FDA's device center is busily punching up draft guidances again, but today we're back into the faces-and-places discussion just like last time here at MDD Perspectives. This time, the churn is on Capitol Hill, which is also where two tax issues seem likely to end up on a more or less fast track to nowhere.

Paul Ryan's dirty job

Let's get one thing out of the way quickly. If you were Paul Ryan, would you want the job of Speaker of the House of Representatives? I'd pass, but it appears he has corralled a lot of the wayward tempers in the GOP. Still, there's time for him to think better of this idea.

Corporate American might think the problem with Ryan as speaker is that the tax reform push may lose steam over the near term. Nothing against Kevin Brady, but Ryan has a brand Brady lacks, so one has to wonder if tax reform is going to suffer if Ryan does indeed take the job, which by some accounts is a near certainty.

Of course, speaker Ryan would have the clout to make tax reform a priority, but how quickly will things move in the Ways and Means Committee if he's not there? There's little time left to act this year, and next year is an election year. All things considered, corporate tax reform may have to wait until 2017, and we'll see if the new occupant of the Oval Office is more interested in doing something both parties can accept than the incumbent.

Hitchhiker beware

The device tax repeal is back in vogue again, thanks to efforts on the part of House and Senate Republicans to repeal the Affordable Care Act. The House of Representatives passed a bill that would repeal much but not all of the ACA – including the device tax – and the authors of the bill apparently intended this legislation to show up in the Senate as a budget reconciliation bill, thus requiring only 51 votes for passage.

The problem? The Senate parliamentarian said the first edition of the House bill doesn't qualify as a budget reconciliation document. Ergo, any Senate vote on that bill would need 60 votes, which means the GOP would have had to bring over six votes from among 44 Democrats and two independents who caucus with them. As the saying goes, good luck with that.

Rep. Tom Price of Georgia has offered an amendment to the House bill that would pull the repeal of the Independent Payment Advisory Board to get the House bill in under the budget reconciliation requirement, but there are those who continue to insist on an all-or-nothing approach.

It's tough to predict how this Obamacare repeal push will work out on Capitol Hill, but it's really all for naught, isn't it? There is no way President Obama will sign anything like this, but getting a bill to the President's desk would at least look good on the campaign trail next year.

GOP leaders tried to tie the device tax repeal to the debt ceiling discussion in 2013, but the Senate leadership seems ill-disposed to try that again this year. Hence, it's safe to conclude that the device tax repeal is another 2017-or-bust item.