On November 2, 2023, in a marathon day for health care policy, both the Medicare Payment Advisory Commission (MedPAC) and the Medicaid and CHIP Payment and Access Commission (MACPAC) held the first day of their November meetings. MedPAC covered Rural Emergency Hospitals, Dual Eligible Special Needs Plans (D-SNPs), hospice, and software payment. MACPAC held a panel and a discussion on Medicaid unwinding.
Good morning from Washington DC and welcome back after a week which the House of Representatives elected a new Speaker of the House, Representative Mike Johnson (R-La.)! After much fanfare and internal squabbling, House Republicans came together last week and decided to move forward in a collegial (almost friendly) manner to select the new Speaker. Speaking of friendly, this weekend saw the passing of Friends star Matthew Perry leaving many of us nostalgic over the years 1994-2004 and offering a bit of nostalgia for more bipartisan times. Now that the House can move forward in normal order, we are reminded that larger issues remain. With Halloween tomorrow, your author will be going door to door with his two young children and hoping that lawmakers can put on their best bipartisan costumes and work together to help prevent the upcoming government shutdown. What’s next? These are the questions we are examining in this Halloween edition of the Week Ahead!
The Administration
In a bold move to take the lead in the artificial intelligence arena, the Biden Administration issued a landmark Executive Order on “Safe Secure and Trustworthy Artificial Intelligence” in an effort to position America as frontrunner in the use of AI. The EO aims to protect Americans from the harmful effects of AI systems, build cybersecurity systems to develop AI tools, develop protocols for AI and national security, and advance the responsibility of AI in healthcare practices. In terms of healthcare specifically, the EO directs the Department of Health and Human Services to create a program to evaluate potentially harmful AI-related healthcare practices. It will aim to advance the responsible use of AI in healthcare and the development of affordable and life-saving drugs. The EO comes at a time where both the House and the Senate are admittedly months away from developing legislation, and where 7 in 10 Americans remain concerned about the use of AI in healthcare.
The Senate
The Senate is back in action today, continuing efforts to resume passage of the three-bill “minibus” containing the funding bills for the Agriculture-FDA, Transportation-HUD, and Military Construction-VA. Last week Senators discussed various proposed amendments to the appropriations package and will continue to address pending amendments this week, with the goal of passing the package by the end of the week. In notable committee activity, the Senate Health, Education, and Labor Pensions Committee, Subcommittee on Employment and Workplace Safety, will hold a hearing on Tuesday entitled, “AI and the Future of Work: Moving Forward Together.” Is it possible Senators will display AI avatars dressed for Halloween? On Wednesday, The Senate Committee on Veterans’ Affairs will hold a hearing entitled “Foundation of Care: Examining Research at the Department of Veterans Affairs.”
As we look towards November 17th and the next government shutdown date, we are left to wonder where various healthcare efforts remain. The Senate will look to move forward with bipartisan efforts to reign in pharmacy benefit managers and expand access to mental health services. Leader Schumer still has eyes on passing a bipartisan health package. Senators from both sides of the aisle have been on record opposing Medicaid DSH cuts which were prevented as part of the current short-term funding measure. The upper chamber will undoubtedly look to continue to prevent the scheduled cuts in any upcoming government funding package.
The House
The House returns on Wednesday with a round of votes on censures of certain members, as well as addressing funding proposals for Israel and Ukraine. Newly elected Speaker Johnson is in favor of separating funding of Israel from Ukraine and is working on an aid package to Israel with attached pay-fors. The White House asked for emergency funding for Israel, and it is highly unusual that such a request be accompanied by pay-fors. The House Freedom Caucus, in a friendly effort to back the Speaker, appears to be ready to provide Speaker Johnson with some slack as it relates to negotiating a continuing resolution to fund the government. The Speaker and his team are looking at January 15th or April 15th of next year as potential dates to extend funding of the government. Other funding purists in the House wish to move forward with passing as many appropriations bills as possible. For the moment, healthcare legislation remains on the backburner, except for larger items such as preventing large Medicaid DSH payment cuts – which could be part of a CR as bipartisan support remains for the issue.
Create a great week!
