Health Policy Updates

Update #6 June 5, 2017


What’s next in Washington in terms of AHCA developments? (written by a colleague at CPEHN, but it was so helpful I wanted to share it:)

Senate Republican leadership is in conversation with the Parliamentarian regarding the AHCA’s compliance with reconciliation rules. Senators are rumored to be ready to unveil their own partial draft repeal bill this week.

Once Senate Republican leadership has come to agreement on language for their own version of the bill, they will need another Congressional Budget Office (CBO) score before they can vote on the legislation. As a reminder, the Senate version must save at least the $119 billion that the CBO estimated would be saved under the House version.

Once a score is released, Senate leadership can offer their version of the legislation as a substitute for the bill passed in the House and move to take a vote.

When the bill goes to the Senate floor, Senate rules require 20 hours of debate before a vote followed by unlimited amendments (vote-a-rama). Only 51 votes are required to pass budget reconciliation in the Senate.

Since the Senate will not pass the same bill as the House, the legislation will either go to a conference committee or directly back to the House for a final vote. If the bill makes it through these steps, the bill would then be sent to the President for his signature

What is happening at the State level?

Budget discussions have begun in earnest.

Regarding the two different 340 (B) changes that the Governor briefly discussed in the two different versions of his budget, it looks like we will have more time to work out a system to make sure there are no duplicate discounts in the 340 (b) program, but we should be aware that reckoning with this issue is delayed, not eliminated.  We expect to see some additional action by the State on the 340 (b) issue in the next year.   We have been advocating to restore the $100 million in primary care workforce development funds that were put in last year’s budget but pulled by the Governor in his January proposal. So far, the Assembly has proposed to restore the funds, but the Senate has not, meaning that this will be an issue in the conference committee.

What is happening at the local level? (Thanks to Human Services Network for information)

Mayor Edwin Lee announced recently that his proposed City budget for Fiscal Years 2017-19 will include a 2.5% nonprofit cost-of-doing-business increase on general fund contracts for each of the next two budget years. He also announced $6 million in funding to address nonprofit displacement, including supporting permanent real estate and long term leases for San Francisco nonprofits.

 Nonprofits have also advocated for funding to help with minimum wage and paid parental leave expenses enacted as City ordinances and there is some funding available to help cover the costs of minimum wage increases for nonprofit employees working on City contracts. 

Last year, the City passed a new paid parental leave law that requires San Francisco employers to supplement the compensation that the State requires for paid parental leave. . The new Ordinance took effect on January 1 2017 for employers with 50 or more employees. It will apply on July 1, 2017 for employers with 35 or more employees and on January 1, 2018 for employers with at least 20 employees.  During last year's budget process, HSN secured $200,000 to help nonprofits cover the costs of this new mandate, however, it is only recently that there is a process to actually procure this funding. A nonprofit should request funds from its contracting department. such as DPH,  for any eligible expenses incurred since January 2017. The funds will be available only to city-funded nonprofits, for general fund contracts, and only for employees working on the contract. They may be used to cover the additional compensation to that employee.