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The daffodils are in full bloom in Washington and Congress and the administration are trying to make the most of the next 2 weeks before taking a break for the Easter holiday. There’s a lot going on in DC, so let’s get to it!
The Administration
All eyes on are the President’s annual budget release which will set out the President’s priorities for the government heading into the November elections.
- Pay attention to what the President is proposing that can be done through Executive Order or regulation vs. what needs Congressional action. While the “dead on arrival” phrase is often used in Washington, some things will be deader than dead, if that’s a thing, but anything the President can do on his own is fair game.
On March 1, President Biden gave his third State of the Union address, leaning into issues that energize the Democratic base and remind viewers and voters of his accomplishments. For health care, he:
- promised to restore Roe v. Wade as the law of the land, noting how red states have restricted access to IVF
- expressed his desire to extend the Medicare insulin cap at $35/month to those with commercial insurance
- made the case for expanding the number of prescription drugs subject to Medicare negotiations beyond current law
The Senate
The Senate took a victory lap over the weekend by passing a package of 6 bills to fund the government through September, including the Food and Drug Administration. Congress now has 2 weeks to figure out how to fund the rest of the government before the March 22 deadline to avoid a partial government shutdown.
- As an aside, how many times have we typed those words – avoiding a government shutdown – in the last few years? We’ve lost count….
With immigration remaining at the forefront, the next set of bills, including Defense, Homeland Security, and Health and Human Services, won’t come so easily.
For health care, the Senate Finance Committee will host Sec. Becerra for a discussion of the President’s budget on March 14. Yes, there will be partisanship but that isn’t what most interests us….
- Watch for Senators’ priorities as they comment on the budget – this shows what each is championing and what might be able to move forward yet this year.
The House
The House comes back to take up 11 bipartisan bills coming out of the Transportation and Infrastructure Committee under suspension of the rules. But partisan tensions are sure to resume later in the week as the House brings up a resolution denouncing the Biden Administration’s immigration policy.
For health care, the focus is on the committees this week. On March 12, the House Energy & Commerce Committee will be meeting to markup and move 19 bipartisan health-related bills, covering a wide range of issues, including maternal health, dementia treatment, cancer screening and a host of other initiatives. One bill of note that has garnered considerable attention is the “Dr. Lorna Breen Health Care Provider Protection Reauthorization Act” (H.R. 7153), which seeks to raise awareness and provide resources to address the mental health issues facing the health care workforce.
Also, on March 12, the House Ways & Means Committee will hold a full committee hearing titled, “Enhancing Access to Care at Home in Rural and Underserved Communities,” which will include testimony from both patients and providers about the challenges in improving access to in-home care and to modernizing the delivery of care in rural and other underserved communities.
There You Have It
We at Chamber Hill Strategies, are counting down the days:
- 10 days left of winter
- 11 days till the men’s NCAA basketball tourney starts
- 12 days to avoid a government shutdown
Health Care Policy in the 2024 State of the Union Address
Heading into election season, President Biden delivered his annual State of the Union Address with a number of familiar health care policy mentions. This blog post focuses on what the President talked about, the implications of those issues for 2024, and the chances of movement on these issues in the current Congress.
Inflation Reduction Act
President Biden highlighted the passage of the Inflation Reduction Act (IRA) and the health care provisions in the bill including:
- Medicare drug price negotiations,
- expanded ACA subsidies, and
- the out-of-pocket cap on insulin and other prescription drugs for Medicare beneficiaries.
He called for building on this legislation by expanding Medicare negotiation authority to include more drugs, making the expanded ACA subsidies permanent, and extending the out-of-pocket caps to all Americans. President Biden’s focus on these provisions makes sense given polls such as this one from KFF that show Americans are not very familiar with the specifics of the IRA.
Abortion
President Biden spoke forcefully about his view that reproductive rights should be protected. Polls, such as this one from KFF, show that the issue is very important as a motivator for the Democratic base and key constituencies. President Biden called for Congress to send him a bill to make Roe v. Wade the law of the land. He also highlighted his opposition to state bans on abortion or efforts to curtail access to services such as IVF.
Protecting Medicare
President Biden reiterated his opposition to what he described as efforts to cut Medicare. This portion of the speech elicited jeers from the Republican side of the aisle. As we mentioned in a previous blog, this issue is especially important for older voters, so we expect the President to continue to highlight ways his administration is protecting Medicare, especially in geographical areas with high concentrations of older voters.
Hope for Bipartisanship
President Biden did include some areas of health care policy in the 2024 State of the Union where there is strong potential for bipartisanship. For example, the president spoke about:
- federal funding for the ARPA-H and
- efforts to address concerns about fentanyl.
The President also mentioned a new Women’s Heath Research initiative that he will be asked Congress to fund in the coming days.
So What?
It is difficult to see how Congress can move on any major health care legislation before the election, given the fragile majority Republicans hold in the House and the almost-default requirement for at least 60 votes in the Senate. It was certainly important for the President to bring up these ideas given how much voters want to hear from the president and his opponent about their respective health care policy proposals. If there is going to be any movement in Congress on health care policy in this election year, we expect areas of health care policy in the 2024 State of the Union such as federal funding for cancer research and efforts to address concerns about fentanyl to be the areas where any movement occurs.
On March 8, 2024, MedPAC commissioners discussed the Acute Hospital Care at Home (AHCaH) program reviewing pros and cons and whether the program should continue. After reviewing data and discussion, Commissioners were generally optimistic about the benefits of the program and thought it should be continued until more analysis can be completed on program efficacy.
Kicking of Women’s History Month, Nikki Haley won the primary in the District of Columbia, making her the first woman to win a Republican primary in US history. The other big news of the weekend was that congressional leadership, along with congressional appropriators, released a bipartisan package of six bills to stave off a government shutdown. The goal of both chambers is to pass the spending bills by Friday’s partial government funding deadline.
The Administration
President Biden will deliver the State of the Union this Thursday, as the administration hopes to land a winning message with voters. The President will focus on his accomplishments to include infrastructure and others, while he makes the case for another term. The President will rally around staying the course to continue steady progress as opposed to new leadership. Themes will focus on corporations paying their fair share, protecting democracy, and ending cancer among others. Despite having the bully pulpit, many polls show President Biden losing to Donald Trump if the election was held today.
The Senate
The Senate will take up the bipartisan appropriations bills once they are passed by the House to avoid a partial government shutdown on March 8. All signs appear to point to passage, but we can never be too certain in this environment. The bills included are Agriculture-FDA, Commerce-Justice-Science, Energy-Water Development, Interior-Environment, Military Construction-VA, and Transportation-HUD. Both sides of the aisle are claiming victory on this package, as funding in many areas largely remains flat. Funding for the remaining bills will run through March 22 per the earlier passed continuing resolution.
Healthcare
On Wednesday, March 6, the Senate Budget Committee will hold a hearing on how primary care improves health efficiency. Additionally on Thursday, the Senate HELP Committee will hold full committee hearing on the Older Americans Act. The OAA is usually met with bipartisan support.
The House
The House is back in on Tuesday, with 5 bipartisan health policy-related bills on the schedule for the week, covering issues including maternal health, pediatric research, dental health, promoting primary care in Medicaid, and reauthorizing the Firefighter Cancer Registry.
Drawing more attention though will be the House’s consideration of a legislative package that was released Sunday that will finalize funding for government programs and agencies through the remainder of Fiscal Year 2024. In the closely divided Congress, the package gives both parties victories to champion while there will certainly be detractors among their ranks as well. While Republicans are celebrating certain cuts and law enforcement provisions, Democrats are touting their own success in stopping many cuts and policy riders that Freedom Caucus members had been pushing. Even with some naysayers, the House is expected to pass the legislation by a large margin before sending it to the Senate later this week.
Healthcare
In addition to funding these agencies and programs, the appropriations package includes expiring programs included the Medicaid Disproportionate Share Hospitals (DSH) Program, the Work Geographic Practice Cost Index (GPCI) Floor, and funding for Teaching Health Center Graduate Medical Education (THC GME), Community Health Centers (CHCs), and the National Health Service Corps (NHSC). House Energy & Commerce Ranking Member Frank Pallone (D-NJ) praised the agreement which includes a 10 percent increase for CHCs, a 17% increase for the NHSC, and a 56% increase in THC GME. In addition, after much back and forth, the legislation also provides a 1.68% increase in Medicare physician payments to help mitigate the 3.34% cut in Medicare payments that took effect on January 1.
While the final package also includes measures to reauthorize substance abuse programs under the SUPPORT Act, despite previous optimism, negotiators were unable to reach an agreement on larger health legislation on pharmacy benefit manager reforms, site neutral payment policies, and a reauthorization of the Pandemic and All Hazards Preparedness Act (PAHPA). Conversations continue on these measures with action later this year still very much a possibility.
With a busy week for health policy on the House floor, it will be a little quieter week in most House committees. That said, the House Oversight & Accountability Committee’s Select Subcommittee on the Coronavirus Pandemic will hold what could be an interesting hearing on Wednesday, March 6, titled the “White House Role in Pandemic Preparedness and Response,” where it will hear testimony from Maj. Gen. Paul Friedrichs, M.D. (ret.), the White House’s Director of the Office of Pandemic Preparedness and Response Policy.
As always, please reach out with any questions as we continue to track the developments of this week!
