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. 

What Happened, What You Missed: July 25-29

Schumer, Manchin Reach Deal on Sweeping Reconciliation Bill

On Wednesday, Senate Majority Leader Chuck Schumer (D-NY) and Sen. Joe Manchin (D-WV) surprised the political world by announcing they had reached a deal on a new reconciliation bill with provisions to fight climate change, reform the tax code, and extend the enhanced Affordable Care Act (ACA) premium subsidies for three years.  Known as the Inflation Reduction Act, the measure would raise over $700 billion by establishing a 15% corporate minimum tax and allowing Medicare to negotiate  drug prices, among other items.  The bill would also invest nearly $369 billion in a host of clean energy and climate-related programs, including a new $4,000 tax credit for the purchase of used electric and hybrid vehicles. 

CMS Announces Maternity Care Action Plan, Extends Postpartum Coverage

The Centers for Medicare and Medicaid Services (CMS) laid out a new Maternity Care Action Plan on Tuesday that aims to encourage health care industry stakeholders like hospitals and insurance companies to consider key commitments on improving maternal health outcomes.  The action plan is a part of the Biden administration’s overall effort to improve health outcomes and reduce disparities for mothers and infants.  Additionally, CMS approved the extension of 12 months of postpartum coverage under Medicaid and the Children’s Health Insurance Program (CHIP) in Connecticut, Massachusetts, and Kansas.  The extension is estimated to apply to 19,000 people in each of these states, bringing the total number of people eligible for 12 months of postpartum coverage nationwide to 284,000.

W&M Advances Bill to Streamline Prior Authorization

On Wednesday, the House Ways and Means Committee voted unanimously to advance H.R. 8487, the Improving Timely Access to Care Act of 2022.  This bipartisan legislation would modernize the way Medicare Advantage and health plans use prior authorization by establishing an electronic prior authorization process and creating a process for real-time decisions for services and items that are routinely approved.  Backed by both payer and provider organizations, the bill is expected to be brought to consideration on the House floor this fall after lawmakers return from August recess.   The Senate version of the Improving Seniors’ Timely Access to Care Act (S. 3018) has been referred to the Finance Committee, although it is unknown when the committee will take up the bill. 

KFF: Vaccination Rates for Kids under 5 Remain Low

Only 7% of parents of children ages 6 months to 5 years have gotten their kids vaccinated against COVID-19, according to the latest survey data from the Kaiser Family Foundation (KFF).  Unfortunately, the survey data suggests that the number of young, vaccinated children is not expected to rise significantly due to varying degrees of hesitancy among parents.  About 43% of parents surveyed said they will “definitely not” get their kids vaccinated, while 27% are opting for a “wait and see” approach.  The survey noted some partisan differences, as Republican-leaning parents were three times as likely as Democratic parents to say they will “definitely not” get their kids vaccinated.  Additionally, the survey found that 81% of parents who have yet to get their children vaccinated are worried about the side effects or long-term effects of vaccines.

ICYMI: “The Office” Fans Can Experience Dunder Mifflin in DC

Fans of the hit mockumentary sitcom “The Office” can experience their favorite TV series in a new live exhibit that opened Thursday in downtown DC.  According to the website for The Office Experience, visitors can explore 17 different areas that feature set recreations and original costumes and props from the show.  The exhibit was created by the same company that put together the FRIENDS Experience in DC, which closed back in June.  Fans will be able to view The Office Experience through January 16, 2023.

What Happened, What You Missed: July 18-22

Odds of September CR Increase

Senate Appropriations Committee Ranking Member Richard Shelby (R-AL) said bicameral appropriators aren’t likely to agree on topline Fiscal Year (FY) 2023 spending levels until after the midterm election in November, meaning Congress will probably have to pass a continuing resolution (CR) to ensure government funding beyond the current deadline of September 30.  To date, the Senate has yet to introduce any appropriations bills, while the House is much further along in the process, having passed a six-bill minibus on Tuesday. 

Launch of 988 Deemed a Success

Secretary of Health and Human Services (HHS) Xavier Becerra touted last Saturday’s rollout of the new 988 national suicide hotline number a success, with the hotline seeing a 60% jump in calls compared to the previous weekend for the National Suicide Prevention Lifeline.  The administration has spent over $430 million to help states prepare for higher call volumes by hiring more mental and behavioral health counselors to take calls.  Meanwhile, Congress is working on its own proposals to boost access to mental health care services.  In particular, the Senate Finance Committee is set to release legislation that would expand the behavioral health care workforce and allow the integration of mental and primary health care. 

Advocates Call for More Government Action on Long COVID     

The federal government really needs to step up its work on addressing long COVID, according to health care providers and patients who testified before a House Oversight and Reform Select Subcommittee on the Coronavirus Crisis hearing on Tuesday.  Some of the reforms witnesses called for include paid medical leave for patients, enhanced access to disability benefits, and more support for long COVID clinics.  During the hearing, Subcommittee Chairman James Clyburn (D-SC) stressed that more research is needed to understand the causes, risk factors, and effects of long COVID.  Witnesses also discussed the economic impact of long COVID, such as patients leaving the workforce. 

Senate Weighs in on Reforms to Electoral College

A pair of bipartisan Senate bills aim to reform the Electoral Count Act of 1887, which controls the acceptance of presidential votes.  One proposal would increase the threshold to one-fifth of the members of the House and the Senate to object to the election results. Currently, only a single member of the House and Senate can object to a state’s Electoral College votes.  Another bill would increase the maximum penalty for people convicted of intimidating or threatening candidates, voters, and election officials to two years and make tampering with voting systems a federal crime.  Sen. Susan Collins (R-ME) has said that she hopes both bills can be signed into law by the end of the year.

ICYMI: 8 House Offices Are Unionizing

Eight House Democrat offices filed petitions to form unions after a new rule went into effect to allow legislative branch employees to unionize.  Relatively low pay as well as cases of harassment and burnout are among the reasons why staff have long been pushing for the right to organize on the Hill over the past few years.  Now, staff in the eight Democratic offices must wait on the Office of Congressional Workplace Rights to review the petitions before they can hold a secret ballot election to ultimately decide on unionizing. 

FDA User Fee Process: The Clock Is Ticking

September 30, 2022.  That’s the date the Food and Drug Administration’s (FDA) user fee programs for drug products and medical devices are set to expire.  Given the “must-pass” nature of user fee reauthorization, lawmakers and FDA stakeholders are using this moment to advance other FDA-related reforms pertaining to the accelerated approval process, promoting clinical trial diversity, competition in drug markets, and other areas.  While the House and Senate user fee packages are fundamentally similar, there are some differences between the two.  For instance, the Senate package includes policies related to dietary supplements, diagnostic labs, and cosmetics; the House does not.  Given the differences between the packages and the pressure to get a signed bill before the August recess, stakeholders would be keen to watch the legislative process unfold.

A Brief History of the FDA User Fee Process

Enacted in 1992, the Prescription Drug User Fee Act (PDUFA) authorized the FDA to collect user fees from companies that submit applications for drug products.  Since then, Congress has added additional user fee programs for other products like medical devices, generic drugs, and biosimilars.  Congress reauthorizes user fee bills every five years, and the reauthorization process marks an important opportunity for lawmakers to consider FDA-related policies as well as overall FDA performance

Since FDA depends on user fees to operate, failure to reauthorize user fee programs would catastrophically disrupt FDA operations by triggering massive layoffs of career staff who review new drugs and devices and monitor drug safety.   As a result, the timelines for new drug products to reach patients and providers would increase exponentially.   

Although current authority for the user fee programs expires at the end of Fiscal Year (FY) 2022, Congress typically passes reauthorization bills in the summer preceding the September deadline to avoid disrupting FDA operations. With that in mind, the House and Senate are on the clock to pass a legislative package over the next couple of months before the FDA starts handing out pink slips.

What’s in the House and Senate Bills?

The House Energy and Commerce Committee and the Senate Health, Education, Labor, and Pensions (HELP) Committee have already released their own respective user fee reauthorization bills that would reauthorize fees that drugs, biosimilars, and medical device companies must pay the agency for review of their products.  Both bills appear to move forward with fee levels that were negotiated between FDA and industry groups prior to their release. 

Additionally, both bills set out to reform the FDA’s accelerated approval program, which allow the agency to approve drugs more quickly for serious conditions that fill an unmet medical need.  In exchange, drug manufacturers must complete post-approval trials to confirm those clinical benefits – something the FDA has not consistently ensured

Both the House and Senate bills would allow the FDA to require manufacturers to start post-approval studies prior to accelerated approvals, give the FDA more control over study design and deadlines, and create a mechanism for the agency to pull drugs off the market.  The bills also would clarify that post-approval studies could rely on real-world evidence (RWE) to confirm that drugs are effective.  Notably, the Senate bill differs from the House bill in that it would create an interagency coordinating council that would periodically review accelerated approvals.

Additionally, both bills set out to promote drug competition through better access to generic and biosimilar drugs, albeit through different paths.  For instance, the House bill contains provisions that would streamline the generic approval process in certain types of cases, while the Senate bill addresses exclusivity for interchangeable biosimilar products.

Outside of fee proposals, changes to the accelerated approval process, and access to generic and biosimilar drugs, both bills contain several notable differences.  For example, the House bill includes provisions aimed at improving diversity in clinical trials by requiring trial sponsors to submit diversity action plans with details on how the sponsors intend to enroll a diverse group of trial participants.  Other provisions would require the FDA to submit reports on diversity action plans and to hold public workshops on improving trial diversity. While the Senate bill does not contain such a provision, another Senate HELP Committee-approved bipartisan bill, the PREVENT Pandemics Act, does include policy intended to promote clinical trial diversity.

Among the Senate’s user fee package proposals are provisions that would enhance the regulation of laboratory-developed tests (LDTs) by allowing the FDA to regulate LDTs based on the level of risk associated with them, similar to how the agency regulates medical devices.  The Senate bill would also expand the FDA’s ability to regulate dietary products by requiring dietary supplement companies to list their products with the agency, which would theoretically improve the FDA’s ability to enforce consumer protections.  Furthermore, the Senate bill contains a slew of provisions aimed at boosting regulation of cosmetics.  These include requirements for cosmetics manufacturers to register their products with the FDA, new labeling requirements, and the establishment of good manufacturing practice regulations.

What Comes Next?

The House Energy and Commerce Committee voted in favor of its user fee package in the Health Subcommittee on May 11 and the full committee on May 18 with a vote on the House floor scheduled for June 7.   Over in the Senate, the HELP Committee is scheduled to mark up its user fee package on June 14, along with legislation to improve access to mobile health clinics. 

Congress has always addressed the user fee reauthorization legislation ahead of the expiration deadline (September 30), and leaders from both House and Senate committees with jurisdiction over the FDA have publicly stated that they don’t want to hold up the reauthorization process.  However, substantive differences between the House and Senate versions of the reauthorization bill combined with a highly partisan climate have the potential make passing user fee legislation more difficult than in previous years. 

Additionally, the Senate HELP Committee has also voted in favor of its PREVENT Pandemics Act, another top priority of Chair Patty Murray (D-WA) and Ranking Member Richard Burr (R-NC), who is retiring at the end of this year, for enactment.  Likewise, a priority of House Energy and Commerce Health Subcommittee Chair Anna Eshoo (D-CA) will be enactment of her bipartisan House legislation creating the Advanced Research Project Agency for Health (ARPA-H).  It remains unclear if/how these policy priorities and user fee reauthorization packages will come together and form one bill to be signed by the President before the expiration of the current user fee programs. As the summer unfolds, stakeholders would keen to monitor the reconciliation process to see which provisions and changes make it into the final reauthorization bill.

What Will the FY 2023 Appropriations Cycle Look Like?

House and Senate appropriators are poised to introduce their Fiscal Year (FY) 2023 spending bills, kicking off weeks and months of negotiations and hearings.   The FY 2023 appropriations cycle notably follows a lengthy FY 2022 cycle that wasn’t resolved until March 2022.  As lawmakers grapple with the midterm elections, retirements, and economic concerns in the coming months, how likely will the new appropriations cycle spill over into the next calendar year?

What We Currently Know

So far, top congressional appropriators are saying they want FY 2023 appropriations to wrap up in the current calendar year.  In a March 31 hearing, House Appropriations Committee Chairwoman Rosa DeLauro (D-CT) expressed a desire to pass all appropriations bills “on time” so they can be signed into law by September 30, 2022.  But her Republican counterpart, Ranking Member Tom Cole (R-OK), had a more sobering take, saying Congress is unlikely to finish its work on FY 2023 appropriations until the end of the current calendar year.

There are only a handful of other indications as to how the FY 2023 appropriations cycle will pan out.  On April 28, Democratic and Republican leaders of the House and Senate Appropriations committees met to discuss topline spending levels for FY 2023.  While it remains to be seen what came out of the meeting, the dollar figures each side offers will indicate how contentious appropriations negotiations might shape out to be this summer.  For instance, the administration proposed a $1.6 trillion budget for FY 2023, with funding allocations roughly equally divided between defense and non-defense spending.  If Democrats start their negotiations with the president’s budget request, their push is likely to fall flat, as Republicans and some centrist Democrats have been eager for more defense spending. 

There aren’t many more details about timelines, either.  In the House, the Appropriations subcommittees are reportedly expected to markup their 12 spending bills between June 13 and June 22, with the full committee to follow its markups from June 22 through June 30.  However, all dates are currently tentative, and the committee won’t confirm official dates until a final notice is sent out.

The Senate Appropriations Committee has yet to announce its own tentative timeline, although Senate appropriations hearings always follow appropriations hearings in the House.  This means subcommittee and full committee markups in the Senate will probably be scheduled throughout July and August. 

Which Factors Will Impact FY 2023 Appropriations?

Unfortunately for lawmakers, they’re heading into a new appropriations cycle with many distractions and extenuating circumstances that don’t often come together all at once.  Here are some key factors that will determine whether lawmakers will wrap up the new appropriations cycle before 2022 ends

The Midterm Elections

A “wave” election that could likely see control of the House shift from one party to another is typically a strong indicator of a long appropriations season.  Due to both historical trends and President Joe Biden’s low approval ratings, Republicans are generally favored to regain a majority in the House in the 2022 midterm election this November.  The closest comparison to the 2022 election so far is 2010, when low approval ratings over the Obama administration’s handling of the economy helped flip 63 House seats to the GOP, causing the Democrats to lose control of the chamber.  As a result, Congress didn’t finalize FY 2011 spending bills until March 2011.  2018 saw another wave election, with then-President Donald Trump’s unpopularity supercharging Democratic turnout to help the party flip 41 seats, allowing Democrats to retake the House.  If 2010 and 2018 are any indication, a long FY 2023 appropriations season is likely to coincide with the 2022 midterm elections.

Retirements of Top Appropriators

Some of the current lawmakers who won’t be on the ballot for the 2022 midterm elections include Senate Appropriations Committee Chairman Patrick Leahy (D-VT) and Ranking Member Richard Shelby (R-AL), who will both be retiring at the end of the 117th Congress.  Their pending retirements might incentivize both to reach deals on spending bills sooner rather than later.   Additionally, Sen. Susan Collins (R-ME), who is widely favored to replace Shelby as the Appropriation Committee’s top Republican, has indicated she’d prefer finishing FY 2023 appropriations in 2022 to ensure she can start the new Congress “with a clean slate.”

Inflation

Inflation is at a 40-year high, which could spur lawmakers to reach a final agreement on FY 2023 sooner instead of relying on a series of continuing resolutions (CRs) into next year.  When inflation is at a more typical level like 2% per year, federal agencies can generally make do under a CR and find money in their budgets to ensure there are no interruptions in services or operations.  However, if inflation persists near its current level of 8.5% through September, agencies will have a difficult time operating under a CR as they struggle to accommodate rising prices with budgets frozen at FY 2022 levels. 

With a mix of incentives for and against reaching a budget deal, it’s hard to say when a final FY 2023 spending agreement will be signed into law.  However, election season is busy enough for lawmakers, and with a historic and contention midterm election season almost in full swing, there’s little likelihood Congress will reach an agreement on appropriations before Election Day on November 8. 

What Lawmakers Talked About during the HHS FY23 Budget Hearings

Xavier Becerra made the rounds on Capitol Hill recently in his capacity as Secretary of Health and Human Services (HHS) to testify on the Biden administration’s Fiscal Year (FY) 2023 budget request for HHS.  Beyond the secretary’s submitted testimony – which was virtually the same for every hearing – here is a countdown of the top five health-related topics on lawmakers’ minds that were discussed across seven congressional hearings on the HHS budget request.

5. Ending the PHE

In a few hearings, lawmakers questioned Becerra on when the administration plans to unwind the COVID-19 public health emergency (PHE), which is currently set to expire on July 16, 2022.  Each and every time, Becerra reiterated the administration’s commitment to providing 60 days’ before ending the PHE in order to give states and health care providers time to prepare.  In recent weeks, the administration has given no indication that it will simply let the current PHE expire in two months.  Since May 16, 2022 marked exactly 60 days before the current PHE expiration date, the administration is all but certain to renew the PHE for another 90-day period come July.

4. Telehealth Waivers

One reason why lawmakers are so interested in how long the PHE will last is because several emergency health care flexibilities are tied to the end of the PHE.  These flexibilities include several Medicare telehealth waivers that waive geographic site originating requirements and allow coverage of audio-only services, among other items.  During the hearings, Becerra repeatedly thanked lawmakers extending temporary telehealth waivers for 151 days – 5 months –  beyond the end of the PHE in the Fiscal Year (FY) 2022 omnibus

Members were also strongly supportive of extending at least some of the telehealth waivers permanently. Some of the telehealth benefits lawmakers cited include increased access to health care in rural areas and relief for the health care workforce shortage.  Becerra voiced agreements on telehealth’s many benefits during the hearings, and he urged lawmakers to work with the administration on developing legislation to make the temporary telehealth authorities permanent.  Fortunately, members are already hard at work and a bipartisan group of House members have already introduced legislation to permanently expand coverage of audio-only telehealth and remove geographic restrictions on originating sites.

3. No Surprises Act

Members from both parties across multiple committees criticized the secretary for not following congressional intent in implementing the No Surprises Act because the rulemaking process establishes the Qualifying Payment Amount (QPA) as the presumptive out-of-network rate in the independent dispute resolution (IDR) process.  They argued that doing so tips the scale in favor of insurers during the IDR process. During the hearing, authors of the No Surprises Act like House Ways and Means Committee Chairman Richard Neal (D-MA) said members went to great lengths to ensure that the legislation established a level playing for all factors to be considered in the IDR process.   

In February 2022, a district court ruling struck down provisions of the No Surprises Act that gave weight to the QPA.  Becerra assured members during the hearings that the administration’s final rule on the No Surprises Act will heed the court’s ruling, although he declined to provide a timeline  on when  the rule will be released.  The secretary also said that HHS is working with the Department of Justice (DOJ) on whether to appeal or accept the ruling.  Additionally, Becerra was confident that the new rule will protect patients from surprise medical bills. 

2. 988 Suicide Hotline

988 will officially become the new suicide hotline on July 16, 2022, and members were curious to see how the administration is ensuring the hotline will work from day one.  States and territories will be responsible for operating the actual hotline, and Becerra explained that the administration is providing states with funding to make sure they can onboard enough counselors and behavioral health professionals to take incoming calls.  In the event that existing state call centers are overwhelmed, Becerra told lawmakers that HHS is working to set-up back-up call centers.  As the launch date approaches, Becerra assured the congressional committees that HHS is “keeping tabs” with states on call center preparation, although he noted that some states will be in a better position than others to take calls right away once the new hotline goes live this summer.

1. ARPA-H

The FY 2022 omnibus established the Advanced Research Projects Agency for Health (ARPA-H) as the newest biomedical research agency within HHS.  While members were unanimous in their support of the new agency, some including Reps. Rosa DeLauro (D-CT) and Anna Eshoo (D-CA) were critical of the administration’s decision to house ARPA-H within the organizational structure of the National Institutes of Health (NIH).  DeLauro, Eshoo, and others had been advocating for ARPA-H to be an independent agency within HHS because they felt this arrangement would help cultivate an independent culture within the new agency that would best facilitate the development of new cures.  Additionally, some members including Sen. Jerry Moran (R-KS) and Rep. Tom Cole (R-OK) were concerned that the administration’s was proposing additional FY 2023 funding for ARPA-H at the expense of additional funding for existing research projects at NIH.

Becerra assured lawmakers that the placement of ARPA-H was purely administrative, and he explained that having NIH assume functions like accounting and human resources would allow ARPA-H to focus on developing breakthroughs from the get-go.  To further point to the new agency’s independence, he said the ARPA-H director would report to the secretary – not the NIH director – and he added that ARPA-H would not be “physically housed” within the NIH campus. 

Becerra additionally told the congressional panels that ARPA-H will be operational once a director is appointed.  While the secretary said the search for a director is currently underway, he was unable to provide a timeline. 

Current Members of Congress Who Used to Be Interns

Everyone gets their start somewhere.  For some members of Congress, their careers kicked off at the bottom of the totem pole, by serving as interns for other members of Congress.  Below is a list of key current members whose experience with the legislative branch started with answering phones and other administrative duties.

Speaker Nancy Pelosi (D-CA)

The only woman to serve as speaker of the House of Representatives was exposed to politics at an early age, with her father serving as a Democratic Congressman from Maryland, and later, as Mayor of Baltimore.  Pelosi herself first dipped her toes in the political waters when she interned for Sen. Daniel Brewster (D-MD) while pursuing a Bachelor of Arts (BA) in political science at Trinity College in Washington, DC.

Majority Leader Steny Hoyer (D-MD)

Also serving as an intern in Sen. Brewster’s office alongside the future speaker was the future majority leader, Steny Hoyer.  At the time, Hoyer was finishing up a BA in government and politics from the University of Maryland, College Park.  Just a few years later in 1966, Hoyer was elected to the Maryland State Senate.

Rep. Eric Swalwell (D-CA)

Hoyer isn’t the only University of Maryland alumnus serving in Congress.  While studying for his BA in government and politics, the California native interned with Rep. Ellen Tauscher (D-CA) in 2001 and 2002.  Swalwell has stated that his experience interning on Capitol Hill during the September 11 terrorist attacks cemented his desire to pursue public service. 

Sen. Marco Rubio (R-FL)

While studying at the University of Miami School of Law, Rubio interned for Rep. Ileana Ros-Lehtinen (R-FL), a fellow Cuban American who retired from Congress only a few years ago.  Rubio also worked on the 1996 presidential campaign of Sen. Bob Dole (R-KS) while in law school.

Sen. Mark Warner (D-VA)

While attending George Washington University in the mid-1970s, Warner interned for Sen. Abraham Ribicoff (D-CT).  Shortly after graduating, Warner took a job with then-Rep. Chris Dodd (D-CT) and went on to manage Dodd’s senatorial campaign while studying in law school.

Sen. Kirsten Gillibrand (D-NY)

Like Pelosi, Gillibrand was born into a political family.  Her father was a staffer for Sen. Al D’Amato (D-NY), and her maternal grandmother founded the Albany Democratic Women’s Club.  While studying at Dartmouth College, Gillibrand interned in D’Amato’s Albany office.