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CDC Funding: A Partisan Divide

In recent years, calls to defund or significantly reduce the budget of the Centers for Disease Control and Prevention (CDC) have gained traction among certain Republican factions, especially in the wake of the COVID-19 pandemic. Prominent voices within Congress, aligned with former President Donald Trump, have intensified these efforts, advocating for a rethinking of the CDC’s role and funding in public health.    The July 23, 2024, House Energy and Commerce Health Subcommittee hearing with the CDC Center Directors illustrated the partisan divide, with Republicans doubling down on their concerns that the agency overstepped its bounds during the pandemic and is rife with inefficiencies, and committee Democrats, led by Ranking Member Frank Pallone, defending the role of the agency in responding to global health emergencies. He blasted Republicans for reporting out a partisan Labor-HHS Appropriations bill that reduces the CDC budget by $1.8 billion.   

The following details the arguments for and against maintaining and increasing the budget for the CDC. 

Republican Arguments for Defunding the CDC 

  1. Government Overreach

Many Republicans have argued that the CDC overstepped its authority during the COVID-19 pandemic when the agency enforced policies such as mask mandates and lockdowns. They assert that these decisions should be left to individuals or local governments rather than dictated by federal agencies. 

Sen. Rand Paul (R-KY) has made calls for defunding the CDC due to its overreach during the pandemic. He has criticized the agency for infringing on individual freedoms through mandates on masks and vaccines, suggesting that such decisions should not come from a federal entity. 

During the July 23, 2024, House Energy and Commerce Committee hearing, Chair Cathy McMorris Rodgers (R-WA) expressed serious concerns over the CDC’s actions during the pandemic. McMorris Rodgers questioned the agency’s authority to impose mandates restricting personal freedoms, echoing the broader Republican argument against what they see as federal overreach in health policy. 

Rep. Marjorie Taylor Greene (R-GA) has taken her opposition to the CDC further by introducing legislation in 2021 to defund the agency, citing violations of constitutional rights during the pandemic. She maintains this stance, calling for dismantling the CDC to prevent future government overreach. 

  1. Inefficiency and Bureaucracy

Several Republicans have argued that the CDC has become inefficient, suggesting that reducing the agency’s budget would force the agency to focus on its core mission rather than expand into what they view as politically charged areas, like gain of function research. 

Rep. Jim Jordan (R-OH) has prioritized advocating for reducing the size of federal agencies, including the CDC, citing inefficiency.  He criticized the CDC during the COVID-19 response, suggesting in 2023 that its bloated bureaucracy prevented the agency from functioning effectively and that budget cuts going forward would help streamline its operations. 

Sen. Ted Cruz (R-TX) echoed similar concerns, arguing that unchecked funding leads to inefficiency within large federal agencies like the CDC. In early 2023, Cruz called for greater oversight and budget reductions, noting the CDC’s inconsistent messaging during the pandemic as evidence of poor management. 

  1. Economic and Social Impact

Many Republicans contend that the CDC’s recommendations during the pandemic, such as business closures and stay-at-home orders, caused unnecessary economic harm. They argue that defunding the CDC would prevent similar policies from being implemented in the future. 

In 2023, Sen. Cruz continued to push for budget reductions in the CDC, claiming that the agency’s pandemic policies contributed to significant economic damage, particularly for small businesses. He argued that budget cuts would reduce the CDC’s ability to impose economically harmful measures in the future. 

Sen. Paul has similarly highlighted the negative economic impact of the CDC’s pandemic restrictions. In 2023, he renewed calls for defunding the agency, suggesting that this would prevent the CDC from causing similar disruptions in future health emergencies. 

Democratic Arguments for Maintaining or Increasing CDC Funding 

In contrast, some Democrats argue that defunding the CDC would severely weaken the country’s ability to respond to health emergencies. They contend that the agency’s funding should be maintained or increased to ensure the U.S. remains prepared for future health crises. 

  1. Public Health Protection

Democrats consistently argue that the CDC plays a crucial role in protecting public health, particularly in managing pandemics and responding to bioterrorism threats. They contend that defunding the agency would leave the U.S. vulnerable to future health crises. 

Sen. Patty Murray (D-WA) has consistently advocated increasing the CDC’s budget. In 2023, she argued that cutting the agency’s funding would leave the country unprepared for future public health emergencies, putting lives at risk. 

  1. Research and Innovation

Democrats emphasize that the CDC is a leader in public health research, including vaccine development and disease surveillance. They argue that defunding the agency would stifle innovation and slow the development of treatments for infectious and chronic diseases. 

Rep. Rosa DeLauro (D-CT), Ranking Member of the House Appropriations Committee, has consistently highlighted the CDC’s critical role in public health research. In 2023, she argued that reducing the CDC’s budget would halt progress on key research initiatives essential for preventing future outbreaks. 

  1. Preventing Future Crises

Democrats argue that investing in the CDC now will help prevent costly public health crises in the future. They contend that cutting its budget would increase the likelihood of more frequent and severe outbreaks. 

Sen. Elizabeth Warren (D-MA) has long argued that public health funding is critical for crisis prevention. In 2023, she warned that defunding the CDC would undermine the country’s ability to detect and respond to emerging health threats. 

  1. Economic and Social Stability

Democrats argue that a well-funded CDC protects public health and supports economic stability. By preventing widespread disease outbreaks, the CDC helps avoid the economic disruption seen during the COVID-19 pandemic. 

Ranking Member Frank Pallone (D-NJ) of the House Energy and Commerce Committee has stressed the economic benefits of a robust public health infrastructure. He has pointed out that the CDC’s work in preventing diseases and managing outbreaks keeps people in the workforce and reduces health care costs. He has consistently supported increased funding for the CDC, warning that cuts would put public health and the economy at risk. 

Conclusion 

The debate over CDC funding reflects deep partisan divisions. On one side, Republicans like Sen. Paul and Rep. Taylor Greene argue that the CDC has overreached, is inefficient, and should have its budget reduced or eliminated.  

On the other side, Democrats like Sen. Murray, Rep. DeLauro, and Rep. Pallone argue that the CDC is essential for public health protection, research, and crisis prevention. They warn that defunding the agency would leave the country unprepared for future health emergencies, threatening public safety and national security. 

Further partisan disagreement over CDC funding is likely to continue into the lame duck session and efforts to fund the government in FY 2025.  

Week Ahead: Last Week, Best Week?

Congress returns just in time to consider a bipartisan agreement to keep the government funded through December.  On the other side of Pennsylvania Avenue, Ukrainian President Volodymyr Zelenskyy is coming to meet with President Biden and Vice President Harris about the state of the war against Russia. Let’s see what this consequential week holds. Welcome to the Week Ahead! 

The Administration  

Yet Another Obamacare Challenge 

The Department of Health and Human Services (HHS) has requested the Supreme Court review a court decision that partially blocked enforcement of the Affordable Care Act (ACA) mandate for employers to cover certain preventive health services at no-cost. At issue in this challenge is the ruling by the 5th Circuit Court of Appeals that members of the U.S. Preventative Services Task Force (USPSTF)were not properly appointed under the U.S. Constitution’s appointments clause (governing the appointment of Executive Branch officials). The ACA requires that private insurers cover at no cost services that the USPSTF has rated either “A” or “B” (meaning the panel finds that the services have a substantial or moderate net health benefit.) 

 

Will the Supreme Court take up this challenge, and if they do, how will the new Administration respond?  We will also be watching to see to what extent fights about the ACA impact the election, especially with Republican Vice Presidential candidate J.D. Vance’s recent reopening the issue on the campaign trail. 

 

FTC Sues PBMs 

In other health care legal news, the Federal Trade Commission (FTC) announced legal action against the three largest pharmacy benefits managers (PBMs), arguing that these entities have engaged in anticompetitive practices designed to increase profits from insulin.  

The Biden Administration has made addressing concerns about anti-competitive economic practices a top priority, and the FTC has been a leader in those efforts. The agency has faced both internal and external criticism for being too political, but Lina Khan, the agency’s chair, has won bipartisan praise from at least one Republican – J.D. Vance. This means regardless of who wins the White House in November, Chair Khan will have at least the potential for an ally in either Administration. 

The Senate  

Rare Pediatric Disease Priority Review Voucher Program Gets HELP Vote  

The Senate Health Education, Labor, and Pensions Committee will hold a markup on September 26. This markup includes health care legislation such as S. 4583, which would reauthorize the Rare Pediatric Disease Priority Review Voucher Program through September 30, 2024. A similar version of this bill passed out of the House Energy and Commerce Committee in May and both bills have bipartisan support.  

Legislation to reauthorize the Rare Pediatric Disease Priority Review Voucher Program has garnered bipartisan support in both chambers. However, it has also faced criticism based on concerns that not enough oversight is being done to ensure it is meeting its goal of incentivizing the development of rare pediatric disease treatments. We will be watching to see what the Senate HELP Committee will do in regards to legislation to reauthorize this program.  

Health Care Hearings 

  • September 24: Senate Health, Education, Labor and Pensions Committee hearing on Novo Nordisk’s pricing of diabetes and obesity medication 
  • September 24: Senate Finance Committee hearing on women’s reproductive health care 
  • September 25: Senate Homeland Security and Governmental Affairs Committee business meeting, including re: S.4667, the Risk Research Review Act 
  • September 26: Senate Environment and Public Works Superfund, Waste Management, and Regulatory Oversight Subcommittee hearing on the public health impacts of PFAS exposure 
  • September 26: Senate Health, Education, Labor, and Pensions Committee executive session to consider legislation  

The House 

More Health Care Bills on the Docket  

Just like last week, the House has several health care bills on its schedule for floor action the week of September 23. This list of bills includes legislation related to pediatric drug development (H.R. 3433) and Medicaid coverage for U.S. service members (H.R. 8108) that just passed out of Energy and Commerce on September 18. 

Notably absent from the list: Legislation to extend COVID-era telehealth flexibilities, such as the Telehealth Modernization Act (H.R.7623), which also passed out of the Energy and Commerce Committee on September 18. As a reminder, those flexibilities are set to expire at the end of the year. We will be watching for action on this when Congress returns in November. 

Healthcare Hearings 

  • September 25: House Veterans’ Affairs Committee hearing on supporting the Veteran caregiver community 
  • September 26: House Oversight and Accountability Health Care and Financial Services Subcommittee hearing on recent Biden Administration action related to Medicare Part D  

There You Have It 

Election season is in full swing, with early voting already underway in three states! Are you registered to vote? If not, get registered here. Make it a great week!  

Week Ahead: Debates, Deadlines, and Democracy!

With the first (only?) Harris vs. Trump debate behind us, Congress is looking to get a funding deal as they try to get back on the campaign trail ahead of the election. We are hearing the chances are increasing for a bipartisan continuing resolution, but with this Congress in this election cycle, anything is possible. With that, let’s get into it. Welcome to the Week Ahead!  

The Administration 

The Department of Health and Human Services’ Office of Research Integrity ( HHS ORI) is scheduled to publish a rule on September 17 that finalizes the 2024 Public Health Service (PHS) Policies on Research Misconduct, which has not been updated for 19 years. HHS noted that many public comments on this rule expressed general support for better execution and oversight of research misconduct proceedings.  

Oversight of federally funded research has also recently received bipartisan interest in Congress. On September 9, the House of Representatives passed the BIOSECURE Act (H.R.8333) by a vote of 306-81. This bill would prohibit federal agencies from awarding contracts, loans, or grants to biotech companies owned by foreign adversaries. We will be watching to see if this bipartisan interest in oversight of federal funding of research continues into the next Administration and the next Congress.  

The Senate  

Schumer Plans Second Vote on IVF Bill 

Senate Majority Leader Chuck Schumer (D-NY) announced that the Senate plans to hold a second vote on legislation to protect access to vitro fertilization (IVF), a type of fertility treatment. Sen. Schumer has criticized Republicans for previously opposing bringing the legislation up for a vote in June (although Sens. Lisa Murkowski (R-AK) and Susan Collins (R-ME) did vote to bring the bill up for debate).  

We do not expect the bill to move forward this time around, and we suspect Sen. Schumer knows it won’t either. But it is a good opportunity for the Majority Leader to highlight the issues of abortion access and reproductive health, which have generally been seen as winning issues for Democrats following the overturning of Roe v. Wade 

SFC Highlights IRA Ahead of November  

Speaking of highlighting issues before the election, the Senate Finance Committee is scheduled to hold a hearing on the impact of the Inflation Reduction Act on health care costs. As is often the case with congressional hearings, you can identify how the majority feels about the issue or issues being addressed in the hearing by the title: “Lower Health Care Costs for Americans: Understanding the Benefits of the Inflation Reduction Act.”  

We expect Democrats on the committee to use the hearing to praise the Biden-Harris (with perhaps more emphasis on Harris) Administration for implementing the law and highlight how Medicare is already in the process of negotiating drug prices for Medicare beneficiaries to reduce costs. Expect Republicans to counter with charges that the law implements price controls that deny seniors access to innovative treatments and will cause health plans to raise premiums.  

Other Senate Health Hearings     

  • 9/18: Senate Homeland Security and Governmental Affairs Committee business meeting (agenda includes S.4667, the Risky Research Review Act, to create a board to oversee potentially risky scientific research) 
  • 9/19: Senate Health, Education, Labor, and Pensions Committee executive session to consider contempt resolutions against Steward Health Care CEO for refusal to testify  

The House 

Health Markups Maybe on the Horizon  

It sounds like some health care bills might make an appearance in upcoming House Committee markups. Specifically, we are hearing that the House Energy and Commerce Committee is looking to a markup this week which may include extending COVID telehealth flexibilities and other health care bills. Additionally, the House Ways and Means Committee might be looking to move on rural health legislation before the House adjourns at the end of September.  

We will be watching to see if any of these bills make it into an end-of-the-year legislative package.  

Health Care Week at Last? 

We previously reported on the potential for a “health care week” where the House might consider several bills related to health care. Although that never materialized, we expect to see a lot of health care action this week.  

House Majority Leader Steve Scalise (R-LA) announced the schedule for floor action that includes several health care bills on topics such as Medicaid access to care, reauthorization of funding for disease-specific research programs, telemedicine, and more. You can find the list of these bills (along with links to bill text) here 

Passing the House is one thing, but might these bills be included in an end-of-the-year legislative package?  It’s always easier to get bills included in an end-of-the-year package if they are bipartisan and have passed one chamber of Congress. The health care bills that could be considered this week all meet the first part of that criteria. For example, H.R.4758, the Accelerating Kids’ Access to Care Act has 76 Democratic and 48 Republican cosponsors.  

Other Health Care Hearings  

  • 9/18: House Ways and Means Health Subcommittee hearing on chronic disease prevention and treatment 
  • 9/18: House VA Health Subcommittee hearing on oversight of the Veterans Suicide Hotline 
  • 9/18: House VA Health Subcommittee markup  

There You Have It 

On September 17, we celebrate Constitution Day because this is the date the document was signed back in 1787. Check out this list of facts about the Constitution from the National Archives. Do you have any fun facts about the Constitution? Let us know! Make it a great week!  

Week Ahead: We’re Back

Congress is returning to town, with a deadline fast approaching to fund the government past September 30. The word is that Speaker Mike Johnson (R-LA) is planning on bringing up a continuing resolution (CR) that would provide level funding for the government. But Senate Majority Leader Chuck Schumer (D-NY) and Appropriations Chair Patty Murray (D-WA) issued a joint statement on September 6 calling the bill highly partisan and pre-blaming House Republicans of a potential government shutdown.  With that, let’s get into it. Welcome to the Week Ahead!  

The Administration 

Harris and Trump Prepare for Big Debate 

Vice President Harris and former President Trump will face off for the first time on a debate stage on September 10  in Philadelphia. There is a lot to watch for, but we will especially be on the look out to see how the candidates try to position themselves on health care issues. Specifically, will VicePresident Harris be asked to explain her current position on Medicare for All? Will former President Trump be asked if he still wants to repeal the ACA? We will tune in to find out! 

Season of Rules 

The Centers for Medicare and Medicaid Services (CMS) will close the comment period on two proposed rules this week: the Calendar Year 2025 (CY2025) Physician Fee Schedule proposed rule and the CY2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule. We are also expecting HHS to issue a rule to expand coverage mandates for certain types of health plans to provide mental health and substance abuse coverage. 

So What? We will be watching to see how CMS resolves concerns raised about the more controversial parts of the proposed rules. For example, the American Medical Association has been very upset about the proposed reimbursement cuts in the proposed physician fee schedule rule. However, these cuts are Congressionally mandated so there is not much the agency can do. We expect more anger from the AMA if the proposed cuts are finalized.  

The Senate 

HELP Hearing Drama 

The Senate Health, Education, Labor, and Pensions (HELP) Committee is scheduled to have a hearing on September 12 to examine the bankruptcy of Steward Health Care and the impact that management decisions had on patient care. Chairman Bernie Sanders (I-VA) issued a press release Friday announcing the committee will still move forward with the hearing despite Steward CEO Ralph de la Torre’s refusal to testify.   

Dr. de la Torre is refusing to testify, despite a bipartisan subpoena issued by the committee in July. Dr. de la Torre had reportedly requested delaying his testimony until after federal investigations into fraud and corruption allegations were complete but HELP Chair Sanders was not interested in delaying committee action in the wake of what he calls an “outrageous display of corporate greed” that put “patients and communities at risk.” We will be monitoring how the Committee proceeds in the wake of Dr. de la Torre’s decision not to testify.  

Wanted: A New Member for Senate Finance  

After former Sen. Menendez (D-NJ) announced he would be stepping down in light of bribery charges, the Senate Finance Committee was left a member short. This matters because the Committee now has an equal number of Republican and Democratic Senators, which makes it hard for the majority to move legislation unless they have support from at least one member of the minority.  

So, what is to be done? Democratic New Jersey Governor Phil Murphy appointed George Samir Helmy to serve as a U.S. Senator on August 18 until the winner of the November election is determined. To keep things simple, Helmy might be given the opportunity to serve on the Finance Committee until the November elections.  

The House 

BIOSECURE Act on Deck 

House leadership looking to advance biosecurity legislation targeting Chinese biotechnology firms, has placed the BIOSECURE Act (H.R. 8333) on a list of items that could be considered the week of September 9. This bipartisan bill would prohibit federal agencies from awarding contracts, loans, or grants to biotech companies owned by foreign adversaries. The bill would apply the ban to five specific companies of concern and require the publication of a list on an annual basis. The bipartisan bill, which would have major implications for the global biotech industry, has the support of BIO and is expected to pass by suspension. 

Looking ahead for Ways and Means… and Energy and Commerce 

The Ways and Means Committee is planning to get back into the swing of things with health care activity later in September. The committee is likely to hold a hearing on special needs plans (SNPs) focusing on coordination of care and the cost of chronic care. In addition, word is that the committee will also meet to mark-up various bills, including some health priorities, later this month. 

We also are still expecting the Energy and Commerce Committee to announce a mark-up of multiple health bills, including an extension of telehealth flexibilities, later this month.   

Other Health Care Hearings 

  • September 10: House Oversight and Accountability Subcommittee on Government Operations and the Federal Workforce hearing on improper payments and fraud in pandemic programs  
  • September 10: House Energy and Commerce Health Subcommittee legislative hearing on FDA food and tobacco product regulation 
  • September 10: House Education and Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing on employer-sponsored health benefits 
  • September 10: House Select Subcommittee on the Coronavirus Pandemic hearing with former NY Governor Cuomo 
  • September 10: House Veterans’ Affairs Subcommittee on Economic Opportunity Oversight hearing on evaluating mental health support programs for separating servicemembers 
  • September 11: House Veterans’ Affairs Health Subcommittee legislative hearing 
  • September 11:  House Energy and Commerce Subcommittee on Oversight and Investigations hearing on the organ procurement and transplantation network 
  • September 11: House Judiciary Subcommittee on the Administrative State, Regulatory Reform, and Antitrust hearing on PBMs 
  • September 11: House Appropriations Subcommittee on Agriculture, Rural Development, and Food and Drug Administration and House Agriculture Subcommittee on Nutrition, Foreign Agriculture, and Horticulture oversight hearing on food distribution shortages in tribal and elderly communities. 

There You Have It 

Are you planning on watching the presidential debate? Do you play Debate Bingo?  How many health care priorities are on your card? Let us know! Make it a great week!  

Week Ahead: Prepping for a Fast September

Even though Congress hasn’t returned to town, we are resuming the Week Ahead with a preview of what we will be watching for this month. And while we don’t have predictions on who will win the NFL season opener between the Chiefs and the Ravens, we do have plenty to say about what we expect to see in Washington. So, with that, let’s get into it. Welcome (back) to the Week Ahead!  

The Administration 

Biden-Harris Not Slowing Down on ACA Spending 

With record levels of enrollment in plans provided by the Affordable Care Act (ACA), President Biden continues to invest in his legacy to expand insurance coverage.  On August 26, 2024, the Centers for Medicare and Medicaid Services awarded $100M to organizations to help those in underserved communities sign up for coverage.  

Steps like funding for organizations to help keep ACA enrollment up in underserved communities are certainly going to be ways that the Harris-Walz ticket will try to distinguish itself from the Trump-Vance ticket. More U.S. adults hold a favorable view of the ACA than an unfavorable one, according to the latest polling by the Kaiser Family Foundation. How former President Trump, Sen. Vance, and the Congressional Republicans talk about the ACA continues to be a tricky matter as  they look to win back the White House and Senate and maintain control of the House of Representatives.  

FDA Authorizes Updated Novavax Shot 

On August 30, 2024, the Food and Drug Administration (FDA) granted Emergency Use Authorization (EUA) to an updated version of the Novavax COVID-19 vaccine. According to the agency, this vaccine better targets variants of the virus currently circulating across the country. The updated vaccine is authorized for individuals 12 years of age and older.  

This news comes as the United States is experiencing a surge in COVID-19 cases driven by the KP.3.1.1 variant. As summer turns into fall and winter, we expect agencies like the FDA, such as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), to continue to make headlines with stories about their work to stay ahead of new variants of the disease. These variants might drive even worse surges in months when more Americans spend more time indoors.  

The Senate  

Only one health care hearing is currently scheduled for September, but it’s a big one.  Novo Nordisk’s global CEO, Lars Fruergaard Jørgensen, will appear to answer the not-so-subtle charge of “Why Is Novo Nordisk Charging Americans with Diabetes and Obesity Outrageously High Prices for Ozempic and Wegovy?” at the Senate Health, Education, Labor, and Pensions (HELP) Committee. On April 24, Senate HELP Chair Bernie Sanders (I-VT) launched an investigation into Novo Nordisk’s pricing of Ozempic and Wegovy, two popular diabetes and obesity drugs. Chair Sanders threatened a subpoena vote to force testimony by the company’s President of North American Operations. That threat was dropped when the company’s global CEO Jørgensen agreed to testify instead. 

On September 24, 2024, one big thing we will be watching for is how much the ongoing presidential race impacts the hearing. Will Democrats use the event to highlight Vice President Harris’ plans to extend current caps on insulin and other prescription drugs to individuals outside of Medicare? Will Republicans bring up that the Trump Administration created a model to provide insulin to Medicare Part D beneficiaries for no more than $35 before the Inflation Reduction Act mandated it?  

The House  

The House Might Bounce Early  

What we are hearing is the House may not be back in town as long as previously advertised, instead choosing to adjourn a week early and be gone the last week of the month.  

So what? If the House does decide to leave early, it is not scheduled to return until after the deadline for passing legislation to keep the government open. Under the truncated schedule, the House would dedicate one week to focus on legislation related to China and one week to passing a continuing resolution (C.R.) to keep the government open.  However, as anyone familiar with Congress knows, passing government funding bills can be tricky.  

Health Care Hearings  

In addition to a China Week and consideration of a C.R., we are also hearing the possibility of health care bills being considered by the House Ways and Means Committee and the Energy and Commerce Committee before the end of September. Specifically, Ways and Means may be planning a catchall markup to consider several bills, including some related to health care. Energy and Commerce is rumored to be marking up health care legislation, including telehealth legislation. 

There You Have It 

As mentioned, NFL football returns this week, and your author is pumped, especially since his Green Bay Packers are playing in a special Friday game in Brazil (Go Pack Go!). Did you know that Jennifer Bell’s former boss, Sen. John Thune (R-SD), is a Packer fan? Bet you thought he was a Vikings guy. Nope! Who’s your favorite team? Let us know! Make it a great week!  

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