FW: DC Update on Budget, Health Care Law, Ass't Secretary for MH/SA

NYAPRS Washington Updates
April 25, 2017

Budget Impasse, Government Shutdown?

  • President Trump indicated last night that he's willing to back away from his demand that a government funding bill include money to build a wall on the Southern border, a move that could help clear the way for Congress to avoid a shutdown. A senior administration official tells NBC News that the president is open to obtaining funding for the border wall in the regular appropriations process for 2018 later this year instead of insisting it be included as part of the large spending bill to keep the government's lights on past this week. Such a development would be welcome news on Capitol Hill as congressional negotiators struggled to work past the administration's demands that few members wanted.
  • President Trump plans to stick with his campaign pledge to slash the corporate tax rate from 35 percent to 15 percent, but many wondered how can the president deliver the "massive" tax cut he promised without also blowing a massive hole in the budget. A senior administration official confirmed the planned reduction to corporate rates.

No Action on Healthcare Bill Expected This Week

  • Press secretary Sean Spicer said Monday that the White House’s priority on legislation to repeal and replace Obamacare is to “get it done right” instead of rushing a bill through in order to meet a created deadline or claim a legislative victory. The press secretary insisted that reports of a White House push to move health care legislation this week do not reflect the Trump administration’s true thinking and that House Speaker Paul Ryan, House Majority Leader Kevin McCarthy and House Majority Whip Steve Scalise will make any call on scheduling a vote on health care legislation.
  • Representative Dave Brat of Virginia, a member of the conservative House Freedom Caucus, said the healthcare vote will more likely come in early May. Brat said if compromises that conservatives and moderates have worked out with the administration materialize when the bill is written, “that gets a lot of us toward a ‘yes,’ along with a couple of other items we’ve been negotiating.”
  • According to a Kaiser Family Foundation report out yesterday, if Obamacare subsidies die, government could pay $2.3 billion more next year
  • Sixty percent of Republicans say they either want lawmakers to strike down the ACA entirely or try again on a replacement plan, according to the latest poll from POLITICO and Harvard's T.H. Chan School of Public Health.

White House Advances McCance-Katz as New HHS Assistant Secretary
for Mental Health and Substance Abuse; Murphy Blasts Her Selection

  • The White House announced late last week that it had chosen Elinore McCance-Katz, M.D. Ph.D as the first Assistant Secretary for Mental Health and Substance Abuse inside the Department of Health and Human Services ending months of speculation about who would be selected. The announcement came after much speculation that Dr. Michael Welner, a forensic psychiatrist, would be chosen.
  • According to a summary from Congressman Tim Murphy, the Assistant Secretary for Mental Health and Substance Abuse chief duties are to:

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    “promote, evaluate, organize, integrate, and coordinate research, treatment, and services across departments, agencies, organizations, and individuals with respect to the problems of individuals with substance use disorders or mental illness.

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    ensure access to effective, evidence-based treatment for individuals with mental illnesses and individuals with a substance use disorder”

  • Dr. McCance-Katz has authored or co-authored more than 100 papers and conducted extensive research in substance abuse and addiction, notably opioid addiction.
  • She formerly served as SAMHSA’s first chief medical officer in 2013 but left after only two years.
  • In a critical essay published in the Psychiatric Times, Dr. McCance-Katz wrote that SAMHSA’s Center for Mental Health Services, which administers federal mental health programs, ignored serious mental illnesses and evidenced based practices in favor of feel-good recovery programs that were politically popular but did little to help persons diagnosed with debilitating disorders. She claimed that SAMHSA was openly hostile toward the use of psychiatric medicine, didn’t focus on helping the seriously mentally ill, and questioned whether bipolar disorder and schizophrenia were even real, arguing that psychosis is just a “different way of thinking for someone experiencing stress.”
  • Despite that many of these positions are in synch with his frequently expressed criticisms of SAMHSA and federal mental health policy, Rep. Murphy blasted McCance-Katz’ selection: “I am stunned the President put forth a nominee who served in a key post at SAMHSA under the previous Administration when the agency was actively opposing the transformative changes in H.R. 3717, the original version of my Helping Families in Mental Health Crisis Act. His statement goes on to blame Dr. McCance-Katz for SAMHSA’s “multiple failed practices and wasteful spending” and for while she was at SAMHSA, for “questionable hiring practices, no accountability for federal grants, an anti-medical approach to serious mental illness and substance abuse treatment and most importantly, the continued upward rise of suicide and substance abuse deaths.” The tirade appears to be set off by the White House’s passing over of Murphy’s controversial pick, Dr. Michael Welner.

New York News

  • Paul Francis, deputy secretary for health in the Cuomo Administration said this week that he did not expect that New York will move toward a single-payer system.