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Over the weekend, fans of horse racing enjoyed an exciting Kentucky Derby that ended with a narrow win for Mystik Dan! As Congress returns, members are already lining up for their own race to the Memorial Day recess and looking ahead to the big race of the 2024 elections. Welcome to the Week Ahead!
The Administration
Medicare Drug Negotiation: Round 2
The Centers for Medicare and Medicaid Services (CMS) published a notice alerting the public about an opportunity to comment on the agency’s draft guidance for the 2nd round of Medicare price negotiations as authorized by the Inflation Reduction Act (IRA). This round of negotiations will add another 15 drugs to the 10 drugs currently moving through the negotiation process. These 15 drugs are scheduled to be announced by February 1, 2025, and any negotiated prices will be effective by 2027.
There are some potential roadblocks in the way even as the Biden Administration is moving confidently along with implementing the IRA, including:
• Legal challenges: Pharmaceutical companies and trade associations have brought several lawsuits to stop the negotiations, claiming that the action is unconstitutional and leaves drug manufacturers with little bargaining power because they either have to accept the government’s price or choose not to participate in the Medicare program.
• A 2nd Trump Administration: It’s not clear that Trump’s return to the White House would spell the death of Medicare price negotiations. After all, during his first administration, Trump signed an executive order to direct Medicare to pay no more than the lowest price at which the drug is sold in any other developed nation. However, a 2nd Trump Administration would face tremendous pressure from congressional Republicans to end the program.
The Senate
Health Care Stowaway on FAA Bill
This week, the Senate is scheduled to resume consideration of H.R.3935, a bill to reauthorize the Federal Aviation Administration (FAA) through FY2028. Obviously, this is not a health care bill, but a little bit of what might be considered health care policy managed to sneak aboard the bill before it passed the House. Specifically, the bill bans the FAA from imposing mask or COVID-19 vaccine mandates on passengers, air carrier employees, or FAA employees. Not too long ago, such a provision would have probably caused a bit more of an uproar among Democratic members of Congress. But it appears Captain Schumer is planning for clear skies ahead.
FDA Chief to Defend Budget
Food and Drug Administration (FDA) head Dr. Robert Califf, is scheduled to testify before the Senate Appropriations Ag-FDA Subcommittee on May 8. Although the hearing is about the President’s FY25 budget request, we will also be listening to other topics related to the FDA, such as the recently finalized rule that gives the FDA the authority to regulate lab-developed tests or the delayed rule to ban menthol-flavored cigarettes
Also on Our Radar
• The Senate Budget Committee will hold a hearing on Administrative Burdens in Health Care on May 8.
• The Senate Armed Services Subcommittee on Personnel will hold a hearing on May 8 where Assistant Secretary of Defense for Health Affairs Lester Martinez-Lopez will be testifying.
The House
To Legislate or Motion to Vacate?
The House has a full agenda on the floor but the question is, will House Republican leadership be able to keep things on track, or will they be derailed by Rep. Marjorie Taylor Greene’s (R-GA) motion to vacate against House Speaker Mike Johnson (R-LA)?
The good news for the Speaker: House Democratic leadership has announced they will table Rep. Greene’s motion to vacate the Chair. So, he is probably safe. For now.
The bad news for the Speaker: If Rep. Greene or someone else brings up another motion to vacate, will House Democrats step up again, and if so, what will they ask for in return?
Ways and Means Makes a Way on Health Care
Last week, we saw a lot of health care action from the House Energy and Commerce Committee with subcommittee hearings on Medicaid and the Change Healthcare cyberattack. Not to be outdone, the House Ways and Means Committee is expected to hold a full committee markup this week to consider legislation to extend telehealth flexibilities initiated during the COVID-19 public health emergency, along with some additional reforms and flexibilities.
So what? The markup on telehealth legislation will be the first time this year that a committee has marked up legislation to extend the telehealth flexibilities granted during the COVID-19 pandemic.
Other Health Care Hearings in the House
Just in case you thought Ways and Means was going to have all the fun this week, here are some other health care hearings we are tracking in the House this week:
• May 8: House Small Business Committee hearing on regulatory burdens on small businesses in healthcare
• May 8: House Homeland Security Subcommittee on Counterterrorism, Law Enforcement, and Intelligence hearing on foreign anomalous health incidents
• May 8: House Natural Resources Indian and Insular Affairs Subcommittee hearing on the FY25 Budget Request for the Bureau of Indian Affairs, Indian Health Service, and Office of Insular Affairs
There You Have It
Did you watch the big race? If so, did you get dressed up? If you didn’t watch, how did you spend your Saturday? Reach out and let us know. Here’s to a great week!
On May 1, 2024, UnitedHealth Group (UHG) CEO Andrew Witty testified before the Senate Finance Committee and the House Energy and Commerce Subcommittee on Oversight and Investigations. Read more about UHG’s response to the Change Healthcare attack.
On April 30, 2024, the House Energy and Commerce Health Subcommittee held a hearing entitled “Legislative Proposals to Increase Medicaid Access and Improve Program Integrity.” This hearing featured a discussion of several bills related to the Medicaid program.
Unseasonably cool weather in Washington last week left us feeling less than springy. However, we did see a thawing of relations between Republicans and Democrats on a foreign aid package. Additionally, the endorsement of Speaker Mike Johnson (R-LA) by former President Trump likely brings some feelings of rejuvenation to the embattled Speaker. The forecast this week calls for a return of Congress, a response to the Biden administration’s nursing home staffing mandate, and a possible rule on lab-developed tests (LDTs). Welcome to the Week Ahead!
The Administration
While Congress was out of session, the Administration dispatched several highly-anticipated final rules, including the nursing home staffing ratio rule, the Medicaid managed care rule, the Medicaid access rule, and an FTC ban on non-compete agreements, among others.
Banning menthol in cigarettes did not get finalized. On April 26, Health and Human Services (HHS) Secretary Xavier Becerra acknowledged the need for more time, likely in part due to concerns that the rule would lead to increased law enforcement activity in minority communities.
4-1-1 on LDTs: Despite all the regulatory activity, we are still waiting on a proposed rule granting the Food and Drug Administration (FDA) explicit authority to regulate LDTs. We expect that rule any day now.
The Senate
UnitedHealth Group CEO Comes to Town
United Healthcare Group CEO Andrew Witty testifies before Congress about the Change Healthcare cyberattack. His first stop will be a Senate Finance Committee hearing.
Some things we will be watching:
• Will GOP members use the hearing to criticize the Biden Administration’s response to the cyberattack, or will they focus their attention on UnitedHealth Group’s response?
• Will any members discuss or propose legislative action to address broader concerns about cybersecurity? In particular, we will be watching to see if Sen. Mark Warner (D-VA) uses the hearing to advocate for legislation he introduced earlier this year that would tie federal payments to health care providers after a cyberattack to the adoption of cybersecurity standards.
• How will Mr. Witty respond to allegations that United Healthcare has not done enough to help providers in the wake of the attack?
Other Notable Senate Hearings
- April 30: Senate Armed Services Subcommittee on Personnel hearing on access to pharmaceuticals
- May 2: Senate HELP Committee hearing on the shortage of minority health care professionals and the maternal health crisis
The House
Movement on Appropriations
What’s happening: Last week, the House Appropriations Committee released guidance for members on FY 2025 Community Project Funding (earmarks). This comes as the House just finished FY 2024 appropriations only one month ago.
The House Labor, Health and Human Services Appropriations Subcommittee holds its Member Day on April 30.
What it means: The pace is quick: members must submit programmatic and language requests by May 1 and Community Project Funding Requests by May 3. We know how deadlines drive activity in DC!
House Energy and Commerce GOP Looks to Strike Back on Nursing Home Staffing Rule
What’s happening: On April 30, The House Energy and Commerce Health Subcommittee will consider the Protecting America’s Seniors Access to Care Act (H.R. 7513), which would block the implementation of the recently finalized minimum staffing rule during its legislative hearing entitled “Legislative Proposals to Increase Medicaid Access and Improve Program Integrity.”
Some Democrats have crossed the aisle to support this bill. Rep. Jared Golden (D-ME) is one of the bill’s cosponsors, and Rep. Terry Sewell (D-AL) supported the bill’s passage out of Ways and Means. That being said, most Democratic members are supporting the administration’s action. Given the small majority Republicans hold in the House, not to mention the Democratic majority in the Senate and Democratic President, getting this bill across the finish line may be a tall order.
In Other House Committee News
- The House Oversight Select Subcommittee on the Coronavirus Pandemic will hold a hearing on May 1 with the president of EcoHealth Alliance. EcoHealth Alliance has been accused by some House GOP members of funding risky gain-of-function research so this hearing will certainly be feisty.
- After his appearance before the Senate Finance Committee on the morning of May 1, UnitedHealth Group CEO Andrew Witty will be crossing over to the House for an Energy and Commerce Oversight Subcommittee hearing about the Change Healthcare cyberattack.
There You Have It
What are your favorite springtime activities? Did you get to do any spring break traveling this year? Reach out to share and compare. Here’s to a great Week!
