays through Dec. 11, 2020, the implementation of scheduled allotment reductions for Medicaid disproportionate share hospitals.
||Extension of Community Mental Health Services Demonstration Program
||This provision extends through Dec. 11, 2020, the authorization for the certified community behavioral health clinics demonstration.
|Title IV – Part B Premium Adjustment
||2021 Medicare Part B Premium and Deductible
||This provision freezes the Medicare Part B standard monthly premium at the 2020 amount. It imposes a fee equal to 25% of the difference between the 2020 amount and the preliminary monthly actuarial rate for 2021. Beneficiaries will pay a surcharge averaging $3 on the monthly premium until the supplemental Medical Insurance (SMI) Trust Fund is repaid for the Medicare Advance Payment program loans funded from the SMI during the COVID-19 pandemic. This provision also authorizes the transfer of funds from the Treasury Department to the SMI to cover the amount the SMI provided the Medicare Advance Payment program.
|Title V – Improving the Accelerated and Advance Payment Programs
||Modifying Accelerated and Advance Payment Programs Under Parts A and B of the Medicare Program During the COVID-19 Emergency
||For payments made under the Medicare Accelerated and Advance Payment Programs between when the CARES Act was enacted and the end of the COVID-19 public health emergency, this provision: lowers the interest rate, reduces the recoupment percentage and extends the periods before repayment periods begin and before full repayment is required.
|Title VI - Offsets
||Inclusion in the Medicaid Drug Rebate Program of Covered Outpatient Drugs for Medication-Assisted Treatment
||This provision makes a technical correction to clarify that drugs and biologicals used for medication-assisted treatment and covered by Medicaid from Oct. 1, 2020, onward will remain eligible for Medicaid program rebates.
||Medicaid Improvement Fund
||This provision increases funding for the Medicaid Improvement Fund to $3.4 billion.
Click here for a copy of the legislation.