Check out our expert take on key activity shaping health care policy
Insights
Featured Blogs
We sit down with Shawn Friesen, principal at Chamber Hill Strategies, to talk about advocacy strategy, relationships and what drives him.
What are some of your most impactful wins throughout your career in healthcare?
One of the first wins that I often think back on relates to the Medicare Modernization Act. During my time on Capitol Hill working for a member on the House Ways and Means Committee, we successfully included provisions for Medicare Advantage in the Act which was a huge win for us at the time. During my time at the American College of Surgeons, we got a surgeon appointed to the influential Medicare Payment Advisory Commission (MedPAC). This was a large collaborative advocacy effort that involved multiple teams, advocates, and the Mississippi delegation. Because of this effort, we were successful in adding a unique physician voice to MedPAC who understood the issues that both physicians and patients were seeing in operating rooms and hospitals. At the American Academy of Dermatology Association, I’m proud of the success we had in raising awareness of the importance of skin cancer screenings and prevention by reintroducing and growing an annual skin cancer screening event on Capitol Hill. More recently, I am proud of the progress that was made in securing provisions in the user fee legislation that will help improve regulatory processes so patients can access the medication they need.
You’ve navigated through diverse sectors within the healthcare industry starting with your role in government to almost two decades working with associations. What valuable lessons have you learned in adapting your advocacy approach when transitioning between these different environments?
It’s incredibly important that wherever you are, you find shared interests among diverse stakeholders, perspectives, or individuals. Sometimes those people aren’t aligned with you on some issues, but in healthcare, you often find there are other issues where you can work together on shared priorities. Most issues that we deal with daily cut across political parties, geographical regions, and differing perspectives. When advocating for any issue, it’s vital to use these shared interests to build a coalition or team effort to ultimately move that issue forward.
What are your favorite aspects of healthcare policy?
First, healthcare affects everyone of all ages, backgrounds, and political persuasions. It is an important component of everyone’s day-to-day existence. While there are many issues that people might feel removed from, healthcare and health policy effects apply to everyone—both individually and to people’s loved ones. Also, I’ve always been interested in the intersection of healthcare and the impact of different policies on the many small businesses that deliver healthcare services or products. I am particularly interested in how healthcare entities can be impacted as small businesses by different policies that we might not normally think of as healthcare policies.
What is your favorite aspect of advocacy as a whole?
I think that relationship building is simultaneously the most important part and my favorite part of advocacy. I also enjoy having the opportunity to always keep learning—whether through reading or from the experiences of others. Ultimately creating new relationships, growing deeper in old relationships, and finding opportunities to collaborate and work with others to achieve a goal that makes an impact is what I enjoy most about my work in advocacy.
How did you intentionally build strong relationships with stakeholders and former colleagues, contributing to the growth of your extensive professional network?
I have never been afraid to build relationships with people who have different perspectives and backgrounds than my own. Even though we may disagree on some issues—maybe even strongly—at the end of the day, we are people who care about many of the same things and those shared interests can provide opportunities to work together to achieve success.
On December 5-6, 2023, the House Energy and Commerce Committee marked up 19 bills related to health policy matters that largely focused on Medicare coverage processes, provider sustainability, and improving patient access to care through lower costs.
Welcome back to Washington, DC the town which continues to provide as much drama as Hollywood but without the glitz and glamour. The weather remains mild, but the heat is on for the Biden Administration and Congress to come to an agreement on a supplemental funding package for Ukraine, Israel, and Taiwan. As per the usual, this weekend your author took his four-year-old daughter to the movies, this time to see Trolls Band Together. The theme focused on a music group overlooking its differences and working together during an emergency to save one of their own from a potentially fatal outcome. If only Congress could take a cue from the third installment of the animated trilogy and work together to end the year on a successful note. Some say it happened this past week with the ousting of the disgraced George Santos from the House, but we here in Washington know there is much more to be done. We are in December and much more needs to be done! Welcome to the Week Ahead!
The Administration
As the end of the year approaches, we are beginning to see priorities of the Biden Administration being challenged by a divided government. The Biden Administration will continue this week to focus on pushing for its war supplemental focusing on aid to America’s allies. Much remains to be seen on this matter as congressional Republicans are demanding border security measures be coupled with the supplemental. Of particular concern remains additional funding to Ukraine, which could see Congress pass for a third time on providing additional resources. In a memo to Congress, Budget Director Shalanda Young expressed the urgency of providing additional funding to Ukraine, as she expressed no more funds exist to support Ukraine. Around 60% of the funding has remained here at home to improve military preparedness here at home, while shipping out equipment to Ukraine.
Among other White House initiatives, House Republicans are pushing back on the Supplemental Nutrition Program for Women, Infants and Children. The House failed to include extra aid money for the WIC program which helps low-income moms and babies. The program usually enjoys bipartisan support, but House Republicans are pushing to cut spending for the program this year. The Biden Administration has requested an additional $1 billion in funding for the program.
The Senate
Majority Leader Schumer is looking to move this week on putting the war supplemental on the Senate floor. The sticking point for the package, as mentioned previously, is that Republicans want to make any funding package contingent on border security reform measures. While both Senate and House Democrats agree some border reform measures are needed, Republicans are pushing for more aggressive measures on the border front. They want to include language from HR2, which Democrats view as a non-starter. Weekend talks on working together fell apart, but we can hope lawmakers return to work together to resolve the disagreement as the world is watching.
In notable committee activity this week, the Senate Finance Committee plans will hold a hearing entitled, “Drug Shortages: Examining Supply Challenges, Impacts, and Policy Solutions from a Federal Health Perspective.” The hearing will touch on drug shortages in light of critical diseases to include cancer drugs.
The House
The never-ending drama continues to drag out in the House. Last week Congressman Santos was expelled from Congress for ethical violations, (and there were a lot of them), and next the Speaker is saying he has enough votes to bring up articles of impeachment against President Biden. Deep divides remain in the narrowly controlled Republican House and more retirements are rumored by the end of the year (including former Speaker McCarthy).
With only two more weeks to go, Speaker Johnson’s honeymoon is over. The Republican majority narrows to three with Santos out and the government shutdown is looming after the holidays. The Speaker said last week they need to fund Ukraine, which sent the Freedom Caucus in an uproar. The rest of the conference is not even close to agreeing on a foreign aid package that funds Israel, Taiwan, and the border. Speaker Johnson has his work cut out for him finishing up the rest of the year and going into next. There are even rumblings they might even call to vacate the Chair on HIM!
As last week, much of Congress’s attention this week will continue to be on matters other than health care. While health policy won’t be on the floor, and even though Congress extended several expiring health provisions and programs into January, that doesn’t mean that work on important health policy matters won’t be happening. The House Energy and Commerce Committee announced that it will hold a markup of 44 pieces of legislation, with over 20 being of health policy in nature, on Tuesday. Tuesday’s markup could provide an insight into what additional provisions Congress might include in health-related legislation early next year as Congress had extended several health programs and provided protections from potential cuts into January as well.
Among the legislation being considered on Tuesday will be legislation aimed at lowering prescription drug costs and targeting pharmacy benefit managers and certain PBM practices. In addition, the Committee will consider measures to extend the work Geographic Practice Cost Index floor, to revise the phase in of certain payment changes for lab services, and an extension of certain expiring incentive payments for alternative payment models. In addition, of particular interest, will be the Committee’s consideration of legislation that H.R. 6545, the Physician Fee Schedule Update and Improvements Act, which would not only include a provision providing an additional relief of 1.75%, over current law, to mitigate the 3.4% cuts in Medicare physician payments in 2024, but it would also reform and update how budget neutrality requirements impact Medicare payment rates to physicians and other providers as well. While previous indications pointe to the fact it was doubtful that Congress would take action to provide any relief from cuts to Medicare physician payments, assuming Committee approval this week, along with Senate Finance Committee’s action last month, there seems to be growing interest in providing some relief from pending Medicare physician payment cuts in 2024—even if that relief may need to be retroactive.
Create a great week!
Biden Invokes DPA to Address Drug Shortages
On Monday, President Joe Biden invoked the Defense Production Act (DPA) during an inaugural meeting of the Council on Supply Chain Resilience to ease drug shortages. The announcement comes amid shortages of penicillin, Adderall, and certain cancer drugs that have affected doctors and patients across the nation. The administration plans to use the DPA to invest $35 million to support domestic manufacturing of essential medicines and key ingredients. Additionally, the White House will appoint a new Supply Chain Resilience and Shortage Coordinator to focus on long-term supply chain issues, and the Defense of Defense (DOD) will release a report on pharmaceutical supply chain resilience.
US Life Expectancy Sees Post-COVID Bump
The US life expectancy rate rose for the first time since the COVID-19 pandemic began, according to data from the Center for Disease Control and Prevention (CDC). Researchers found a 1.1-year increase in 2022, bringing the overall life expectancy to 77.5 years. This marks a reversal of the 2.4-year life expectancy drop that occurred over 2020-2021, which was largely driven by COVID-19 deaths. Native Americans saw the largest life expectancy increase of 2.6 years, while the life expectancy gap between White and Black Americans narrowed slightly in 2022. However, CDC researchers did note a rise in deaths from flu, pneumonia, kidney disease, and fetal and infant conditions in 2022. The CDC also found that deaths from suicide reached a record high of nearly 50,000 in 2022.
Lawmakers Explore Use of AI in Health Care
Members of the House Energy and Commerce Health Subcommittee heard from health care industry stakeholders in a hearing on Wednesday about the potential for artificial intelligence (AI) to decrease administrative burden and improve care delivery. However, witnesses warned that regulations will be needed to protect patients’ privacy and ensure that AI does not discriminate against patients. While subcommittee members were particularly interested in the ways AI could address clinician burnout as well as workforce shortages, there has yet to be any significant momentum on legislation to address AI in health care settings.
Califf Taps New Principal Deputy Director for FDA
FDA Chief Scientist Namandjé Bumpus will succeed Janet Woodcock as the agency’s Principal Deputy Director, according to an announcement from FDA Commissioner Robert Califf. Earlier this month, Woodcock announced that she will be stepping down from her role in early 2024, marking the end of a 37-year career at FDA that included stints as action commissioner as well as head of the agency’s Center for Biologics Evaluation and Research (CBER). Bumpus’ priorities in her new role include the creation of a new model for the office charge of inspecting facilities that manufacture drugs and medical devices. Prior to joining the FDA in August 2022, Bumpus chaired the Department of Pharmacology and Molecular Sciences at the Johns Hopkins University School of Medicine, where she conducted research on drug metabolism and the effects of antivirals on humans and pathogens.
ICYMI: High Winds Take Down White House Christmas Tree
The White House Christmas Tree was a casualty to 46 mph winds that befell the National Capital Region on Tuesday, just two weeks after the tree had been planted at the White House Ellipse. The incident caused 20 ornaments to fall from the tree, although none of the ornaments were damaged. Fortunately, the tree was raised just hours later, allowing the White House Christmas Tree lighting ceremony to continue as planned.
