It will be important for children's hospitals to work together to help shape policy in key areas, and the association will be focused on providing the most effective platform to support these efforts.
The election will bring about changes for children's health care in the United States. While uncertainty remains about the transition period, Children's Hospital Association staff members discussed possible actions during the lame duck session, a projection of President-elect Trump's likely health care agenda, changes expected in the 115th Congress, and more.
Lame duck session activity
While national attention focuses on what lies ahead for a new Congress and Trump administration, business is not yet complete for the 114th Congress. Back in session this week, Congress is faced with a number of decisions that will affect health care funding and delivery.
On Dec. 9, the current continuing resolution (CR)—which provides temporary funding for federal discretionary programs and prevents a government shutdown—will expire. Final FY 2017 funding levels for a number of programs related to children's health care, including the Children's Hospitals Graduate Medical Education (CHGME) program and the National Institutes of Health (NIH), could be determined during the lame duck session.
However, it's possible Congress will decide to pass another short-term spending bill that provides funding only into early 2017, leaving final decisions on FY 2017 funding for these and other programs in the hands of the new Congress and new president.
It remains to be seen how active Congress will be during this period in terms of passing other legislation. One bill that children's hospitals will be watching closely is the Advancing Care for Exceptional Kids Act of 2015 (ACE Kids Act).
This bipartisan legislation is designed to provide better coordinated care for children with complex medical conditions enrolled in Medicaid, leading to reduced federal and state spending. A petition asking Congress to pass the ACE Kids Act received over 16,000 signatures and was delivered to the leadership offices on Capitol Hill this week.
President-elect Trump's health care agenda
Given his lack of previous work in politics or health care policy, it's difficult to predict the direction President-elect Trump's health care agenda will take. His health care platform during the campaign focused on many proposals long sought by congressional Republicans, including repealing and replacing the Affordable Care Act (ACA). As president, it's likely Trump will work with the Republican-controlled Congress to pass legislation very early in his term to repeal the ACA, either in part or completely.
As a candidate, Trump also expressed support for converting Medicaid to a block grant program. At this point, it is not clear how he and Congress plan to proceed on Medicaid. Next year, however, it's expected they will attempt to ease the path towards major reforms in a number of areas—including the tax system and entitlement programs like Medicaid—through the use of the reconciliation process. This mechanism allows the party in control of the Senate to pass major budget-related legislation with the consent of a simple majority in the chamber.
Find more information on President-elect Trump's plans on his transition website.
Children's health care in the 115th Congress
Both the House and Senate will remain under Republican control next year, though with slightly smaller margins in each chamber. This week, House Republicans confirmed that Rep. Paul Ryan, R-Wis., will continue as speaker. On the other side of the Capitol, Sen. Mitch McConnell, R-Ky., will again serve as majority leader in the Senate. On the Democratic side, Sen. Chuck Schumer, D-N.Y., will take over as minority leader in the Senate.
However, Democratic leadership elections within the House have been postponed until the end of the month, creating some uncertainty as to whether Nancy Pelosi, D-Calif., will remain minority leader.
In addition to working with the new president on implementing his agenda, the 115th Congress will face a number of decisions in its first year that will affect children's health care. The future of the Children's Health Insurance Program (CHIP) will figure prominently on this list, as it expires on Sept. 30, 2017. Further, Congress must address the debt ceiling limit and ensure funding for FY 2018 and potentially FY 2017, should they be unable to reach a decision during the lame duck session.
Children's Hospital Association actions
Prior to the election, the association shared a white paper with the Trump transition team highlighting the importance of strengthening children's health as a priority across the federal government, and also the need to protect coverage and access to care while ensuring continuing innovation.
Children's hospitals will need to continue to engage with the new administration and the next Congress early in 2017 as discussions accelerate on issues like extending CHIP funding and Medicaid reform. It will be important that children's hospitals work together to help shape policy in these and other key areas, and the association will be focused on providing the most effective platform to support these efforts.
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