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D.C.’s Annual Exercise in Futility

03/12/19

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Shoshana Krilow, Vice President, Public Policy and Government Relations

Take a deep breath, roll your eyes, say a cheer or shed a little tear – depending on your views – but no matter what your thoughts are, the president’s budget request you are hearing so much about right now is NOT LAW.

Let me repeat – the 150 pages of policy proposals, priorities and funding levels that the White House just released are NOT LAW. As a quick reminder, in order for policies to become law, they must first pass both chambers (House of Representatives and Senate) of Congress and then be signed by the president. As we have all learned over the last, oh … several decades … that can prove quite difficult to accomplish!

That said, each year around this time, the president releases what is called the “budget request” for the upcoming fiscal year (Oct. 1, 2019 - Sept. 31, 2020). This request outlines both big-picture priorities and specific proposals for each of the executive branch agencies as well as dozens of pages of summary tables which detail, essentially, the money that may be saved and money that may be spent on these various proposals. 

Each year, no matter who is in the White House, policymakers from the opposite side of the aisle on Capitol Hill call this request “dead on arrival.” Even in the best of times, when Congress is politically aligned with the White House, this budget request is still just that – a request. People won’t wake up tomorrow to a new border wall, reduced co-pays, or sadly, an end to HIV/AIDS. Instead, we will wake up hearing very similar messages out of both Democrats and Republicans, ranging from calling the president “out-of-touch” to him being “strong and doubling down” on his most pressing priorities.

In the coming weeks, we are going to hear a LOT more from pundits and policymakers on both sides about the different funding levels between the Department of Defense and the Department of Health and Human Services (HHS). We are going to hear a lot more from those same folks about the need to lower drug prices as well as secure our borders. We are going to hear from each cabinet secretary on his or her agency’s top priorities and the critical need for the funding the president has requested.

However – at the end of the day – or fiscal year – what we are likely to see is policymakers scrambling to cobble together something, anything to avoid another government shutdown.

But because we have learned that not all policies must actually be passed by Congress and signed into law to be implemented …

The current administration is nothing if not unpredictable. Regardless of what Congress does, or doesn’t do, with this budget request, it’s likely that the executive branch agencies will do all they can to implement some of the president’s priorities via administrative action. From HHS, we could very well see (unwelcome) additional cuts to 340B hospitals simultaneously with (welcome) actions that would enhance competition among generic drugs. Vizient will weigh in, early and often, on behalf of our members as Congress and the White House move some of these proposed policies forward.

But for now, breathe – and sigh/cry/cheer – with the knowledge that what was news yesterday (the budget) will be fleeting and something else will be dominating the news cycle tomorrow.

About the author. As vice president of public policy and government relations, Krilow leads Vizient’s government relations, monitoring federal legislative and regulatory developments of importance to Vizient and its members. She has worked as a strategic advisor to health sector clients with a particular concentration on Medicare, the pharmaceutical and insurance industries, and the Affordable Care Act. Krilow also brings deep legislative expertise having spent several years on Capitol Hill, where she worked as a health policy advisor for Representative Marion Berry (D-Ark.) and Senator Joseph Lieberman (I-Conn.).

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