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Resetting the Race

Date: July 22, 2024

The last couple of weeks have been chaotic to say the least with the attempted assassination of former President Trump and President Biden announcing he will not run for reelection. All this comes as Congress prepares to hear from Israeli Prime Minister Benjamin Netanyahu and start the mad dash to August recess. So, let’s get into it. Welcome to the Week Ahead!

The Administration

President Biden became the first President since LBJ to announce on July 21st, that he would not seek a second term as President of the United States. This raises a whole host of questions. Here is what we know and what we don’t yet know about this historic decision.

What we know:

President Biden has endorsed Vice-President Harris to be the Democratic nominee for President

Prominent Democrats, including the Clintons, Rep. Jim Clyburn, the campaign arm of the Congressional Black Caucus (CBC) and Congressional Progressive Caucus Chair, Rep. Jayapal (D-WA), have also endorsed Harris

At this point, the Democratic National Committee is planning on moving ahead with the plan to formally nominate their candidate by virtual roll call in the first week of August

What we don’t know yet:

What will the Democratic National Convention look like? Open Convention? Brokered convention?

Will anyone challenge Harris?

Who will be the Democratic Vice-Presidential nominee?

President Biden not seeking a second term also raises questions about what the rest of his term will look like. The President is determined to serve through the end of his term, but prominent Republicans are already calling for President Biden to resign effective immediately. We’ve heard rumors that efforts to get President Biden’s cabinet to invoke the 25th Amendment may see a new lease on life following Biden’s announcement.

President Biden’s remaining months in office may be spent trying to cement his legacy. Something that could make that more challenging is the recent repeal of Chevron Deference Doctrine by the Supreme Court, which ended the long-held practice of giving deference to federal agencies when the laws they are tasked with implementing are not clear. How the Biden Administration navigates in this new post-Chevron era will impact the likelihood that notable health care rules, including a nursing home staffing mandate and one that would regulate lab-developed tests as medical devices, survive legal challenges.

The Senate

Waiting on Appropriations

The big question in the Senate: what is the timeline for marking up the remaining appropriations bills? On July 11, the committee approved the :Legislative Branch, Ag-FDA, and the Military Construction-VA bills unanimously. On July 25, the Committee is scheduled to markup the Commerce-Justice-Science, State and Foreign Operations, and Transportation-House and Urban Development bills.

What about the rest? If the Appropriations Committee advances the three bills they are scheduled to markup on July 25, that still leaves 6 remaining appropriations bills, including the one for Labor-HHS. Will the Senate Appropriations Committee continue its record of bipartisanship, or will it get caught up by partisan disagreements or political gamesmanship?

Senate Health Care Hearings This Week

July 24: Senate Homeland Security and Governmental Affairs Committee hearing to consider S. 4667, the Risky Research Review Act, S. 4697, the Healthcare Cybersecurity Act of 2024, and H.R. 3254, the First Responder Access to Innovative Technologies Act

July 25: Senate HELP Committee hearing to authorize an investigation into the bankruptcy of Steward Health and subpoena Chairman and CEO Dr. Ralph de la Torre

The House

Health Care Week on Hold?

Recent talk about a “Health Care Week” in the House where several health care bills would be considered may be put on hold because of the attempted assassination of former President Trump. Conversations we are having on the Hill seem to suggest that the assassination attempt has sucked the oxygen out of the room needed to talk about anything else. It seems likely that any remaining oxygen left this week will focus on the news of Biden’s dropping out of the race and what the new Democratic ticket will look like.

So what? There are only two legislative weeks left before August recess. After that, election season will be in full swing, and before you know it, we are eating turkey and singing Christmas carols. The time is especially short for House Energy and Commerce Chair Cathy McMorris Rodgers (R-WA) who is a champion of many of the bills that might be considered during a “Health Week” and one of the members who is retiring from Congress.

Appropriations Woes

The House also must fit appropriations into the already tight schedule, and the recent failure of the House to pass its appropriations bill for the Legislative Branch (usually a light lift) signals there may be trouble ahead. Given these difficulties, it seems likely that the House will need to consider a short-term continuing resolution to keep the government funded from October through the election. That doesn’t mean House leadership is giving up on passing appropriations legislation. On July 22, the House Rules Committee is scheduled to meet to consider four appropriations bills (Financial Services and General Government, Interior and the Environment, Energy and Water, and Agriculture and FDA.

One more thing: Even if any of the House appropriations bills are DOA in the Democratic Senate, these bills still serve as important markers for what members care about.

House Health Care Hearings

July 22: House VA Subcommittee on Technology Modernization hearing on Assessing Electronic Health Records Modernization

July 23: House Oversight Committee hearing on PBMs

July 23: House Energy and Commerce Health Subcommittee hearing on the CDC

July 24: House Natural Resources Subcommittee on Indian and Insular Affairs Legislative hearing, including legislation related to IHS

There You Have It

Did you watch the RNC? If you did, you may have gotten a free Kid Rock performance. That was just one thing that made the final night unique, even though Kid Rock has been a mainstay of previous Republican Conventions. Now we look ahead to the DNC which is set to be interesting for a whole different set of reasons. Make it a great week!

How does the Chevron Decision affect health care policy?

Date: July 10, 2024

On June 28th, the Supreme Court ruled to overturn the “Chevron” deference doctrine (in Loper Bright Enterprises v. Raimondo). The 1984 Chevron defense directs the nation’s courts to defer to a government agency’s interpretation of statute under circumstances where the law was vaguely written. The June 28th ruling shifts the deference away from the executive branch to the judicial branch when congressional intent is implicit.

Analysts and legal scholars agree that this will have dramatic consequences for health care, calling into question government rules on everything from nursing home care to clinical lab regulation to coverage mandates under the Affordable Care Act (ACA).

Why will this shift affect so many aspects of health care? First, federal laws are often written vaguely to provide agencies flexibility to implement the changes as needed. That vagueness allows technical and scientific experts to make real-world policy decisions on how to implement what Congress passes. So, 50+ years of healthcare policy in action is now open to challenge, re-writing, and nullification.

Second, the ruling will unleash a torrent of litigation. One friend of the court brief filed by the American Cancer Society and other organizations stated that this ruling would open a “litigation tsunami” on even long-settled healthcare policy. This could leave regulation with even more holes depending on rulings in different local, state, and federal courts – causing providers, insurers, and other healthcare players to struggle with compliance.

Third, the ruling could lead to more uncertainty and less stability for players in the healthcare system. For example, even simple things like the government deciding what to pay hospitals or physicians could be subject to long legal battles that could disrupt payments and patient care.

Lastly, this could significantly delay any enactment of new policies by the agencies and Congress. For example, scholars are pointing out that the FDA is extremely risk adverse and this ruling could significantly delay the release of new drugs and treatments. Congressional experts are also warning that this could slow the Congressional draft/legislating process even more as Congress would have to take more time drafting their legislative language to avoid future legal challenges. This could also pose a significant threat to those issues that need faster rulings – like supplemental appropriations (e.g., funding for things like the war in Ukraine) or regulations surrounding use of Artificial Intelligence (AI).

We will continue to watch as things unfold, but it is extremely likely that new lawsuits will be filed to stop the nursing home staffing rule, the LDT lab rule, and price negotiations for Medicare drugs.

Navigating Healthcare Transparency: Administration's Push for Medicare Advantage Clarity

House Ways and Means Hearing on Rural Health access 3.12.24

Date: June 21, 2024

On March 12, 2024, the House Ways and Means Committee held a hearing titled “Enhancing Access to Care at Home in Rural and Underserved Communities.” Though initially previewed to focus on the Hospital at Home model, the hearing centered entirely on telehealth. Chairman Jason Smith (R-MO) highlighted the benefits of telehealth in his opening statement, while Ranking Member Richard Neal (D-MA) discussed the healthcare achievements of the Biden administration over the past four years. Witnesses included patients, healthcare providers, and policy experts who emphasized telehealth’s potential in rural communities and addressed challenges such as internet access, alternative sites for telehealth, and ensuring patient adherence to treatment regimens.

The hearing also covered Medicare and private plan payments and regulations for telehealth, suggesting payment parity with urban settings and financial incentives for telehealth clinicians. Discussions highlighted the need for changes in Medicare policies requiring a nurse’s presence for at-home infusion services and streamlining multi-state credentialing for care providers. The bipartisan nature of the hearing underscored a shared commitment to revisiting the topic and enhancing healthcare access in rural and underserved communities.

Meet Josh Knaak: Passionate Public Policy Professional

Date: June 12, 2024

We caught up with our associate Josh Knaak to learn what drives him, his experiences on Capitol Hill and on the campaign trail, and why he is valuable to our clients.

What inspired you to get involved in politics and public policy?

I first became involved in politics after several of my friends and family were the victims of crime. This inspired me to get involved in local politics. I realized that I enjoyed working to find solutions to problems, and politics and public policy provided me a way to be a part of the solution.

What drew you to Chamber Hill Strategies? What are you most looking forward to in your new role?

I heard about Chamber Hill Strategies from various colleagues on Capitol Hill who told me great things about the firm, including the daily newsletter PolicyCrush, and Jennifer Bell’s positive reputation. I also knew that Chamber Hill Strategies is a leading health care-focused lobbying firm and I wanted to be part of continuing to build on that legacy. I’m excited to dive deeper into health care policy and use my working knowledge of the legislative process and current Congressional players to serve the needs of our clients.

What has your day-to-day schedule looked like so far as an Associate at Chamber Hill Strategies?

One of my main responsibilities right now is to produce PolicyCrush, our daily news service that gives readers an at-a-glance resource of the most important announcements in health care. It’s a thrill to create something that thousands of readers around the country rely on – including readers in the federal government. I use a high-refined curation to cull through what’s important and what’s not important for our readers to know about the public and private sectors. We cover Congress and the Administration. Medicare, Medicaid, health insurance, health tech, quality and innovation. It’s a lot of ground to cover and the rapid pace of information keeps me and our dedicated subscriber base on our toes!

Can you share more about your experience on Capitol Hill? What lessons did you learn there that will help you succeed at Chamber Hill?

My experience on the Hill featured work in both the House and Senate. I gained experience tracking legislation, meeting with lawmakers from both chambers of Congress, developing voting recommendations, formulating memorandums for legislative staff, and assembling committee binders. I always love learning new things and my experience on the Hill taught me a lot about how Congress operates, the legislative process, and the importance of interpersonal relationships. These are all important areas to learn about for anyone who wants to make a difference in public policy. I can apply my knowledge about Congress and the legislative process to help me communicate with clients about what is going on in Washington. I can also utilize the relationships I cultivated during my time on the Hill to advance the interests of our clients.

Do you have a particular experience from your time on the Hill that sticks out to you?

One experience I won’t forget happened during my tenure with Senator Cassidy’s (R-LA) office. Sen. Cassidy is a member of the Senate Veterans’ Affairs Committee. So, while I was with his office, I took the opportunity to meet with other Senators of the Senate Veterans’ Affairs Committee. I enjoyed talking with them about their ideas to improve the quality of life for our Veterans.

What specific areas of health care interest you?

I am interested in learning how I can help Veterans who have fought in the wars of Afghanistan and Iraq are still facing health issues. Many of the Veterans who fought in these wars are struggling to get access to the health care they need. I am also interested in the cost of prescription drugs.

Is there anything else you think clients or prospective clients should know about you?

Not only am I diligent and responsive, but I’m also an energic person who knows his way around Capitol Hill. 

If you would like to learn more about how Josh and the rest of the Chamber Hill Strategies team can help meet your advocacy needs, please contact us.