Hot Button Blog

Health Care Reform Implementation Update May 16, 2012

Mark Alderman — Wed, 16 May 2012 10:23:00 -0500

Last week, HHS announced the first round of 26 Health Care Innovation Awards, CMS published the names of providers that have demonstrated meaningful use of electronic health records, and New Jersey Governor Chris Christie vetoed a bill to establish a health insurance exchange in his state.

AT THE AGENCIES

CMS published the names of Medicare providers that have demonstrated meaningful use of electronic health records and received incentive payments as of March 2012.

On Tuesday (5/8), HHS announced the first round of 26 Health Care Innovation Awards totaling $122.6 million. The next batch will be announced in early June. The awards support innovative projects throughout the country that are expected to save money, deliver high quality medical care and enhance the health care workforce.

CMS is encouraging states to control Medicaid costs by overhauling dual-eligible programs instead of cutting provider pay.

ON THE HILL

On Thursday (5/10), the Senate Finance Committee convened a group of former Medicare administrators to discuss the sustainable growth rate formula. The group talked about setting the sustainable growth rate close to the physicians’ own practices and moving away from a fee-for-service model.

IN THE STATES

On Thursday (5/10), New Jersey Gov. Chris Christie vetoed a bill from the majority Democratic state legislature that would have set up a health insurance exchange in the state. Gov. Christie said that if the Supreme Court upholds the Affordable Care Act, he would reconsider.

Illinois currently pays more than $800 million each year for retirees' health care, and 90 percent of those retirees pay nothing toward their health-insurance premiums. The Illinois Senate approved a measure that would end this taxpayer-subsidized benefit.

THIS WEEK

On Tuesday (5/15) at 10:00 a.m., in the Capitol Visitors Center Room SVC212-10, The National Coalition on Health Care held a forum on innovative private sector strategies to curb health costs.

On Wednesday (5/16) at 10:00 a.m., the Senate Health, Education, Labor and Pensions Committee will hold a hearing titled "Identifying Opportunities for Health Care Delivery System Reform: Lessons from the Front Line."

To view our compilation of recent health care reform implementation news, click here.

An Apple a Day . . .

Howard Schweitzer — Wed, 09 May 2012 15:53:09 -0500

Great post (http://bit.ly/JgeuB6) on the GigaOM Apple Blog today about Apple's lobbying efforts -- or lack thereof. Like Microsoft, Google, and other heavyweight companies, Apple will have to become more active in Washington. They've simply become too big, and they have an ever increasing target on their backs. But "active" doesn't have to mean blanketing Washington with money. Like all things Apple, the company can craft and execute a carefully considered strategy, leveraging the strength of their brand, to connect with policy makers in DC.

Infrastructure Alert - May 9, 2012

Robert Freeman — Wed, 09 May 2012 15:35:16 -0500

Over the past two weeks developments on the Hill have been mostly behind the scenes as members return to town this week to begin conference meetings on a long term transportation reauthorization bill. An agency report showed that the transportation sector lost 17,000 jobs in April, despite an overall increase in job growth in the United States, and five states received invitations to advance to the next stage of this round of the TIFIA program.

On the Hill

This week Congress returns to Washington after a week of recess to begin conference work on a transportation reauthorization bill. The 47 member conference comprises 14 Senators (eight Democrats and six Republicans) and 33 Representatives (20 Republicans and 13 Democrats). Earlier this year, the Senate passed a two-year, $109 billion bill and the House passed a 90-day extension with provisions that included approval for the Keystone XL pipeline, state regulation of coal-ash and environmental streamlining. While many of these provisions have drawn bipartisan support in the past, Democrats have spoken of their preference to keep any legislation focused solely on transportation funding in order to keep from jeopardizing viability for a long-term bill. House Republicans have made clear that they want any bill to include the House-passed measures. Conference meetings will begin this week as members try to compromise before current funding ends on June 30.

This week the House of Representatives plans to vote on legislation to extend the Export-Import Bank’s authority to help finance export sales for three years and raise its lending limit to $140 billion by 2014. Officials project the bank will reach its $100 billion lending cap by the end of May. Manufacturers, including Boeing, had supported extending the bank’s authority and raising its lending cap.

At the Agencies

Statistics released Friday by the Bureau of Labor Statistics showed the nation's economy added 115,000 jobs in April. However, the job growth did not extend into the transportation sector, reporting a loss of 17,000 jobs in the month of April. Many hope that these new statistics will urge Congress to pass a long-term reauthorization bill before the November elections.

The U.S. Department of Agriculture announced that rural electric cooperative utilities in 10 states will receive $334 million in loan funds from the USDA’s Rural Development Rural Utility Service. The loans will be spent developing smart grid technology and improvements to power infrastructure.

U.S. Transportation Secretary Ray LaHood today announced the release of Federal Railroad Administration (FRA) guidance for railroads and public transit agencies to help keep pedestrians safe near train stations. As required by the Rail Safety Improvement Act of 2008, FRA developed the document, Pedestrian Crossing Safety at or Near Passenger Stations, in consultation with rail safety partners in government, industry and labor.

In the States

New York: On May 4, Governor Andrew Cuomo announced that a second round of $750 million will be available in competitive awards for the state's 10 Regional Economic Development Councils. Last year, New York awarded $785 million in economic development grants to the 10 regional development councils. Additionally, Governor Cuomo announced the members of the NY Works Task Force – a 13-member panel that will oversee the state’s infrastructure projects. The federal government has declined New York’s request to give the state a low-interest loan to help fund the new Tappan Zee Bridge. Earlier this year, the state requested a $2 billion TIFIA loan (Transportation Infrastructure Finance and Innovation Act) to help cover the cost of the $5.2 billion dollar project. TIFIA loans are used for large-scale state infrastructure projects ($50 million or more) and are not to exceed 33 percent of total project costs. Despite this setback, New York officials are optimistic that the project will receive federal assistance in the next round of TIFIA funding.

Oklahoma: On April 25 the Oklahoma Senate passed legislation to create an infrastructure bank to receive and distribute federal funds for state infrastructure projects. The bank is slated to receive funds through the federal TIFIA program and then the bank will approve loans and grants to in-state transportation infrastructure projects.

Missouri: The Missouri Senate has killed a bill that would have permitted tolls along most of Interstate 70 in Missouri. The bill would have allowed a private company to collect tolls in exchange for financing improvements to I-70. However, the bill faced strong opposition from the state’s trucking and gas station industries, along with citizens who were against further increasing the cost of driving. The Missouri Senate instead chose to form a committee to study all of the state’s infrastructure needs over the course of the next year.

California: The widening of the Riverside Freeway was one of five projects across the nation to receive a low-interest TIFIA loan. The Riverside Freeway is one of California’s busiest highways and connects Riverside and Orange counties. The project will add an additional lane in each direction, extend the 91 Express Lanes, and make general improvements to nearby streets. The TIFIA loan will be $444 million and the entire project is slated to cost approximately $1.3 billion.

Upcoming Events

On Wednesday, May 9 at 9 a.m. the Energy and Power of the House Energy and Commerce Committee held a hearing on Environmental and Grid Reliability and Hydropower Development.

On Thursday, May 10 at 9:30 a.m. the Energy and Environment Subcommittee of the House Science, Space and Technology Committee will hold a hearing titled "Supporting American Jobs and the Economy through Expanded Energy Production: Challenges and Opportunities of Unconventional Resources Technology."

Health Care Reform Implementation Update May 8, 2012

Mark Alderman — Tue, 08 May 2012 14:23:17 -0500

Last week, the Obama administration announced that it would likely give Oregon $1.9 billion to get a new Medicaid initiative started and that it would provide $10.4 million to 70 grantees for rural health care and $728 million to more than 400 community health centers. Also last week, Massachusetts House leaders released their first version of legislation to reform the state's health care financing system by setting a target for the rate at which health spending should rise.

IN THE COURTS

On Friday (5/4), a federal appeals court ruled that Texas cannot ban Planned Parenthood from receiving state funds, at least until a lower court has a chance to hear formal arguments. As background, last year Texas legislators passed a law to effectively remove Planned Parenthood and other abortion providers from the Texas Medicaid Women's Health Program, and Planned Parenthood clinics sued the state to maintain funding.

AT THE AGENCIES

On Thursday (5/3), the Obama administration announced that it has tentatively agreed to chip in $1.9 billion over five years to help Oregon get a new health care initiative off the ground. Through the new program, the roughly 600,000 Oregon Medicaid enrollees will gain access to "coordinated care organizations," which are designed to help patients maintain their health and stay on top of treatments for chronic medical conditions.

On Wednesday (5/2), HHS Secretary Sebelius announced that rural health care providers across the country will receive over $10.4 million to provide direct health care services to their communities. Each of 70 grantees will receive approximately $450,000 over a 3-year period.

On Tuesday (5/1), HHS announced plans to provide more than $728 million in funding for more than 400 community health centers nationwide. Through the Patient Protection and Affordable Care Act, this funding will support 398 renovation and construction projects at community health centers.

On Wednesday (5/2), federal authorities charged 107 doctors, nurses and social workers with Medicare fraud as part of a nationwide crackdown on unrelated scams.

IN THE STATES

On Friday (5/4), Massachusetts House leaders released their first version of legislation to reform the state's health care financing system in order to bring health care costs under control. The bill proposes setting a target for the rate at which health spending should rise.

Kentucky Gov. Steve Beshear said that if the Supreme Court upholds the health care law, he plans to issue an executive order establishing a Kentucky health benefit exchange, which would allow individuals and small businesses to shop for health plans online and compare coverage, provider networks and costs.

In Oregon, enough health care providers have signed up for Gov. Kitzhaber's Coordinated Care Organization Medicaid plan that 90 percent of Medicaid recipients will be covered.

IN THIRD PARTIES

According to a new report from the Commonwealth Fund, the United States spends more than 12 other industrialized countries on health care, but does not provide superior care. The report's authors said that the cause of the higher costs is unnecessary and inefficient medical services.

THIS WEEK

On Monday (5/7) at 2:00 p.m. in 210 Cannon, the House Budget Committee was scheduled to mark up pending legislation on an alternative to the budget sequester.

On Wednesday (5/9) at 8:30 a.m. in the Falk Auditorium at 1175 Massachusetts Ave. NW, The Brookings Institution will host an event titled "Bringing Health Care into the 21st Century."

To view our compilation of recent health care reform implementation news, click here.

Health Care Reform Implementation Update May 1, 2012

Mark Alderman — Tue, 01 May 2012 08:49:57 -0500

Last week, the Medicare Board of Trustees released its annual report, the House of Representatives voted to take money from the healthcare overhaul to extend low interest rates for federal student loans, and the House Energy and Commerce Committee approved a proposal package that aims to save the federal government about $114 billion over 10 years by repealing several Affordable Care Act provisions.

AT THE AGENCIES

On Monday (4/23), the Medicare Board of Trustees released its annual report. The report shows that the hospital trust fund, or Medicare Part A, has an insolvency date of 2024. The trustees said that without the Affordable Care Act, the insolvency date would be 2016.

On Tuesday (4/24), CMS released a proposed rule that updates payments to acute-care and long-term-care hospitals for 2013 and includes several provisions that aim to improve quality. The American Hospital Association expressed disappointment that CMS used outdated data and a flawed methodology to implement coding cuts and also said CMS failed to account for the sequester, which is scheduled for January.

According to a final rule issued by CMS on Tuesday (4/24), all providers and suppliers who qualify for a National Provider Identifier (NPI) will be required to include the NPI on any enrollment applications to Medicare and Medicaid. An NPI is a 10-digit number that identifies a health care provider. CMS says that this requirement will save Medicare about $1.6 billion over 10 years. According to CMS, this rule will enable it and the states to link provider claims to the ordering or certifying physician or eligible professional and to check for suspicious ordering activity.

ON THE HILL

On Friday (4/27), the House of Representatives voted mostly along party lines to take money from the health care overhaul to extend low interest rates for federal student loans. The House sent the measure to the Senate, where Democrats are likely to reject it.

On Wednesday (4/25), the House Energy and Commerce Committee approved a proposal package that aims to save the federal government about $114 billion over 10 years by repealing several Patient Protection and Affordable Care Act provisions. Some of the proposals included in the package would repeal the law's Prevention and Public Health Fund, repeal HHS' unlimited direct appropriation to establish state health exchanges, cut funding for the Consumer Operated and Oriented Plan program, which would provide government loans to nonprofit health plans and repeal Medicaid maintenance-of-effort requirements.

On Thursday (4/26), Republicans on the House Energy and Commerce Committee released a report titled "Higher Costs, More Confusion, Less Coverage." The report says that some companies anticipate their health care costs will increase because of higher taxes, fees and administrative burdens under the reform law. House Democrats accused Republicans of creating a "fundamentally misleading" report.

On Monday (4/23), the GAO released a report saying that the Medicare Advantage demo is expensive, poorly run and should be canceled. CMS responded to the GAO report saying that the demo "will lead to faster and larger quality improvements" and that the project has helped the agency to improve its star-rating system so that it places "greater emphasis on clinical outcomes and beneficiary experience measures."

IN THE STATES

Colorado is beginning to expand its Medicaid roles. It is one of the few states that is expanding the program before 2014, when the Affordable Care Act requires it. Beginning in mid-May, Colorado will start offering Medicaid to those at 10 percent of the federal poverty level. It will not, however, be able to enroll everyone who meets this threshold in the program. Those who can become Medicaid beneficiaries will be chosen by a lottery in each county.

IN THIRD PARTIES

One of the first Affordable Care Act provisions to go into effect is the "medical loss ratio" provision, which requires that insurers spend at least 80 percent of every premium dollar on medical costs. U.S. health insurers will pay $1.3 billion in rebates to consumers and employers this year due to this provision. According to a new report from the Kaiser Family Foundation, almost a third of people who bought their own health insurance last year will get rebates averaging $127.

THIS WEEK

On Friday (5/4) at 1:00 p.m. in Brookings' Falk Auditorium, the Brookings Institute's Campaign 2012 project will hold a discussion on health care reform, the fifth in a series of forums to identify and address the 12 most critical issues facing the next president.

On Friday (5/4) at 12:15 p.m. in 902 Hart, the Alliance for Health Reform and the Centene Corporation will sponsor a luncheon briefing to address the question, "Behavioral Health: Can Primary Care Help Meet the Growing Need?"

To view our compilation of recent health care reform implementation news, click here.

Infrastructure Alert - April 25, 2012

Robert Freeman — Wed, 25 Apr 2012 15:25:33 -0500

After the House passed a new short-term transportation funding extension, which included provisions important to House Republican leaders, both chambers have signaled that they will attempt to compromise on a longer term funding bill through conference negotiations. Current federal transportation funding is set to expire at the end of June. The Department of Transportation continues to work within budget constraints to give states and municipalities more flexibility with regards to funding and permitting processes. And individual states are following suit with new and innovative funding models, such as in Virginia where a private venture company will help finance the construction of a new tunnel in exchange for the right to collect toll revenue for a set period of time.

On the Hill

Last week the House of Representatives approved the 10th extension of transportation funding since 2009. The proposed extension would extend funding from its current deadline of June 30 to September 30. Now the short-term legislation moves to the Senate where negotiations will begin in the upcoming weeks. Members of the Senate conference committee will try to reconcile the House’s bill with the Senate’s previously passed two-year transportation reauthorization legislation. Senate and House leaders could name members to their conference committees starting as soon as this week.

One of the more controversial measures in the House’s new funding extension was the approval of the Keystone XL oil pipeline. The White House has already threatened a veto should a bill coming out of the Senate and House conference maintain the pipeline approval provision.

On Wednesday April 18, the House Water Resources and Environment Subcommittee, chaired by Congressman Gibbs (R-Ohio),held a hearing with the Army Corps of Engineers, shippers, and industry officials on the importance of preserving the reliability of the Inland Waterways System. House Republicans said they hope to attract more private investment funding to help pay for much needed maintenance to locks, dams and inland water ways. Industry witnesses gave their support to the WAVE4 Act, introduced by Congressman Whitfield (R-Ky.), which would revise the cost-sharing arrangement between the federal government and the barge industry to provide needed maintenance of waterway infrastructure. However, the bill has been criticized for increasing the federal government’s subsidy of barge shipping transit.

This week, the House will consider four cybersecurity bills. The different pieces of legislation intend to help address urgent security needs, including promoting information sharing and protecting critical infrastructure and communications. According to the Republicans, one of the bills, the Cyber Intelligence Sharing and Protection Act (CISPA) introduced by Mike Rogers (R- Mich.), would establish an information-sharing mechanism between the intelligence community and the private sector to defend against attacks from foreign elements. On a voluntary basis, the private sector would be able to pass information on specific cyberattacks along to federal agencies with a guarantee of liability protection and freedom from proprietary and privacy concerns and agencies would be able to provide key threat information to companies to help them defend themselves. A competing Senate bill, sponsored by Senator Lieberman (I-Conn.), would instead mandate information sharing through government regulation. The Senate bill is supported by President Obama.

At the Agencies

Last week, U.S. Department of Transportation Secretary Ray LaHood announced that the agency will lead the effort to help expedite federal permitting for a 1,000 mile pipeline modernization project by NiSource, Inc. The project will modernize NiSource, Inc.’s Columbia Gas Transmission, LLC gas transmission and storage system by replacing aging infrastructure that serves communities in six states, including the Marcellus shale gas production region, where the majority of the pipeline infrastructure is more than 40 years old and running on inefficient platforms. This project will take place in Kentucky, Maryland, Ohio, Pennsylvania, Virginia and West Virginia.

On April 20, Secretary LaHood announced that rail car manufacturers across the country will have an opportunity to submit bids to produce the first American-made, standardized passenger rail cars. The $551 million request for proposals to manufacture approximately 130 new bilevel passenger rail cars in America comes from a groundbreaking multistate effort to jointly purchase standardized rail equipment to be used on Amtrak’s intercity routes in California, Illinois, Michigan, Indiana, Missouri, and potentially Iowa. The funding is being provided by the Federal Railroad Administration’s High-Speed and Intercity Passenger Rail Program.

Selected transit agencies in 175 budget constrained municipalities may now use certain Federal Transit Administration funds to cover the cost of the gas, diesel, and electric power that keeps buses, light rail, streetcars, and other transit vehicles up and running. The recipients benefiting from this spending flexibility appeared in the April 12 Federal Register. The provision, part of Congress’s fiscal year 2012 appropriations legislation, allows transit operators to use a portion of their allocated funds specifically for this purpose.

In the States

New Jersey: A report released by the Office of Legislative Services concluded that the New Jersey Transportation Trust Fund is locked in an “unsustainable pattern” of borrowing to pay for transportation projects. New Jersey is the second biggest transportation funding borrower in the country, trailing only Texas. This year marks the first time that money from gas, sales, and other taxes earmarked for transportation spending ($895 million) did not cover debt payments. By mid-2012 the New Jersey Transportation Trust Fund is projected to be $13.4 billion dollars in debt.

New York: On April 16, Governor Andrew Cuomo announced an almost $27 million investment for NY Works projects that will allow for flood control and dam repair projects in the Southern Tier. The "New York Works" was a cornerstone of the final 2012-2013 state budget and intends to create jobs through infrastructure development.

New York City has launched a $250 million construction project to boost economic development in New York Harbor. The project will remove existing underwater structures in the Anchorage Channel (which connects Staten Island and Brooklyn) so that the waterway can be dredged and deepened to accommodate increased cargo volumes and larger vessels in the future. The Port of New York and New Jersey is the largest on the East Coast and accounts for 40 percent of the East Coast shipping trade.

Tennessee: Tennessee Gov. Bill Haslam and the Tennessee Department of Transportation (TDOT) released a three-year transportation program featuring approximately $1.5 billion in infrastructure investments. TDOT is unique as it is only one of five state departments of transportation that do not borrow money to fund projects. The three-year program funds improvements to the interstate highway system, including the addition of truck climbing lanes, ramp enhancements and interchange reconstruction projects.

Virginia: On April 16, Governor Robert McDonnell announced that the commonwealth has obtained the necessary funding to go ahead with a public-private partnership bridge project. The Elizabeth River Crossing project includes a third tunnel built under the Elizabeth River between Norfolk and Portsmouth and upgrades to existing tunnels. The P3 is a partnership between the commonwealth and Elizabeth River Crossing, a private venture. Under the terms of the agreement, the Virginia Department of Transportation will maintain ownership of the infrastructure and the private venture will finance and build the facilities, as well as operate and maintain them for a 58-year period in exchange for the right to collect toll revenue from traffic using the tunnel.

Upcoming Events

On Wednesday, April 25 at 12:00 p.m. the Courts, Commercial and Administrative Law Subcommittee of the House Judiciary Committee held a hearing on legislation that would overhaul the federal permitting process, including environmental assessments and environmental impact statements.

The Coast Guard and Maritime Transportation Subcommittee of the House Transportation and Infrastructure Committee will hold a hearing on Thursday, April 26 at 9 a.m. titled "Regulation of the Maritime Industry: Ensuring U.S. Job Growth While Improving Environmental and Worker Safety."

On Thursday April 26 the American Road and Transportation Builders Association will hold its National Transportation Workforce Summit in Washington, D.C.

Health Care Reform Implementation Update April 24, 2012

Mark Alderman — Wed, 25 Apr 2012 14:21:31 -0500

Last week, the House Ways and Means Committee marked up a proposal that calls for those who receive tax subsidy overpayments due to the Affordable Care Act to repay them, and a new study by The Commonwealth Fund shows that 26 percent of American adults were uninsured at some point in 2011.

IN THE COURTS

The Maine Equal Justice Partners and the American Civil Liberties Union of Maine Foundation brought a lawsuit in Maine on behalf of a man who lost his health care benefits while battling cancer and seeks class status for an estimated 500 others who lost coverage due to waiting periods for benefits.

ON THE HILL

On Wednesday (4/18), the House Ways and Means Committee marked up a proposal that could affect how the government implements the Affordable Care Act's health insurance purchase tax subsidy provision. If it is upheld in the Supreme Court, the law would create a new system of refundable income tax credits that people will be able to use to buy health insurance. Congressmen have noted that the mechanics of the law may end up giving some taxpayers bigger health insurance subsidies than they are entitled to receive. The new proposal calls for those who receive overpayments to repay them in full.

On Wednesday (4/18), the Judiciary Committee got close to adopting medical malpractice legislation capping non-economic damages at $250,000. The committee recessed before it took a final vote.

IN THIRD PARTIES

According to the latest Quinnipiac University poll, 49 percent want the court to strike down the Affordable Care Act, while 38 percent do not.

A new study by The Commonwealth Fund shows that 26 percent of American adults were uninsured at some point in 2011. The leading cause of lack of insurance was job loss or job switch. The report goes on to say that the Affordable Care Act will help close these gaps by making it easier for individuals to buy insurance when they do not have access to an employer-based policy.

IN THE STATES

On Friday (4/20), the Arkansas Legislative Council endorsed a plan for the state to use a $7.7 million federal grant to fund planning for the Affordable-Care-Act-required state insurance exchange.

THIS WEEK

On Tuesday (4/24) from 8:30 a.m. to 11:30 a.m., AEI hosted an event titled "The Future of Medicare: A Reality Check." The agenda can be found here http://www.aei.org/events/2012/04/24/the-future-of-medicare-a-reality-check/.

On Tuesday (4/24) at 10:00 a.m. in 215 Dirksen, the Senate Finance Committee held a hearing titled "Anatomy of a Fraud Bust: From Investigation to Conviction," focusing on a recent Justice Department sting operation that resulted in charges against 91 people accused of defrauding Medicare for nearly $300 million in false billings.

On Wednesday (4/25) at 10:00 a.m., the Senate Veterans' Affairs Committee will hold a hearing titled "VA Mental Health Care: Evaluating Access and Assessing Care."

To view our compilation of recent health care reform implementation news, click here.

Infrastructure Alert - April 13, 2012

Howard Schweitzer — Fri, 13 Apr 2012 13:35:54 -0500

Action on the hill is currently quiet as Congress is in the midst of their spring recess. Prior to skipping town, both houses passed a 90-day extension of federal transportation funding. Even though President Obama had hoped House Republicans would back the Senate’s two-year bill, the House wanted more time to work on their own multi-year bill. This extension is the ninth continuance of the last multi-year transportation bill. Elsewhere in Washington, demand for the TIGER Grant program is vastly outpacing supply and limited infrastructure funding has been made available for states that have had assets destroyed in natural disasters. At the state level, Maryland, Texas, and New York are all looking towards public-private partnerships as a way to launch new infrastructure projects in the midst of constrained budgets.

On the Hill

On March 30, President Obama signed a short-term, 90-day transportation funding extension. Passed quickly before the spring recess by both chambers in order to avoid a funding gap, the measure extends current funding levels until June 30. Although the Senate recently passed a bipartisan two-year transportation bill, the House was unable to pass its own funding legislation and refused to take up the Senate bill. This is the ninth continuing resolution of the last multi-year highway legislation that was originally set to expire in 2009.

Representative Ed Whitfield (R-Ky) has introduced legislation that would adopt a plan for fixing the nation’s locks, dams and waterways. The Waterways are Vital for the Economy, Energy, Efficiency, and Environment (WAVE4) Act would revise the cost-sharing arrangement between the federal government and the barge industry and provide needed maintenance of waterway infrastructure such as locks, dams, and levees. The bill comes at a point of contention between the administration and industry, as the president has put forward a plan to raise fees on shippers to pay for necessary maintenance through raising an additional $1 billion over 10 years.

On March 21 Senators Jeff Merkley (D-Ore.) and Richard Lugar (R-Ind.) introduced the Rural Energy Savings Program Act (S. 2216), which would create a new loan program through the Rural Utilities Services, an area of the Agriculture Department that helps to fund electric infrastructure such as power plants and transmission lines. The legislation would expand the government’s ability to provide loans to rural electric cooperatives to assist with performing energy efficient upgrades.

In two different Capitol Hill hearings on March 28, both Democrats and Republicans in the House Energy and Water Development Appropriations Subcommittee and the Senate Energy and Water Appropriations Subcommittee criticized the administration’s 2013 budget proposals for the Army Corps of Engineers and the Bureau of Reclamation. The president’s budget proposes a 5.4 percent reduction in the Army Corps fiscal year 2013 budget. Both subcommittees felt that this level of funding was inadequate to achieve necessary infrastructure and maintenance investment.

At the Agencies

On April 2, U.S. Transportation Secretary Ray LaHood announced nearly $62 million in funding for seven states to help cover the costs of repairing roads and bridges that have been damaged by natural disasters or catastrophic events. The states receiving funds are Alabama, Alaska, Kentucky, Maine, South Carolina, Washington, and Wyoming.

Demand for Transportation Investment Generating Economic Recovery (TIGER) Grants continues to greatly outpace supply, with the Department of Transportation receiving application requests for $10.2 billion in funds. According to a statement from the Department of Transportation last week, requests are more than 20 times the $500 million available for the grant program, which funds projects that promote environmental and economic sustainability.

In collaboration with the Department of Energy and other agency participants, on March 30 the Obama administration issued a Memorandum of Understanding with the governors of Illinois, Michigan, Minnesota, New York, and Pennsylvania to announce an effort to streamline the efficient and responsible development of offshore wind resources in the Great Lakes. The memorandum will enhance collaboration between federal and state agencies to expedite the review of proposed projects.

On March 30, the U.S. Department of Transportation’s Maritime Administration awarded a $34.6 million contract for the design and construction of a new facility near Beaumont, Texas to house eight of the largest government ready reserve fleet cargo ships.

In the States

Maryland: Maryland Governor Martin O’Malley has proposed a bill to make it Maryland policy to seek out private partners to build, operate, and maintain public assets. The House of Delegates has already approved the controversial bill, which includes a committee amendment that would expedite the legal process for the defendants of public-private partnership lawsuits. On April 4, the Senate Budget and Taxation committee questioned members of the O’Malley administration about the amendment’s retroactive effect on a lawsuit filed by Baltimore business owners against a $1.5 billion State Center project.

Texas: The city of Fort Worth is considering entering into a public-private partnership to design, build, and finance a new public safety center that will include facilities for the city’s police and fire departments. Fifteen teams have responded to the request for proposals and Fort Worth will begin the interview process this week. Fort Worth believes that the use of a public-private partnership will result in a shortened delivery time with a fixed date of completion.

New York: Continuing with the public-private partnership theme, New York Governor Andrew Cuomo is seeking legislation that would allow private equity firms to help finance public projects. Such a bill would authorize the state to lease existing infrastructure assets to help pay for the construction, maintenance, and operations of new infrastructure, including the new Tappan Zee Bridge. While the New York State Senate has already passed legislation that would allow public-private partnerships, the State Assembly has yet to vote on their version of the bill.

On April 3, New York announced the infrastructure projects that will be financed by the New York Works program. The New York Works program, which was part of the same legislation that allowed design-build construction projects in New York, will fix and repair 2,000 miles of roads and 110 bridges using a mix of existing state and new federal money. Specific projects include $145 million in bridge work over the Hudson River near Albany, $85 million for the Peace Bridge toll plaza in Buffalo, $81 million for the Newburgh-Beacon Bridge southern span deck replacement in Orange and Dutchess counties, $32 million for replacing the Patterson Bridge in Corning, and $13 million for the Major Deegan Expressway in the Bronx. Cuomo said that the money spent in connection with the New York Works program will be in addition to money spent on core transportation projects.

California: California Governor Jerry Brown announced a $120 million dollar settlement with NRG Energy Inc. that will fund the construction of a statewide network of charging stations for zero-emission vehicles. The settlement announced today resolves 10-year-old claims against a subsidiary of Dynegy Inc., then a co-owner with NRG of the portfolio of power generating plants currently owned by NRG in California, for costs of long-term power contracts signed in March 2001. One hundred million dollars from the settlement will fund the fast-charging stations and the installation of the plug-in units and electrical upgrades, at no cost to taxpayers. The remaining $20 million will be directed to ratepayer relief. The plan is to build at least 200 public fast-charging stations and 10,000 plug-in units. Further, Governor Brown signed an executive order that sets forth targets for electric vehicles. These targets include ensuring that all major cities in California have adequate electric infrastructure by 2015 and putting 1.5 million zero-emission vehicles on California roads by 2025.

Don't Be Fooled By The Front Page

Madeline Lurio — Thu, 29 Mar 2012 14:45:34 -0500

As the government works on a budget for fiscal year 2013, the press has been emphasizing the differences between the various budgets that have been proposed. The President is required to submit a yearly budget to congress and in early February he released his plan for fiscal year 2013. The Senate and House budget committees then release their own budgets, drawing from or purposely deviating from the President’s. Paul Ryan (R-WI) released his own budget last week, which is backed by House Republican leaders. The Ryan budget was touted as being in stark contrast to the President’s budget, spending less on an entitlements and transportation initiatives than the Administration’s proposal. And to further complicate onlookers, just this week House Democrats released their $3.6 trillion budget. Although the Democratic plan has no chance of passing the House, it is an important signal about how their priorities differ from House Republicans. The introduction and press around these different budgets signal disagreement and opposing priorities between the different political parties and chambers- a situation that is pretty much inherent to the 112^th Congress.

Despite the press around how different the various budget proposals may be, the facts remain; every year the government will continue to spend money, there are actually many points of overlap in “competing budgets”, and the budget serves mostly as a blueprint for the various appropriation committees which allocate the actual money. In fact, if you look at side by side comparisons of the various proposals, it is possible to see where they are in agreement and where programs seem to be caught in the political crossfire. More often than not, you can predict what programs are in jeopardy by reading the proposals and engaging with relevant leaders who are involved with the appropriations process. While the budget process may be a highly politicized procedure, programs will continue to be funded and areas of agreement will remain, despite the many media reports suggesting otherwise.

Infrastructure Alert - March 26, 2012

Robert Freeman — Tue, 27 Mar 2012 07:47:28 -0500

As Congress heads towards a two-week break surrounding the Easter holiday, little has been resolved surrounding the major issues facing how the nation will fund major infrastructure and transportation safety programs over the coming years. While the Senate was able to pass a bill to authorize major programs and outline funding priorities for a two-year period, the House has been unable to make any progress and will most likely pass another short term extension before heading home for the break. Set against what seems to be a gridlock in Congress, the administration and broad coalition of U.S. business interest are calling for action on a longer term funding measure that states need to plan. To support these calls, the administration released a new report pointing to the gap between current levels of investment and what is actually need to just maintain our current highway and transit system and states continue to focus on innovative financing for a wide range of infrastructure projects.

On the Hill

On March 14, the Senate passed its two-year, $109 billion, transportation reauthorization bill, Moving Ahead for Progress in the 21st Century Act (MAP-21). The bill passed by a vote of 74 to 22, with 22 Republicans voting to pass the legislation. The reauthorization bill provides transit agencies increased flexibility to spend federal money during times of economic hardship and streamlines the “New Starts” program, which eliminates duplicative steps and allows smaller projects ($100 million or less) to complete an expedited review process.

After both supporting their long-term transportation reauthorization bill, which would have tied transportation funding to revenues gained from expanded oil drilling, and rejecting the Senate passed bill, House Republicans introduced a three-month, short term transportation funding extension. House leaders hope that over the 90-day period they can rally more support for a long-term bill. The short-term bill would continue to fund transportation at current levels and would be the ninth extension since a long-term bill was passed.

Complicating the situation, Senator Majority Leader Reid (D-Nev.) has said he is “not inclined” to support a short term extension. In the event no bill is passed and funding comes to a halt, Democrats estimate that thousands of projects across the country will be put on hold, threatening countless American jobs. They maintain that any funding shutdown for transportation will cause colossal problems in comparison to last year’s partial FAA shutdown.

As the government works through its process for determining a fiscal year 2013 budget, House Budget Committee Chairman Paul Ryan (R-Wis.) introduced his budget plan, which is backed by House Republican leaders. The plan seeks to shrink the deficit to $3.13 trillion over 10 years, undo 2010 health care reform, and modify entitlement programs. Ryan’s legislation was introduced in contrast to President Obama’s budget which was introduced last month. The Republican bill would cap discretionary federal spending at $1.029 trillion, which is $18 billion dollars less than is provided in the president’s budget, and would spend 25 percent less on infrastructure than the president’s plan.

At the Agencies

On March 16, Department of Transportation Secretary Ray LaHood announced the completion of a new report on the status of America’s transportation infrastructure. The report, 2010 Status of the Nation’s Highways, Bridges and Transit: Conditions and Performance, points to a sizeable gap between current spending and projected levels of investment needed to maintain the nation’s highway and transit systems. The report projects that the United States will need $101 billion annually, plus increases for inflation, from all levels of government for the next 20 years to keep the highway system in its current state. It also identifies significant opportunities for investments to improve the current state of highways and bridges that could total up to $170 billion a year.

Last week President Obama, in collaboration with the Department of Energy, announced a new Executive Order on Improving Performance of Federal Permitting and Review of Infrastructure Projects, which will require agencies to make faster permitting and review decisions for vital infrastructure projects while protecting the health and vitality of local communities and the environment.

The Department of Transportation announced $25 million in competitive funding to help communities advance local transit options. The funds are available through the Federal Transit Administration’s Alternatives Analysis grant program. The notice of funding availability can be found here.

On March 20, Secretary LaHood announced $9.98 million in Department of Transportation grants for 15 small shipyards through the country to pay for modernizations that will increase productivity and competitiveness.

In the States

Illinois: The Chicago Infrastructure Trust continues to be lauded as an innovative approach to infrastructure investment. Although private financing is a key component of the Chicago Infrastructure Trust, selected infrastructure projects will remain in public control. Avoiding putting public assets squarely in the hands of private companies may alleviate a traditional public concern of public-private partnerships.

New York: The New York Thruway Authority is in the process of negotiating a deal with unions that will save the state $300 million and help accelerate the construction progress of the new Tappan Zee Bridge. The deal would save the state money by “unifying work rules, implementing a no-strike clause, providing a flexible work week [and] allowing the contractor to control work sequencing and operations.” There are still four consortiums competing to win the $5.2 billion bridge project.

Delaware: A $3.7 million grant was approved to help pay for a runway extension project at Sussex County Airport in Georgetown, Delaware. The grant money comes from the Delaware New Jobs Infrastructure Fund. The Infrastructure Fund was set up in 2011 to help finance transportation improvements such as roads, utilities and airports.

California: Discussions are heating up in California over the state’s controversial high-speed rail plan. At a Senate hearing on March 13, Dan Richard, the head of the California High-Speed Rail Authority, claimed that the project will cost less than the initial estimate of $98 billion. Within the next two weeks, the California High-Speed Rail Authority intends to release a final business plan that will be evaluated by the state Legislature. The Legislature will then vote on whether to spend $2.7 billion to match $3.3 billion in federal funds to start building in the Central Valley in early 2013. Richard has also recently attended several town hall meetings across California to discuss the project’s financing, environmental impact, and potential economic benefits.

Vermont: The Vermont House Transportation Committee has proposed a $639.4 million spending package on roads, bridges and other forms of transportation infrastructure. The budget allocation, which is the largest ever and $103 million more than last year, is primarily due to the increase in federal funding in the wake of damage caused by Tropical Storm Irene.

Upcoming Events

On Tuesday, March 27th at 10:00 a.m. the House Water Resources and Environment Subcommittee will hold a hearing on "A Review of the President's FY2013 Budget Request for the Army Corps of Engineers."

On Wednesday, March 28th at 2:30 p.m., the Energy and Water Development Subcommittee (Chairwoman Feinstein, D-Calif.) of Senate Appropriations Committee will hold a hearing on the fiscal 2013 appropriations for the Army Corps of Engineers.

On Thursday, March 29th at 10:00 a.m., the Transportation, Housing and Urban Development, and Related Agencies Subcommittee of the House Appropriations Committee will hold a hearing on management issues at the Department of Housing and Urban Development and the Department of Transportation.

Sequestration

Madeline Lurio — Mon, 19 Mar 2012 12:15:18 -0500

With the media and American public focused on the presidential race and never-ending drama of the Republican primaries, Congress has been largely shielded from the spotlight these past few weeks. Whether or not the public is paying attention, Congress has countless issues to deal with before and immediately following the election, and we should not expect the next few months and lame duck session to be any quieter than the current presidential primaries. Tax reform, the expiring Bush tax cuts, once again raising the deficit ceiling and passing a comprehensive budget are all issues that need to be dealt with in the upcoming months. Issues that we all know bring contrasting views from all sides.

Perhaps most notably left off of our current national radar has been the impending sequestration brought on by the Budget Control Act of 2011. Unless the Congress works together to change the effects of the Super Committees failure to reach a deal, we will see across the board cuts starting just as a president assumes office in 2013. The deficit reduction sequester was designed to achieve savings of $1.2 trillion through 2021. The majority of the savings come from discretionary programs that are funded by annual appropriations legislation as opposed to mandatory programs, which are also known as direct spending, or entitlement spending. The required savings are to come half from defense programs and half from non-defense programs.

Arguably most important is that for 2013, all programs will be subject to cuts on an individual basis unless they have already been exempted (for example many programs that benefit low-income beneficiaries). While these issues may be currently out of sight, out of mind, we must remember that the cuts are very real and have fast approaching implications for individuals and businesses that depend on and are accustomed to funding from the federal government. The budget discussion will undoubtedly return to the spotlight over the upcoming weeks and months; however, now is the time to be discussing and make heard the probable consequences.

Health Care Reform Implementation Update March 14, 2012

Mark Alderman — Wed, 14 Mar 2012 12:20:35 -0500

In the past week, HHS released the final rule for health insurance exchanges; the White House coordinated events to be held outside the Supreme Court during the March 26-28th arguments; and New York State warned health insurers that they would lose state contracts if women on Medicaid were denied their choice of higher-cost, brand-name contraceptives.

IN THE COURTS

On Wednesday (3/7), White House officials summoned leaders of nonprofit organizations that strongly back the Affordable Care Act to help coordinate plans for a prayer vigil, press conferences and other events outside the Supreme Court during the arguments, which begin in two weeks.

AT THE AGENCIES

On Monday, HHS released the final rule for health insurance exchanges. The long-awaited regulation stresses state and federal flexibility. The regulation lays out state functions: certifying "qualified health plans"; operating a website for comparing plans; running a toll-free hot line for consumer support; providing grants to "Navigators" for consumer assistance; determining eligibility of consumers for enrollment in qualified health plans; and helping with enrollment.

On Friday (3/9), Farzad Mostashari, the national coordinator for health information technology at the U.S. Department of Health and Human Services, said the government is proposing that medical providers have the capability to exchange patient data by 2014.

IN THE STATES

A report released on Monday (3/5) by nine state attorneys general says the Obama administration has broken the law and overstepped constitutional bounds 21 times.

On Tuesday (3/6), in a speech to the Greater Boston Chamber of Commerce, Massachusetts House Speaker Robert DeLeo offered business leaders a preview of state legislation aimed at reining in health care costs. Rep. DeLeo predicted the House proposal would make "aggressive" changes in disclosure requirements for the industry, give consumers and businesses more ability to make informed health care choices, and encourage employers to offer health and fitness incentives for workers.

On Thursday (3/8), Texas Gov. Rick Perry directed state officials to begin looking for money to fund the Medicaid Women’s Health Program in case the Obama administration revokes federal funding amid a fight over clinics affiliated with abortion providers.

According to a new report and accompanying white paper from the National Governors Association, Top IT Actions to Save States Money and Boost Efficiency, states could make better use of information technology to be more efficient and improve services.

On Monday (3/5), New York State warned health insurers that they would lose state contracts if women on Medicaid were denied their choice of higher-cost, brand name contraceptives unless cheaper, generic methods “fail first.”

THIRD PARTIES

A new study published Monday (3/5) in Health Affairs challenges the premise that electronic health records will reduce costs.

To view our compilation of recent health care reform implementation news, click here.

Infrastructure Alert - March 13, 2012

Howard Schweitzer — Tue, 13 Mar 2012 15:46:22 -0500

Washington, D.C., continues to arm wrestle over transportation funding legislation, as the Senate and House work to move competing legislation. Last week saw support for the House bill crumble away, even as leaders tried to work out contentious provisions in their bill. Meanwhile, the Senate has compromised on a series of amendments and says they will finish work on their bipartisan bill by the end of this week. Despite the glacial pace on the Hill, there has been much activity and many funding announcements at the agencies and on the state level. Very noteworthy was Chicago’s announcement that it will create an Infrastructure Trust, which will leverage private investment to retrofit buildings in the city for greater energy efficiency.

On The Hill

This past week the Senate moved closer to passing a bipartisan transportation bill. The bill, combining work from the Senate Banking, Commerce, Finance and Environment and Public Works committees, would reauthorize transportation funding for two years at $109 billion.

After weeks of negotiations Senate Majority Leader Reid (D-Nev.) and Senate Minority Leader McConnell (R-Ky.) agreed to consider 30 amendments, 18 of which actually relate to provisions in the 1500 page bill. At the end of last week, senators had voted on nine of the amendments, passing four and rejecting five. Included in the rejected provisions were proposals to expedite the approval of the Keystone XL pipeline. The Senate resumes voting on the remaining amendments this week with a vote on final passage expected Tuesday.

On the other hand, the past two weeks saw the House of Representatives moving farther, and farther away from passing the House Republican Leaders’ original 5 year, $260 billion transportation reauthorization. In hopes of passing the bill, Rep. Boehner (R-Ohio) had restored dedicated transit funding but kept out many other provisions considered to be controversial, such as new revenues through expansion of domestic drilling and spending levels that many conservatives in his own party considered too high.

After failing to gather support for the original proposed five year legislation, Republican leaders also attempted to work with an 18 month bill, but it quickly became clear that a shorter, extension type bill would not pass the House either. As passage of the Senate bill looks likely, many believe that the House’s only option is to take up the two year Senate bill or draft its own legislation that is very similar.

In other Hill news, last Thursday the House Appropriations Subcommittee on Transportation held a hearing on the Department of Transportation’s Fiscal Year 2013, $74 billion budget request. Secretary Ray LaHood testified on funding needs for surface transportation and aviation. Subcommittee Chairman Rep. Tom Latham (R-Iowa) highlighted what he described as problems with the proposed budget. Latham said the administration's proposal would not be able to pass the House of Representatives.

At The Agencies

U.S. Department of Transportation Secretary LaHood announced that 12 cities and states will share $16.9 million to relocate, replace, and improve segments of railroad track under the Federal Railroad Administration (FRA)’s Rail Line Relocation and Improvement competitive grant program. The FRA received more than $67 million in state and local government requests for these funds, which will be used to enhance safety, livability, and economic development in American communities.

U.S. Department of Agriculture Secretary Tom Vilsack announced that rural electrical cooperative utilities in eight states will receive a share of almost $250 million in funding to install smart grid technologies and make improvements in generation and transmission facilities.

U.S. Department of Transportation Secretary LaHood announced the availability of $500 million in funding for transportation projects in the fourth round of the TIGER (Transportation Investment Generating Economic Recovery) Discretionary Grant program. TIGER grants are awarded to transportation projects that have a significant national or regional impact.

Last month Secretary LaHood also announced that the overwhelming demand for TIFIA (Transportation Infrastructure Finance and Innovation Act) program loans has greatly exceeded the dollars available. The Department of Transportation received 26 TIFIA letters of interest exceeding $13 billion. The high number of applicants for TIFIA credit assistance in response to a Notice of Funding Availability (NOFA) for 2012 follows the trend in recent years of overwhelming demand for the program. Requests in 2010 were more than $12 billion and more than $14 billion in 2011. In light of the increased demand, the president's FY 2013 budget proposes to increase the program's funding level to $500 million which will leverage into approximately $5 billion in TIFIA loans.

In The States

New York: New York Governor Andrew Cuomo has begun holding public hearings on the soon to be constructed new Tappan Zee Bridge. Some of the major issues thus far are mass transit and bus lanes, noise due to construction, and the aesthetics of the new bridge.

Illinois: Chicago Mayor Rahm Emanuel announced the creation of the Chicago Infrastructure Trust, which will leverage private investment for retrofits to help achieve greater energy efficiency. The private financing will be provided by five organizations: Citibank, Citi Infrastructure Investors, Macquarie Infrastructure and Real Assets Inc., J.P. Morgan Asset Management Infrastructure Investment Group and Ullico. The trust’s first project, Retrofit Chicago, will retrofit municipal buildings to reduce energy consumption by 20 percent. The mayor and his administration maintain that the program will create an estimated 2,000 jobs.

Kansas: U.S. Transportation Secretary Ray LaHood announced a $54.6 million loan to Kansas City Southern Railway Company for the purchase of 30 new General Electric locomotives. The loan is from the Federal Railroad Administration’s Railroad Rehabilitation and Improvement Financing (RRIF) Program. This program provides direct loans for eligible borrowers to acquire, improve, or rehabilitate rail and rail-related intermodal equipment and facilities. There is currently up to an aggregate of $35 billion available in the RRIF program for these types of projects.

Massachusetts: Massachusetts Governor Deval Patrick filed a $1.5 billion bond bill authorizing the state’s first infrastructure bank. The bank will leverage private investments to help fund transportation infrastructure. The bill includes $1 billion for statewide road and bridge improvements and $311 million for improvements to rail and transit infrastructure. Although the bill only provides funding for one year, Patrick intends to introduce a five-year bond bill to help finance long term transportation infrastructure projects.

Indiana/Kentucky: Indiana Governor Mitch Daniels and Kentucky Governor Steve Beshear have signed an agreement to finance the construction of the $2.6 billion Ohio River Bridges Project signed an agreement to finance the construction of the $2.6 billion Ohio River Bridges Project. The two states will evenly divide the financing and the construction of the project. Kentucky will use a design-build approach to construct a new Interstate 65 bridge and will finance the project through toll-revenue bonds. Indiana will construct an East End bridge between Utica, Indiana and Prospect, Kentucky and will use a private-sector team for financing, construction, and long-term maintenance.

Events This Week

On Thursday, March 15 at 9:00 a.m. the Senate Appropriations Committee will hold a hearing on the 2013 budget for the Department of Transportation.

On Wednesday, March 21 at 10:00 a.m. the House of Representative’s Transportation, Housing and Urban Development, and Related Agencies Subcommittee of the House Appropriations Committee will hold a hearing on appropriations for fiscal year 2013 for the Department of Transportation and HUD. Shaun Donovan the secretary of Housing and Urban Development will testify.

On Wednesday, March 21 at 10:00 a.m., the House Transportation and Infrastructure Committee Subcommittee on Water Resources and Environment will hold a series of hearings titled "Review of Innovative Financing Approaches for Community Water Infrastructure Projects."

On Thursday, March 22 at 10:00 a.m., the House of Representative’s Transportation, Housing and Urban Development, and Related Agencies Subcommittee of the House Appropriations Committee will hold a hearing on appropriations for fiscal year 2013 for Federal Aviation Administration, Federal Highway Administration, Federal Railroad Administration, and Federal Transit Administration. The heads of each administration will be present to testify.

Health Care Reform Implementation Update March 8, 2012

Mark Alderman — Thu, 08 Mar 2012 15:50:15 -0500

In the past week, HHS reported that the Affordable Care Act has eliminated lifetime limits on coverage for more than 105 million Americans; a U.S. House subpanel approved a measure to repeal the Independent Payment Advisory Board (IPAB); and House Ways and Means Committee Chairman Rep. David Camp (R-Mich.) requested that the Obama administration explain the additional $111 billion it has requested to implement health reform.

IN THE COURTS

There are now only three weeks until the Supreme Court hears Florida v. Department of Health and Human Services.

AT THE AGENCIES

On Monday (3/5), HHS Sec. Sebelius released a report on how the health reform law has eliminated lifetime limits on coverage for more than 105 million Americans. Before ACA, many Americans with serious illnesses, such as cancer, risked hitting the lifetime limit on the dollar amount their insurance companies would cover.

The Centers for Medicare & Medicaid Services (CMS) is preparing to collect health insurance exchange construction progress reports from the states. Comments on the information collection activity will be due 60 days after the official Federal Register publication date.

Dr. Jacques Roy of Texas is charged with engaging in Medicare fraud that cost the system $375 million by recruiting homeless and fake patients to register for care that was not provided.

On Friday (3/2), federal officials announced that next month, New Hampshire will be the first state to receive ACA funds to keep seniors out of institutions and in their home communities.

ON THE HILL

On Wednesday (2/29), a House subpanel approved a measure to repeal the Independent Payment Advisory Board (IPAB). Two Democrats, including the panel's ranking member, joined Republicans in voting to get rid of the IPAB.

House Ways and Means Committee Chairman Dave Camp (R-Mich.) requested that the Obama administration explain why it needs an extra $111 billion to implement part of the health care reform law.

Sen. Roy Blunt (R-Mo.) proposed an add-on to the transportation bill that would require religiously affiliated hospitals and universities to provide birth control without co-pays to employees. HHS Secretary Kathleen Sebelius said this proposal is "dangerous and wrong" and that "...decisions about medical care should be made by a woman and her doctor, not a woman and her boss." On Thursday (3/1), the Senate rejected Sen. Blunt’s measure.

IN THE STATES

On Thursday (3/1), the Washington State Senate voted 27-22 to set new rules for the state's health care exchange.

On Tuesday (2/28), the Wyoming Senate voted to discontinue funding the Healthy Frontiers Medicaid expansion project.

Oregon Governor John Kitzhaber signed legislation that will allow the state to move forward with plans to overhaul its Medicaid Program. The new health law would allow officials to assign certain Medicaid patients to caseworkers who would manage all aspects of their care, with the goal of eliminating redundant tests and procedures and reducing expensive hospital stays.

Idaho House Republicans voted in favor of a panel to scrutinize how the Affordable Care Act is adopted in Idaho. The bill is now headed to the Senate.

On Monday (2/27), legislation was approved in New Jersey to create a state health insurance exchange.

THIRD PARTIES

On Monday (2/27), the American Medical Association (AMA) reiterated its support for Republican-led efforts to repeal the IPAB, created by the Affordable Care Act. The AMA said the IPAB is the wrong way to control health care costs.

Kaiser Health News reports that 63 percent of Americans said they support the Obama administration's requirement that health insurance plans supply free contraceptives as a preventive benefit for women.

A USA Today/Gallup Poll of the top dozen swing states found considerable opposition to the health reform law. The states surveyed were Colorado, Florida, Iowa, Michigan, Ohio, Pennsylvania, Nevada, New Hampshire, New Mexico, North Carolina, Virginia and Wisconsin.

THIS WEEK

On Tuesday (3/6) at 10:00 a.m. in 1100 Longworth, the House Ways and Means Subcommittee on Health held a hearing on the impact of the Independent Payment Advisory Board (IPAB) on medicine.

To view our compilation of recent health care reform implementation news, click here.

This Week in Infrastructure

Robert Freeman — Wed, 29 Feb 2012 08:43:03 -0500

Over the past month, there has been a considerable amount of infrastructure action at both the federal and state level. The House and Senate have advanced competing transportation bills and it appears that a decision regarding the future of both bills will be reached in the upcoming days and weeks. At the federal agencies, the Department of Transpiration has started the fourth round of the TIGER grant program and the Department of the Interior has recently announced the availability of funding for water infrastructure projects. On the state level, the new Tappan Zee Bridge project continues to progress thanks to the help of favorable legislation that allows design-build projects, a scathing audit of the Port Authority of New York & New Jersey criticizes the organization’s leadership and highlights escalating World Trade Center costs, the Governor of Maryland proposed raising the state gas tax to help fund infrastructure projects, and California is launching an innovative program to invest pension funds in global infrastructure assets.

On the Hill

On February 3^rd, the House Transportation and Infrastructure Committee approved the American Energy and Infrastructure Jobs Act. The bill would authorize new domestic drilling for oil and gas to pay for highways, rails and bridges.

The bill includes an amendment that prevents any of the money from being used on California’s proposed high-speed rail system. California is currently in plans to build a high-speed rail system that would extend from Anaheim to San Francisco at a cost of about $98 billion.

Additionally, the bill would divert almost $25 billion in fuel tax revenue from the Mass Transit Account in order to help fund highways. The Mass Transit Account would be removed from the Highway Trust Fund and replaced with a one-time appropriation of $40 billion. If passed, the bill would mark the first time in over 30 years that there would be no guaranteed funding for public transit.

While the House was able to pass the energy and new drilling portion of the legislation before the President’s Day recess, lawmakers must now deal with many issues relating to the larger bill, such as finding a new offset for funding. The previous offset (what was it) has been taken off the table through the payroll tax extension. Right before the break, House leadership delayed a vote on the final $260 billion complete reauthorization bill due to dissention within the Republican Party. Speaker Boehner says he will now consider scaling back the five year reauthorization legislation and will most likely take out the proposal to remove transit funding from the highway trust fund.

Meanwhile, the Senate is in the process of advancing its own transportation bill - the Moving Ahead for Progress in the 21st Century bill (S. 1813). On February 9, the Senate voted 85-11 to allow the bill to proceed to debate. Supported by the Obama Administration, the bill ties together pieces of work from the Senate Environment and Public Works Committee, the Senate Finance Committee, Senate Commerce and the Senate Banking, Housing and Urban Affairs Committee.

The bipartisan legislation was expected to move more easily though the entire chamber than the House bill, but last week a Senate procedural vote to move forward with voting on the entire bill failed. Numerous amendments from Republicans - including those on unrelated topics such as aid to Egypt and contraception - have tied up the bill over the past few weeks. However, bipartisan compromise on pretax benefits and grants for freight infrastructure programs has Senate leaders in both parties optimistic about the passing of the entire bill once all the amendments have been considered.

The Senate bill is financed by $9.6 billion in offsets from closing tax loopholes as well as $36 billion per year from the federal gas tax, the traditional funding source for transportation bills. This differs greatly from the House bill’s method of financing, which involves tying spending to revenue the federal government would gain from expanded domestic oil-and-gas drilling.

In other Congressional infrastructure news, The Senate Finance Committee accepted an amendment to the Internal Revenue Service code to lift the volume cap (the amount of tax-exempt financing available for certain projects) on private activity bonds for water and wastewater projects and permit Indian tribes to issue tax-exempt private activity bonds for water infrastructure. This move is projected to open up $2-5 billion annually in private capital for water infrastructure projects, often in the form of public-private partnerships.

On February 15, President Barack Obama signed the FAA Modernization and Reform Act of 2012 (H.R. 658). The law provides $63.4 billion in FAA funding over four years, including about $11 billion toward modernization the nation’s air traffic control system. The legislation is a long-term funding bill which will provide the FAA with the necessary funding to ensure stability, improve aviation safety, and upgrade critical infrastructure. The newly passed bill is the first long-term FAA reauthorization measure since 2007.

On February 13, President Obama released his Budget for Fiscal Year 2013 this week which proposes spending $476 billion on highway, bridge and mass transit projects through 2018. The transportation spending is funded in part by ending the wars in Iraq and Afghanistan. The President’s six-year transportation proposal would also expand inter-city passenger rail and add new funding for road and bridge repair. Additionally, it would create a National Infrastructure Bank which would offer broad eligibility and unbiased selection for large-scale ($100 million minimum) transportation, water, and energy infrastructure projects.

Republican Senators announced their intent to introduce competing legislation to Senator Joe Lieberman’s (I-CT.) Cybersecurity Act of 2012. The bill would increase government oversight of some private networks like electric grids, water systems, or transportation, which could be at risk of cyber-attacks. The Department of Homeland Security would be responsible for determining which businesses should be considered critical infrastructure.

At the Agencies

U.S. Department of Transportation Secretary Ray LaHood announced the availability of funding for transportation projects in the fourth round of the TIGER (Transportation Investment Generating Economic Recovery) Discretionary Grant program. TIGER grants are awarded to transportation projects that have a significant national or regional impact.

Secretary LaHood also recommended $2.2 billion in funding to begin or advance construction of 29 significant rail and bus rapid transit projects in 15 states. The Administration claims that the projects, included in President Obama’s proposed Fiscal Year 2013 budget, will put thousands of Americans to work building the vital infrastructure the nation needs to improve access to jobs while reducing U.S. dependence on oil and spurring new economic development.

Department of the Interior Secretary Ken Salazar announced $50 million for Western water infrastructure projects, $30 million of which will be directed to rural areas. The money will help maintain aging systems, restore aquatic habitat and meet increasing water demands of the region. Six rural water projects selected by the Bureau of Reclamation will receive funding under the agency's 2012 appropriation.

The U.S. Department of Transportation has announced a $3.5 million grant to a four-university consortium for research and education on sustainable transportation topics. The consortium, led by Portland State University, also includes the University of Oregon, the Oregon Institute of Technology, and the University of Utah. This new, two-year grant builds on prior work done by OTREC (the Oregon Transportation Research and Education Consortium).

In the States

California: The California State Teachers’ Retirement System (“Calstrs”) is investing $500 million in infrastructure assets across the globe. Calstrs has partnered with Industry Funds Management Pty. Ltd., an Australia-based firm that specializes in infrastructure investments. Budget strain at both the federal and state level has led to opportunities for privatization of infrastructure assets.

New Jersey/New York: On February 7, the first phase of an audit of the Port Authority of New York & New Jersey was released. The audit found that the bi-state agency needs a “top-to-bottom overhaul” due to “a lack of consistent leadership, a siloed underlying bureaucracy, poorly coordinated capital planning process [and] insufficient cost controls.” The Port Authority, which at its core is a transportation infrastructure organization, had seen World Trade Center project costs balloon from an estimated $11 billion in 2008 to $14.8 billion.

New York: On February 9, the New York State Thruway Authority and the New York State Department of Transportation released the list of qualified competitive bidders for the new Tappan Zee Hudson River Crossing Project. The four qualified consortiums are the Hudson River Bridge Constructors, Kiewit-Skanska-Weeks Joint Venture, Tappan Zee Bridge Partners (a Bechtel/Tutor Perini Joint Venture), and Tappan Zee Constructors. These qualified groups will have the opportunity to bid on both the design and construction contract for the new bridge. The Infrastructure Investment Act, passed by the New York State legislature in late 2011, allows certain state agencies to use design-build for capital projects relating to physical infrastructure projects.

Maryland: Maryland Governor Martin O’Malley has introduced a six percent increase in the state gas tax as a way to raise money for the state’s transportation infrastructure needs. The proposed legislation would be phased in over the span of three years and could potentially generate over $600 million for the state. However, so far the plan has received a “chilly” reception with state lawmakers.

Events This Week

On February 28 at 10:00am, the House Transportation and Infrastructure Committee will hold a series of hearings titled "Review of Innovative Financing Approaches for Community Water Infrastructure Projects."

On February 28^th at 10:15am the House Energy and Commerce Committee will hold a hearing titled "Critical Infrastructure Cybersecurity: Assessments of Smart Grid Security."

On February 26^th through 29^th the American Association of State Highway and Transportation Officials will hold a Transportation Policy Conference at the Washington, D.C. Hyatt Regency Hotel.

On February 28^th at 10:00am the Senate Environment and Public Works Committee will hold a hearing on the wastewater and drinking water infrastructure needs of local municipalities, rural communities and other similar jurisdictions, focusing on approaches to expand the ability of these communities to maintain and improve their water systems.

On March 1^st at 10:00am the Transportation, Housing and Urban Development, and Related Agencies Subcommittee of the Senate Appropriations Committee will hold hearings on proposed fiscal 2013 appropriations for departments, agencies and programs under its jurisdiction.

On March 8th at 9:00am the Americas Society will hold a panel discussion titled "Transportation and Communication Infrastructure in Latin America: Lessons from Asia."

On March 8th at 9:30am the House Appropriations Committee's Transportation, Housing and Urban Development, and Related Agencies Subcommittee will hold a hearing on proposed fiscal 2013 appropriations for the Department of Transportation, Secretary Ray LaHood will testify.

Game Changer

Howard Schweitzer — Thu, 05 Jan 2012 11:35:38 -0500

President Obama's recess appointment of Richard Cordray to run the Consumer Financial Protection Bureau is a bold political act, but its significance goes far beyond politics. I remarked today to a key Democratic strategists that this was a declaration of political war with the congressional Republicans. He responded that it's the President's response to a war begun by the Republicans. We both were correct, but the truly remarkable thing about what the President has done here is to strongly assert his constitutional executive power and to undermine the constitutional power of the Senate -- the body from which he rose to national prominence. That's not about Ds or Rs, but about the power of the office of the President of the United States. Decisions like the one the President made have ramifications far beyond the term of the current occupant of the office. They reverberate for years.

Managing Political Risk

Howard Schweitzer — Wed, 07 Dec 2011 11:15:01 -0500

On December 1st I had the opportunity to give a speech at ParenteBeard’s annual Audit Committee Forum. The speech focused on the private sector’s management of political risk at the local, state and federal levels. With the lively discussion and frank questions that followed my presentation, it is clear that there is significant concern from a business perspective on how best to mitigate political risk. The q and a got very lively and there was significant concern among the audience regarding the role that the government has assumed in the private sector. The audience also had a number of questions about the European debt crisis, and whether we have people (Republicans and Democrats) in office today in the US Government who have the wherewithal to make the tough decisions that need to be made to move the country forward. We will post a link to the speech shortly.

November 7, 2012

Mark Alderman — Tue, 15 Nov 2011 10:04:38 -0500

November 7, 2012

That's the date on which the determinative discussions about the Budget Reform Act of 2011 will begin. We all know that this Act created the so-called Super Committee to propose a deficit reduction plan. We also of course know that should the Committee not reach a recommendation or should Congress not enact the Committee's recommendation, then the automatic cuts to defense and entitlements are triggered. The theory of the trigger is that neither side of the aisle will allow sequestration of such a drastic extent to cut into its agenda.

The Committee members are no doubt doing their very best to accomplish their mission. They are - to a man and woman - serious and dedicated public servants. They are also tasked with a hugely challenging assignment and the best thinking du jour is that no deal emerges by the deadline. Further, given the extreme polarity in the Congress, there is no guarantee that a Committee recommendation actually passes both chambers.

That does not, however, mean that the trigger is in fact triggered. Indeed, Congress delayed the effective date of the automatic cuts until January 1, 2013. That provision permits Congress an entire year to pre-empt the sequestration. And 2012 is not just any year - it's the presidential Olympics. The likelihood that a Congress in which every House member and a third of the Senators are running for re-election (with an Armageddon election raging above them) will achieve legislation is remote.

So what happens? What happens is the lame duck session. Win or lose, the President has the leverage of the lapse of the bush tax cuts on December 31, 2012 to drive a deal. The Republicans, with or without the President-Elect, have the automatic entitlement cuts as a hammer. So you heard it here first: A deal will get cracked between November 7 and December 31 2012. A good result? A bad result? Reasonable men and women may differ but good or bad that's where we're headed.

Election Day

Madeline Lurio — Thu, 10 Nov 2011 16:35:42 -0500

Between the Penn State abuse scandal, the Herman Cain harassment allegations, and reports regarding the handling of American soldiers’ remains at Dover Air Force Base, this week’s top new stories have been disturbing, sad and overwhelmingly depressing. Largely overshadowed by these ongoing controversies, the results of this past Tuesday (Election Day) seemed to be under-reported and under-analyzed by the usual pundits and news programs. Although not nearly as significant as last year’s mid-term elections, Tuesday brought wins and political victories for both parties, and signaled that voters are in some ways finding middle ground.

In Ohio, voters both rejected provisions of the President’s health care law and the Republican Governor’s anti-union law. In Arizona, state legislator Russell Pearce who has been spearheading the state’s anti-immigration movement was defeated by another member of his own Republican party. In Mississippi a ballot measure that would extend personhood to fertilized eggs lost. And closer to the capital, voting showed that the Virginia Governorship and State Legislature will be controlled by Republicans, making the state more problematic for Democrats running in 2012.

There is no doubt that voters across the country are still extremely angry. While Tuesday’s voters did not send the same tone of anger towards a particular party as in the 2010 elections, the results did send the message that voters are tired of what they see as government overreach and the translation of a political position into a pass to blindly follow party agendas. And while each party is claiming victory from Tuesday, in truth, the results did not signal a clear leader for 2012. Nevertheless, Election Day’s results do restore some sense that the middle is more common than the prevailing news would like us to think.

Out Of Town

Megan Mortimer — Wed, 02 Nov 2011 08:41:17 -0500

Every American is aware of the partisan bickering in Washington. As this election year really gets underway we can only expect that to get worse. For those of us that are on Capitol Hill and meeting with staff and members, we have seen the uptick in harsh rhetoric about the "other side" and we expect it to increase. Sometimes however the “other side” has little to do with Republican vs. Democrat but more so to do with House vs. Senate. When you look at the House and Senate calendars this congressional session, this is apparent more than usual.

According to the official schedules of the House and Senate the two chambers have only been in town at the same time for 25 weeks out of this year. Many members argue that this time away from Washington is key; it allows them to meet with their constituents and see the real problems that their districts are facing. No one can argue that it is important for representatives to meet frequently with those that they actually represent, but it would seem that a coordination of the two chambers in session schedules would be conducive to getting work done. Thankfully staff members are in town and attempting to work with both opposing party member staff as well as their opposite chamber counterparts. But this lack of cohesive scheduling still creates logistical impediments to drafting and passing much needed legislation. This is only exacerbated by the aggressive party politics of our time and it is clear that as a result the work isn’t getting done. Thus far this session the meager work production proves that. At this point, in an average congressional session, twice as many bills would have been signed into law and Congress has yet to pass a single spending bill for 2012.

During these uncertain times it's important to bring our Nation together and our elected officials should be setting an example of that. Perhaps next session leaders of both chambers and both parties can sit down with their calendars and attempt to coordinate, it will only serve to serve the people they represent all that much better.