In my last Fontenotes, I promised to provide a head’s up on what to be looking for this year from the Courts, Congress, and the Executive Branch.
Health Care in the Federal Court System: 2020 was a long read- and my next edition reviewing anticipated actions by the Executive Branch will be a challenge as well.
But right now, I want to talk about the outlook for Congress in 2020– which promises to be the shortest Fontenotes ever.
Congress isn’t likely to do anything.
Same Players, New Year
Every two years we have a new Congress, right now we are in the 116th.
With very few exceptions (such as Representative Jeff Van Drew’s [NJ] switch from the Democratic to the Republican party), the Senate chamber and House of Representatives from 2019 continue unchanged throughout 2020.
How productive has this cast of characters been to date?
LegiScan (“the nation’s first impartial real-time legislative tracking service designed for both public citizens and government affairs professionals across all sectors”) is the first source I consulted to answer this question.
Their tracking shows that in 2019 there were a total of 50 laws passed on Capitol Hill. Included in that number:
- 18 laws to rename Post Offices, Bridges, a Telescope, a Wildlife Preserve, and designate some memorial coins;
- 7 laws regarding national sites, a Dam and a river on Indian Territory, libraries, and other site-specific Federal programs;
- 3 Appropriation Bills
- 6 laws on terrorism and law enforcement issues;
- 2 laws on narcotics and 1 providing support for Suicide Prevention Coordinators.
Of the remaining dozen, Robocall control, data standards for federal grants, munitions for Hong Kong Police forces, and days on which flying the POW/MIA flag is mandatory all garnered Congressional action. [source: Legiscan]
Congress gives itself a different score- claiming a whopping 114 laws to date for the 116th.
GovTrack.gov “tracks the United States Congress and helps Americans participate in their national legislature.” I am not sure why there is a discrepancy in the numbers- but even if we accept Congress’s self-claimed count, the activity of the 116th is abysmal.
If our current Congress’ score is 114, that is far below the next lowest: 284. That was the total number of laws passed by the 112th Congress (Jan 2011 to Jan 2013). Given there are still 10.5 months remaining for the 116th, it may yet beat the 112th in numbers; a marginal victory when only one Congress passed fewer than 610 laws between 1973 and 1992 (the 97th between Jan. 1981 and Jan. 1983 with a total of 529). [Source: GovTrack by the US Congress]
No matter how you measure it- the 116th is far less active than any other Congress since 1973.
Entering a New Year
There were two health care issues that everyone agreed needed attention when the 116th began more than a year ago: curtailing prescription drug costs and protecting people from surprise medical bills.
Prescription Drug Costs:
The House passed a “sweeping” bill on drug prices in December, which would allow the government to negotiate the price of up to 250 commonly prescribed drugs. The vote followed party lines (230-192), with 2 Republicans crossing over to vote in favor. That Bill is currently sitting on Mitch McConnell’s desk but is a “non-starter” with the GOP and unlikely to ever see Senate consideration.
The Senate has its own Drug Pricing Bill- the Prescription Drug Pricing Reduction Act of 2019. Included in its multiple provisions are a cap on Medicare beneficiaries out-of-pocket drug costs ($3,100/year) and controls on price increases tied to the rate of inflation. That Bill advanced out of the Finance Committee in September and remains on the Senate calendar. Assuming it passes through the Senate, it is dead-on-arrival in the House.
Lowering drug prices is “a main voter priority,” but “Neither the prescription drug bill from House Democrats nor the bipartisan proposal in the Senate Finance Committee has a path forward in a divided Congress.” [quote]
As noted in Bloomberg, perhaps those two bills could be the beginning of negotiations this Spring, but that is a highly optimistic vision.
Surprise Billing Legislation
In a November poll, 44% of respondents had received (or their family) a surprise medical bill from an out-of-network health care provider. Most of these bills arise for care provided at an in-network hospital- in the emergency room, in the operating suite, even on the patient care units.
As demonstrated by this graphic from Modern Healthcare, the problem is growing exponentially:
(For more on why surprise bills occur, and why the problem demands Congressional action, see Fontenotes #77.)
In December, three committees- Health Education, Labor & Pensions in the Senate, and both Energy & Commerce and Ways & Means announced they were working on bipartisan legislation on Surprise Bills. Within weeks the attempt to reach a compromise between the Senate and House faltered.
To further complicate the matter, this week dissension broke out between Democrats in the House over how to address Surprise Medical Bills. As I write this, legislation on this issue appears to be dead.
According to Kaiser polling, protecting the public from surprise medical billing is a top priority for American voters, and still Congress can’t get it done.
What to Expect in 2020
This is the reality of the 116th Congress. Deeply entrenched on either side of a partisan divide, they can’t agree on anything, even issues that are top concerns for the American public.
Would it be wise to predict a flurry of Congressional legislating in 2020 by this crew? If they couldn’t get laws over the finish line in 2019- should we expect better during the inevitable paralysis of any election year? I think not.
Want to Know More?
- Although we all understand the legislative process at its basic level- it is helpful to be reminded of how a bill proceeds through both chambers of Congress and becomes a law. This process was famously captured by Schoolhouse Rock in “I’m Just a Bill.” Enjoy! As you do, think fondly of “Bill’s” voice, Jack Sheldon, who died in January.)
- Want to do more? It may feel like a single voter such as yourself has no power in this frustrating standoff- but I believe it is that perception that creates the reality. Find the name of your Representative in the House here and your Senators here. Write, call, email, or visit them in their home office. Let them know what legislation (and outcome) is important to you. Remind them they work for you!