What Happened, What You Missed: January 30-February 3

Biden Administration to End PHE in May 

The White House announced on Monday that the COVID-19 public health emergency (PHE) will officially come to an end on May 11.  Since it was first declared on January 31, 2020, the PHE has been renewed 12 times at 90-day intervals, with the most recent renewal being January 11, 2023. The end of the PHE will kick off a gradual unwinding of emergency measures and flexibilities related to the use of telehealth and a continuous coverage requirement for Medicaid. The PHE’s termination will also mean the end of free COVID-19 vaccines, tests, and treatments. By announcing the end of the PHE 101 days before May 11, the administration is honoring its commitment to provide 60 days’ notice prior to termination of the PHE. 

Surprise Bill Faces Lawsuit over IDR Process 

The Texas Medical Association (TMA) filed another lawsuit against the No Surprises Act – this time, over a 600% increase in administrative fees for parties seeking to enter the independent dispute resolution (IDR) process to resolve payment disagreements between health plans and out-of-network providers.  The Biden administration increased the $50 initial administrative fee to $350 to account for “increasing expenditures in carrying out the Federal IDR process,” likely due to the fact that more billing disputes have been directed to the IDR process than initially anticipated.  According to the TMA, the jump in administrative fees will disincentivize physicians’ ability to seek arbitration and disproportionally impact specialties with small-dollar claims, like radiology.  The TMA has filed three lawsuits against the No Surprises Act, and a district court ruling from one lawsuit compelled the administration to change its rules pertaining to the IDR process.  

Study: US Health Outcomes Worse Despite Higher Spending 

The US has some of the worst health outcomes among high-income countries despite having the highest health spending per person, according to a study from the Commonwealth Fund.  For example, the study found that the US had the lowest life expectancy at birth, the highest maternal and infant mortality rates, the highest suicide rates, and the highest death rates for avoidable or treatable conditions.  Some of the possible reasons for the poor health outcomes described in the study could be the lack of guaranteed health coverage in the US and the fact that the US has the lowest rate of practicing physicians and hospital beds per 1,000 population.  The study also noted that Americans see physicians less often than residents of other wealthy nations.  

Lawmakers Call for Drug Czar to Be Cabinet-Level Position 

55 bicameral, bipartisan lawmakers sent a letter to President Joe Biden on Thursday calling for the Director of the Office of National Drug Control Policy (ONDCP) to be elevated to a Cabinet-level position to better address the nation’s drug overdose epidemic.  Colloquially known as the “drug czar,” the position of ONDCP director was a Cabinet-level position until 2009 when then-President Barack Obama downgraded it.  Established under former President Ronald Reagan in 1988, the ONDCP coordinates with 19 federal agencies to lead US drug policy.  In the letter, the lawmakers urged President Biden to announce the reinstatement of the position to the Cabinet in the upcoming State of the Union address on February 7 due to a 60% increase in overdose deaths since 2019. 

ICYMI: Modernization Committee Lives On in 118th Congress 

Despite being dissolved at the end of 2022, the House Select Committee on the Modernization of Congress will live on in the 118th Congress as a subcommittee within the House Administration Committee as the the fate of the panel up until this week was in limbo due to a change in control of the House.  Like its predecessor, the new subcommittee consists of four members, equally divided between Republicans and Democrats.  Subcommittee leaders plan on building on the success of the select committee, which includes raising the pay ceiling for staff above what members earn and reviving a more transparent version of the earmarks process. 

What Happened, What You Missed: January 16-20

Administration to Crack Down on Antipsychotics in Nursing Homes 

The Biden administration is getting ready to target the inappropriate use of antipsychotic medications in nursing homes, according to an announcement from the Centers for Medicare and Medicaid Services (CMS). The announcement is part of a larger initiative announced in October to strengthen oversight of the nation’s poorest performing nursing homes.  Starting this month, CMS will conduct targeted audits to determine whether nursing homes are accurately assessing and coding individuals with a schizophrenia diagnosis.  Nursing homes found to be regularly misdiagnosing residents will see changes to their rating in CMS’ nursing home rating system.  CMS will also start to make nursing home citations under dispute available to the public. 

Top White House COVID Official Steps Down 

Dr. David Kessler stepped down this week from his role as Chief Science Officer for the administration’s Covid-19 response.  His departure marks the end of a two-year stint at the White House that included oversight of the federal effort to develop and distribute COVID-19 vaccines and treatments.  In his role, Kessler was responsible for negotiating with drug companies to ensure that vaccines were available to anyone who wanted one.  Kessler is no stranger to public service, having served as Commissioner of Food and Drugs from 1990 to 1997.  The announcement of Kessler’s exit from the administration comes at a time when the federal government is working to shift COVID-19 vaccination from a government-run effort to one that will be managed by the private sector. 

Gallup: Most Americans Have Negative View of Health Care 

48% of Americans rate US health care quality as excellent or good, according to a new poll from Gallup.  The findings represent that for the first time since 2001, which was when Gallup began polling the public’s opinion on health care, that most Americans view health care quality as fair or poor.  The poll found that one of the key reasons that attitudes toward health care have declined is that Republicans’ faith in the health care system has deteriorated since former President Trump left office.  Another major reason respondents cited that health care quality declined was due to the high price of obtaining health care.  Views on health care in the US have gradually declined since their peak in 2012, when 62% of respondents viewed the health care system positively. 

Moderna’s Experimental RSV Vaccine Shows Promise 

Moderna’s experimental RSV vaccine was 83.7% effective at respiratory syncytial virus (RSV) in people ages 60 and older, according to data posted by the company on Monday.  No safety concerns were identified during the clinical trial of the vaccine, which uses the same mRNA technology as the company’s COVID-19 vaccine. The US is currently on the tail-end of a severe surge in RSV infections, which typically kill between 6,000 and 10,000 older adults every year and result in 60,000 to 120,000 hospitalizations.  A 37,000-person Phase III clinical trial is still ongoing, and the company plans on asking the Food and Drug Administration (FDA) to approve the vaccine by mid-year. 

Study Points to Benefits of Hybrid Immunity 

Hybrid immunity is more effective at protecting against severe COVID-19 cases and preventing hospitalization than immunity from infection alone, according to a study published in the Lancet.  The World Health Organization (WHO) defines hybrid immunity as protection in people who’ve been vaccinated for COVID-19 and have been infected with the virus either before or after vaccination.  The study found those with hybrid immunity were 42% less likely to get reinfected a year after their first two COVID-19 vaccine doses and 46% less likely six months after their first booster. While participants who had only been infected were 25% less likely to be reinfected with COVID-19.  The study’s authors recommended that mass vaccination should happen before case surges in the winter because immunity remains effective a year later. 

ICYMI: March for Life Rally Returns Today 

The March for Life returns to Washington, DC today, marking the first such rally of anti-abortion and pro-life advocates since the Supreme Court overturned Roe v. Wade last June.  Unlike previous years, this year’s march will partially go around the US Capitol instead of heading straight to the Supreme Court in order to send a message to lawmakers.  Organizers expect up 50,000 people to show up for the rally, which is similar to previous years.  Washington, DC area residents should be aware of road closures near the National Mall throughout the day.    

What Happened, What You Missed: December 12-16 

White House Revives Free COVID-19 Test Program 

The White House restarted a program to provide free COVID-19 tests to Americans via the US Postal Service, ahead of a possible winter surge as new cases and hospitalizations tick up.  The Biden administration initially began supplying COVID-19 tests by mail in January to address the Omicron surge, but the program was suspended in September due to a lack of funding.  The move is part of a broader COVID-⁠19 Winter Preparedness Plan that includes offering resources and assistance to states to get more Americans vaccinated and boosted, releasing a “winter playbook” for nursing homes and long-term care facilities, and monitoring for new variants.  Households can now order four tests at covidtests.gov, with shipments beginning next week. 

NBPP Proposes to Address Generic Drug Prices, Offer New Special Enrollment Period (SEP) 

The Department of Health and Human Services (HHS) proposed a number of new policies in its proposed 2024 Notice of Benefit and Payment Parameters (NBPP) rule, including one to require Affordable Care Act (ACA) marketplace plans to cover all generic drugs on a new, dedicated generic drug tier with lower cost-sharing.  According to HHS, the new policy would help prevent discriminatory benefit designs, improve access for prescription drugs, and reduce the risk of confusion for ACA plan enrollees.  Additionally, HHS proposed allowing ACA marketplaces to create a new special enrollment period (SEP) for people who lose Medicaid/CHIP benefits.  The proposed policy is likely a preemptive move to address coverage losses from Medicaid redeterminations once the COVID-19 public health emergency (PHE) comes to an end.  Stakeholders have until January 28 to comment on the proposed NBPP rule. 

Initial Data on Moderna’s Cancer Vaccine Show Promise 

Moderna’s mRNA cancer vaccine has resulted in a “clinically meaningful reduction” in the risk of death when used alongside an immunotherapy, according to early-stage clinical trial data released by the company on Tuesday.  Moderna stated in a press release the results amount to a “paradigm shift” in treating cancer by offering a new therapeutic that has significantly fewer side effects than existing treatments like chemotherapy and radiation therapy.  If approved, however, the cost of mRNA vaccines would be a major obstacle, as each treatment would be personalized to each patient. 

SAMHSA Proposes Buprenorphine Prescriptions via Telehealth 

In a notice of proposed rulemaking (NPRM) issued on Tuesday, the Substance Abuse and Mental Health Services Administration (SAMHSA) proposed nixing the in-person requirement to receive a buprenorphine prescription to treat opioid use disorder and allow the treatment to be prescribed via telehealth.  The change is likely intended to address a spike in opioid overdose deaths that began with the COVID-19 pandemic.  Since the start of the COVID-19 PHE, people suffering from opioid abuse have been able to get prescriptions for buprenorphine over audio-only or video telehealth via a temporary waiver.  According to a recent HHS study, people who took advantage of receiving a prescription over telehealth to treat opioid abuse experienced overall positive outcomes.   

ICYMI: Pelosi’s Portrait Unveiled at US Capitol 

An official portrait of Speaker Nancy Pelosi (D-CA) was unveiled in Statuary Hall of the US Capitol on Wednesday.  The portrait depicts the day she was first elected speaker on January 4, 2007.  Senate Majority Leader Chuck Schumer (D-NY) and former House Speaker John Boehner (R-OH) spoke at the unveiling ceremony, and former President Barack Obama delivered remarks via video.  The ceremony also included brief remarks in memory to the artist responsible for Pelosi’s and Boehner’s portraits, Ronald Scherr, who died last week at age 70.   

What Happened, What You Missed: October 24-28 

New White House Plan Aims to Increase Booster Numbers  

President Joe Biden got his updated bivalent COVID-19 booster shot on Tuesday to underscore the administration’s latest push to get more Americans boosted ahead of what’s expected to be a rise in the  case numbers over the coming weeks.  Since the bivalent boosters became available last month, only 8% of eligible Americans have received a shot so far.  Key components of the new plan include education and outreach to seniors and other high-risk Americans, which includes a media campaign and a #VaxUpAmerica Family Vaccine Tour.  The plan also calls for engagement with employers, pharmacies, and schools to urge members of their respective communities to get boosted.   The Biden administration is also urging Americans to get their annual flu shot alongside their COVID-19 vaccine booster. 

Administration Announces New Penalties for Underperforming Nursing Homes 

Some of the nation’s worst nursing homes will soon see stiffer penalties, according to new enforcement measures laid out by the Biden administration last Friday.  The enforcement actions are part of a broader plan to boost nursing home quality that President Biden first announced in his State of the Union Address earlier this year.  Some of the new steps the administration is taking is increasing penalties for nursing homes that fail to address their violations and increasing safety standards. The administration also announced several actions to help nursing homes improve, such as $93 million in grant funding to support workforce development, education, and training.  Nursing homes have come under increased scrutiny over the past few years as the COVID-19 pandemic has exacerbated workforce shortages and resulted in subpar conditions for residents.   

KFF: Employers May Face Higher Insurance Premiums Next Year 

While premiums in employer-sponsored health plans remained stable in 2022, employers could face higher premiums in 2023, according to an annual employer benefits survey from the Kaiser Family Foundation (KFF).  That’s because insurance plans finalized premiums for 2022 before fall 2021, which precedes the surge in inflation observed this year.  While employers have largely absorbed higher premiums thus far amid a tight labor market, KFF notes that a spike in premiums next year could mean employers may have to reconcile between the difficultly of passing higher premiums on to employees while managing their own inflation-driven financial pressures.  The survey also found that nearly a third of large employers say their insurance networks don’t have sufficient access to behavioral health care providers, despite a growing demand among employees for mental health care services.   

NCI: Cancer Death Rate Continues to Decline 

The number of Americans who died from cancer between 2015 and 2019 declined by 2.1%, according to the latest annual report from the National Cancer Institute (NCI).  The biggest decline in cancer deaths was observed in two cancer types:  melanoma and lung cancer.  The report also found modest improvements in the survival rate for pancreatic cancer, which is notable given its association as one of the most lethal types of cancer.  However, the report found that the incidence of new cancers has remained largely unchanged, and that racial and ethnic minorities are more likely to die from certain types of cancer.  

Hill Staffer Unions Ponder Future in GOP-Controlled House 

Ever since Speaker Nancy Pelosi (D-CA) endorsed unions for congressional staff back in February, six Democratic congressional offices have voted to form unions, while another five offices have filed petitions to hold elections on forming their own unions.  As Republicans are likely to control the House in the next Congress, some are worried that staff unions in the House could be short-lived, given House Republican Leader Kevin McCarthy’s (R-CA) opposition to staff unions.  However, some union experts say Republicans may not bother to disband unions because such a move would require statutory changes (as opposed to a simple resolution), as well as the fact that no GOP offices have yet to unionize.  

ICYMI: Marine Corps Marathon Returns to DC 

After a two-year pandemic hiatus, the Marine Corps Marathon is back in action in Washington, DC this Sunday.  The marathon route starts in Arlington National Cemetery and continue across the Key Bridge into Georgetown and Rock Creek Park before heading over to the National Mall and crossing the river back into Virginia.  Up to 30,000 people are scheduled to attend, making it one of the most popular marathons in the world.   

What Happened, What You Missed: October 10-14 

Administration Finalizes Rule to Fix “Family Glitch”  

On Tuesday, the Biden administration issued a final rule to close the “family glitch,” a loophole that blocked family members from receiving Affordable Care Act (ACA) tax credits if a member of their household had access to another source of minimum essential coverage, including employer-sponsored plans. According to the White House, 1 million Americans will gain coverage or see their insurance become more affordable as the result of the rule.  While stakeholders have been largely supportive over the rule, some questioned whether the administration had the authority to make the changes.  The final rule goes into effect in November.   

Walmart Steps into Health Care Research 

Retail giant Walmart launched the Walmart Healthcare Research Institute (WHRI) on Tuesday to add more medical services to its stores and address health disparities.  The new institute will be developing new interventions and medications that can impact underrepresented communities like seniors, rural residents, women, and minority populations.  To enhance clinical trial diversity, the WHRI will initially focus on including members of underserved communities in its studies on treatments for chronic conditions.  According to Walmart, about 4,000 of its stores are located in underserved communities.  The announcement comes amid a Food and Drug Administration (FDA) effort to increase racial and ethnic diversity in clinical trials. 

FDA, CDC Approve Bivalent Booster for Kids 5-11 

Both the FDA and the Centers for Disease Control and Prevention (CDC) signed off on the bivalent COVID-19 vaccine booster doses from Pfizer and Moderna for children ages five to 11 earlier this week.  The bivalent boosters, which target both the original iteration of COVID-19 and the Omicron BA.4/BA.5 subvariants, were made available to all US adults last month.  Only 40% of US children ages five to 11, who have already gotten their two primary doses, are eligible for the booster.  While children are far less likely than adults to face severe consequences from COVID-19, hospitalization rates in children have increased during previous surges, and federal health officials are urging patents to get their kids vaccinated or boosted ahead of a potential new COVID-19 surge in the late fall or winter. 

March of Dimes: Maternity Care “Deserts” Are Increasing 

The March of Dimes painted a sobering picture of the state of maternal health care in the US in a new report that found nearly seven million women of childbearing age and half-a-million babies live in maternity care “deserts,” meaning they lack obstetric hospitals or birth centers.  More so, the report found the number of maternity care deserts has grown 2% since the release of the last report in 2020.  The report also found that racial and ethnic minorities are more likely to live in maternity care deserts.  For example, about a quarter of Native American babies and 17% of Black babes are born in areas with limited or no maternity care services.  As policy solutions, the March of Dimes recommends that Congress passes legislation that will extend Medicaid postpartum coverage from 60 days to a year and expand telehealth services to bridge gaps in health care. 

ICYMI: Library of Congress Kicks Off Fall Concert Series 

If you’re in DC and you’re bummed about missing Jazz in the Garden this summer, don’t worry there are still plenty of opportunities to catch free live music at the Library of Congress Fall Concert Series, which officially starts tonight at the Thomas Jefferson Building.  The inaugural concert will feature Greek, English, Italian, Portuguese, French, and Japanese folk songs.  Piano and opera performances will also be on deck throughout the fall.   

What Happened, What You Missed: August 1-5

Administration Declares Monkeypox a Public Health Emergency            

On Thursday, Health and Human Services (HHS) Secretary Xavier Becerra declared a public health emergency over the monkeypox outbreak, giving federal agencies access to emergency funding and other resources for efforts to fight the virus’ spread.  Becerra is also considering a second declaration that would enable the Food and Drug Administration to issue emergency use authorizations for medical countermeasures like treatments and vaccines.  So far, over 616 cases detected in the US, although that total is likely an undercount. Most cases in the US are concentrated in the gay and queer community, primarily among men who have sex with men.

Administration Releases National Research Plan on Long-COVID

The Biden administration released on Wednesday a national research plan outlining a government-wide agenda focused on improving prevention, diagnosis, treatment, and provision of services for people experiencing long-COVID.  To meet the administration’s objectives, the research plan directs HHS to issue two reports within 120 days laying out an “actionable path forward” to address long-COVID and associated conditions.  The administration also issued a report outlining services and supports for long-COVID patients and as well as resources for individuals confronting challenges related to mental health, substance use, and bereavement.  According to a press release, the administration estimates that nearly one million Americans may be out of the workforce at any given time due to long-COVID, which equates to roughly $50 billion in lost earnings annually.

CMS Finalizes 4.3% Payment Increase for Inpatient Services in FY23

Medicare payments for hospital inpatient services will get a 4.3% boost in Fiscal Year 2023, according to a final inpatient prospective payment system (IPPS) rule released on Monday.  The final rule also carries out the administration’s focus on health equity by adding health equity-focused measures to hospital reporting programs like the Hospital Inpatient Quality Reporting (IQR) Program.  Among other provisions, the rule finalizes proposals to create a “birthing friendly” hospital designation, continue COVID-19 reporting requirements for hospitals, apply a budget-neutral 5% cap on any decrease to a hospital’s wage index from the prior fiscal year, and make prescription drug monitoring program queries mandatory under the Medicare Promoting Interoperability Program.

ICYMI: National Air and Space Museum to Partially Reopen in October

Since March, visitors to the Smithsonian museums in Washington, DC haven’t had the opportunity to view the Apollo 11 command module or the Spirit of St. Louis.  That will change on October 14 when the National Air and Space Museum partially reopens to the public following a lengthy renovation period.  In anticipation of strong interest, the museum will be requiring free timed entry passes that will be available on September 14.  Come October 14, visitors to the museum will have the opportunity to see eight new exhibits, including ones on the Wright brothers and the planets of the Solar System.

Key Primary Races to Watch in August 2022 (8/2/2022) 

The long 2022 primary season isn’t over yet.  Starting today, 15 states will hold primary elections over the next 30 days, and the results of some races will be more impactful than others.  By the beginning of September, American voters are sure to have a clearer idea of the importance of political dynasties, and more importantly, how much influence former President Donald Trump wields over the GOP electorate.   

Michigan Democrats: Levin v. Stevens (August 2) 

Michigan lost a congressional seat in the 2020 Census.  The state’s new congressional map is the product of an independent commission, and while the commission has been successful in avoiding partisan gerrymandering, it wasn’t enough to stop a race between two incumbents.  Both Rep. Andy Levin (D-MI) and Rep. Haley Stevens (D-MI) could have opted to run in the new 10th Congressional District, which leans slightly Republican and contains suburban communities northeast of Detroit.  But instead, both Democratic incumbents chose to seek reelection in the 11th Congressional District, which features a more Democratic-leaning electorate in the suburb’s northwest of Detroit.   While Levin resides in the new district, Stevens’ current district includes much of the new one she’s running in. 

Both Levin and Stevens first entered Congress at the start of 2019, meaning they have been incumbents for the same length of time.  However, Levin has one possible advantage in the form of name recognition.  His father, Sander Levin, served in the House before retiring in 2019, and his uncle, Carl Levin, served in the Senate from 1979 to 2015.   

Missouri Republicans: Greitens v. Schmitt (August 2) 

Eric Greitens was elected Governor of Missouri in 2016, but he resigned in 2018 following allegations of sexual misconduct and violations of campaign finance laws.  Having secured Trump’s endorsement back in 2016, Greitens threw his hat in the ring as a Trump-friendly candidate in the 2022 Republican primary to replace the retiring Sen. Roy Blunt (R-MO) amid a crowded field consisting of Missouri Attorney General Eric Schmitt, Rep. Vicky Hartzler (R-MO), and Rep. Billy Long (R-MO).  While Trump has yet to formally endorse a candidate in the race, he has positively commented on Greitens as recently as July 8.  However, Greitens’ initial lead in the polls seems to have has fallen after allegations of domestic abuse became public and the release of a controversial ad about hunting “Republicans-in-name-only,” or RINOs.  

Currently, one poll has Greitens in third place behind Schmitt and Hartzler, while another has all three candidates tied for first.  As voters in Missouri head to the polls, many Republicans including members of the former president’s inner-circle are currently divided over whether to support Greitens or Schmitt.  However, given Trump’s 15-point victory margin in Missouri two years ago, whichever GOP Senate candidate prevails on Tuesday is all but certain to win in November. 

Arizona Republicans:  Brnovich v. Masters (August 2) 

Arizona State Attorney General Mark Brnovich led the polls for months as the Republican candidate in the primary race for the Senate.  However, Brnovich began to lose ground after former President Trump criticized the attorney general for not supporting him during the 2020 election audit of Maricopa County.  In June, Trump endorsed Blake Masters, bringing the 35-year-old venture capitalist to first place in the polls.  A critic of the validity of the 2020 presidential election, Masters has been also questioning whether the results of the 2022 midterm election will be legitimate, which some Republicans worry could backfire and dissuade some GOP voters from showing up at the polls this November.  Whoever secures the Republican Primary will take on freshman Sen. Mark Kelly (D-AZ) this fall in a race that the Cook Political Report currently rates as a “toss-up.”  But the nomination of a hardcore Trump loyalist and election skeptic like Masters to the GOP ticket could turn off moderate and independent voters, leaving Kelly with a slight edge in November. 

Wyoming: Cheney v. Hageman (August 16) 

Rep. Liz Cheney (R-WY) was a rising star in the Republican Party, having been elected House GOP Conference Chair in August 2019.  However, Cheney lost her leadership position in May 2021 after drawing the ire of House Republicans for her criticism of former President Donald Trump.  Since then, Cheney has only doubled down on her criticism of Trump by serving as the Vice Chair of the January 6th Committee.   

Wyoming voters picked Trump over then-candidate Joe Biden in 2020 by a 40-point margin, so it’s no surprise that Cheney is trailing the Trump-endorsed attorney Harriet Hagemen by nearly 20 points in the GOP primary.  Cheney’s current situation is a sharp contrast from 2020, when she won reelection with 70% of the vote.  Cheney could theoretically find a narrow pathway to victory if she secures the votes of independents and Democrats over the coming days, but a landslide loss would mean the former president is still capable of commanding influence in states that strongly lean red.   

The Rest of Primary Season 

After August 31, only four states have primaries left: Massachusetts’ primary is scheduled for September 6, while Delaware, New Hampshire, and Rhode Island have their primary elections on September 13.  Given the number of consequential primaries in August, however, voters won’t have to wait until the end of the month to get a sense of what the midterm election in November will look like – and how much of an influence the former president has on the GOP.