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What Happened, What You Missed: November 13-17, 2023

Congress Averts Shutdown with “Laddered” CR 

Congress averted a government shutdown days ahead of a November 17 deadline through enactment of a 2-part “laddered” CR this week.  Originally conceived by the House Freedom Caucus and introduced by Speaker Mike Johnson (R-LA), the laddered CR addresses House Republicans’ concerns of voting for another large omnibus funding bill all at once by creating a January 19 deadline for 4 appropriations bills for Fiscal Year (FY) 2024 and a February 2 deadline for the 8 remaining FY 2024 spending bills.  While Democratic lawmakers initially panned the idea of a laddered CR, the measure went on to earn widespread support from Democrats over an eagerness to avoid a shutdown ahead of a busy Thanksgiving travel season, as well as a lack of viable alternatives.  However, the CR’s passage does not meaningfully advance the debate on FY 2024 spending levels, and gridlock on appropriations is expected to continue through the holiday season.  

CDC: Childhood Cancer Deaths Dropped 24% in Last 20 Years 

The rate of pediatric cancer deaths in the US declined 24% between 2001 and 2021, according to new data released by the Centers for Disease Control and Prevention (CDC).  The fall in cancer deaths can largely be attributed to advances in the treatment of childhood cancer, namely leukemia.  However, the CDC data found noteworthy racial and ethnic disparities on pediatric cancer mortality.  While the cancer death rate for all children declined at the same level between 2001 and 2011, Black and Hispanic children saw only a minor drop in cancer death rates between 2011 and 2021.  Public health experts say the financial burden on families with children undergoing cancer treatment as well as limited access to high-quality pediatric cancer treatments like gene therapies may be to blame for these disparities. 

Longest-Serving Physician in Congress to Retire 

Rep. Michael Burgess (D-TX) announced Monday he will not be seeking reelection in 2024.  First elected to Congress in 2022, the obstetrician-turned-lawmaker is the longest-serving physician in Congress, and he currently serves as co-chair of the House GOP Doctors Caucus.  A longtime Republican voice on health care issues, Burgess chaired the Health Subcommittee of the House Energy and Commerce Committee from 2017 to 2019 and served as the subcommittee’s top Republican from 2019 to 2021.  A stalwart critic of the Affordable Care Act (ACA), Burgess played a key role in advancing legislation to overhaul the way physicians are reimbursed by Medicare in 2015. 

White House Announces New Women’s Health Initiative 

President Joe Biden launched the White House Initiative on Women’s Health Research on Monday to address a long-standing lack of funding women’s health research and revolutionize how the federal government approaches the topic.  To be led by First Lady Jill Biden, the initiative plans to deliver recommendations within 45 days on ways the Biden administration can improve how research into women’s health is conducted and identify opportunity for additional investment.  While funding for the National Institutes of Health (NIH) has grown for the past 8 consecutive years, only 10.8% of funding is spent on women’s health.  Additionally, while conditions like heart disease, multiple sclerosis, and Alzheimer’s disproportionately affect women, most of the research and testing around these conditions focus on men.    

ICMYI: DC Teased with Possible Panda Return 

Chinese President Xi Jinping hinted in a speech this week that panda could return to Washington, DC when he noted a desire to “continue our cooperation” panda conservation.  Xi’s remarks came following a meeting with President Joe Biden in San Francisco amid rocky relations between the two powers.  The news sparked hope in Washington, DC area residents who have been mourning the recent departure of pandas from the National Zoo, who have since arrived in China. 

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What Happened, What You Missed: October 23-27, 2023

New Speaker Outlines Plan to Wrap Up FY24 Appropriations Process

In a letter to House Republicans, newly elected Speaker Mike Johnson (R-LA) outlined a plan to extend government funding in the likely scenario that Congress fails to reach a deal before the current November 17 deadline., Johnson proposed a continuing resolution to January 15 or April 15, 2024 in order prevent members from succumbing to pressure to agree to a what Republicans may perceive as a less-than-ideal Fiscal Year (FY) 2024 omnibus before Congress leaves for its holiday season break.  Johnson also laid out a schedule for the House to pass its 8 remaining FY 2024 appropriations bills before November 17.

Survey: 51% Working-Age Adults Struggle to Afford Health Care 

Just over half of working-age Americans across all insurance types have trouble affording health care costs, according to a survey from the Commonwealth Foundation.  Types of coverage surveyed include employer sponsored plans, individual and marketplace coverage, Medicare, and Medicaid.  Additionally, the survey found that more that 50% of respondents who delayed care due to costs said a health problem became worse as a result.  The survey found nearly one-third of Americans have medical or dental debt that they are paying off over time, with 85% owing more than $500.  To address health care affordability, the report suggests lowering health care cost growth and adjusting premiums based on employee income.

Biden Asks Congress for More Money to Fight Fentanyl

The White House requested $1.55 billion from Congress this week to address fentanyl overdose deaths as part of a broader package to address domestic priorities like child care, nutrition assistance, and national security.  The funds would be included with grants the administration currently gives to states, territories, and tribes to support overdose prevention services, bolster addiction recovery, and improve addiction treatment.  The administration also requested funding for 1,000 additional Customs and Border Protection officers to focus on counter-fentanyl trafficking activities.  According to the Centers for Disease Control and Prevention (CDC), 150 people die every day from overdoses related to synthetic opioids like fentanyl.

HELP Committee Advances Bertagnolli Nomination over Sanders’ Objection

National Cancer Institute (NCI) Director Monica Bertagnolli, MD is one step closer to becoming the first permanent National Institutes of Health (NIH) director in nearly 2 years after the Senate Health, Education, Labor, and Pensions (HELP) Committee voted 16-5 to advance her nomination on October 25.  Chairman Bernie Sanders (I-VT) was the sole member of the majority to oppose Bertagnolli’s nomination due to her unwillingness to support the use of march-in rights to address high prescription drug costs.  Sanders’ vote against Bertagnolli has not been his only criticism of NIH – just two days before the committee vote, he alleged that NIH leadership had violated the Bayh-Dole Act by awarding an exclusive patent license for an NIH-funded cancer therapy to a company connected to a former NIH employee.

ICYMI: Bowman Faces the Music for Fire Alarm Shenanigans

Rep. Jamaal Bowman (D-NY) plead guilty this week for the misdemeanor charge of improperly pulling a fire alarm in a congressional office building.  According to a deal with the DC Office of the Attorney General, Bowman’s charges will be dropped in 3 months if he submits a formal apology and pays a ,000 fine. (Provigil)  Typically, one misdemeanor count of a false fire alarm could be punishable by up to 6 months in prison and a $1,000 fine in DC.  Bowman says he pulled the fire alarm because he was trying to unlock a door in order to vote in time.

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What Happened, What You Missed: September 18-22, 2023

House GOP Momentum on CR Comes to a Halt

House Republican leadership scrapped a plan earlier this week to hold a procedural vote on a continuing resolution (CR) to fund the government after September 30 due to lingering opposition from hardline conservatives. Speaker Kevin McCarthy (R-CA) modified plans for a 30-day CR by capping Fiscal Year (FY) 2024 spending levels at $1.47 trillion and adding some border security measures as a means to win over Freedom Caucus members who were initially opposed to a stopgap funding measure. However, nine House Republicans declined to support the new CR proposal, which boosts the odds of a shutdown at the end of the month. Even if McCarthy’s stopgap appropriations agreement had succeeded in the House, his CR would have likely been dead on arrival in the Senate, which has taken a more bipartisan approach to FY 2024 spending.

Administration Revives Free COVID-19 Test Program

The Biden administration is bringing back a program that will allow Americans to order free COVID-19 tests ahead of a possible winter surge in cases. Starting on September 25, every US household can order four free COVID-19 rapid tests on COVIDtests.gov to be delivered directly to their home. According to the administration, the tests are able to detect the latest variants and are intended to be used through the end of 2024. To ensure the availability of tests, the administration is also providing $600 million to 12 manufacturers to produce 200 million tests. For the past three years, COVID-19 cases have peaked in January.

KFF: Most Nursing Homes Don’t Meet Proposed Staffing Requirements

Very few nursing homes in the US meet staffing requirements as proposed by the Biden administration, according to a survey from the Kaiser Family Foundation (KFF). The survey found that less than 20% of nursing facilities would meet the proposed staffing requirements at any time, although results varied across states. While all nursing facilities in Alaska would be able to meet the proposed requirements, only 1% of facilities in Louisiana would meet them. The recently proposed requirements call for facilities to have a minimum of 0.55 registered nurse (RN) and 2.45 nurse aide hours per resident day, as well as require facilities to have an RN on staff 24 hours per day, 7 days per week.

Poll: Americans Want More Controls on Opioids

Voters from both parties broadly agree on increasing control of opioids like fentanyl by enacting stronger border controls and punishing drug dealers, according to a Morning Consult poll. However, there were partisan differences with how to address the opioid crisis, with Republicans opposing harm reduction strategies like syringe services that Democrats tend to support. The poll also found that voters tend to see the opioid crisis more as a security issue than a health issue, which benefits Republican candidates who are perceived as stronger on security than Democrats. Voters who live in border states like Arizona, California, New Mexico and Texas were more likely to label the opioid epidemic as a security issue, according to the poll.

ICYMI: Senate Drops Enforcement of Dress Code

The US Senate will no longer enforce its dress code for senators, according to a recent announcement from Majority Leader Chuck Schumer (D-NY). The change was primarily made to accommodate Sen. John Fetterman (D-PA), who prefers to wear hooded sweatshirts and shorts. Senators from both parties and the Washington Post editorial board were quick to condemn the change, noting that it could lead to a slippery slope where lawmakers would eventually wear sports team apparel and clothing with inflammatory political statements on the Senate floor. However, the dress code will continue to be enforced for Senate staff.

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What Happened, What You Missed: September 4-8, 2023

Odds of Shutdown Grow as Appropriations Gridlock Continues

The White House is urging Congress to agree to a short-term continuing resolution (CR) to keep the federal government open after the current fiscal year (FY) ends on September 30. To date, only the House has advanced an appropriations bill for FY 2024, although the Senate is considering moving forward on a package of spending bills as soon as next week. However, with little time remaining for a bipartisan, bicameral FY 2024 spending agreement, the Senate appears to be signaling that the upper chamber will address the looming appropriations deadline with a bipartisan CR of their own. However, widespread disagreements over spending among Republicans in the GOP-controlled House make the path forward on a bicameral CR increasingly tenuous, which raises the odds for a government shutdown in just over three weeks.

Health Affairs: 32% of HHS Appointees Leave for Private Industry

About one in three political appointees at the Department of Health and Human Services move on to positions in the private industry, according to a study published in Health Affairs. The study examined HHS appointee exits across three presidential administrations from 2004 to 2020. While Republicans were more likely to appoint individuals to HHS from industry than Democrats, political appointees from both parties departed for industry jobs at similar rates. The study’s authors noted that the 32% does represent the true extent of transitions to the private sector, as some non-profit roles support commercial interests. According to the study, appointees’ departures to industry shouldn’t be surprising given higher compensation in the private sector.

Moderna: New COVID-19 Vaccine Effective against BA.2.86

Moderna’s new COVID-19 vaccine that’s set to become available this fall offers a strong immune response to the BA.2.86 Omicron subvariant, according to data published by the company. Moderna’s new vaccine was initially developed to target XBB.1.5, which was the most prevalent Omicron subvariant in early 2023. BA.2.86 has 34 to 36 different mutations in the spike protein compared with XBB.1.5, which has sparked concerns that the new subvariant could evade protection from new vaccines. Fortunately, according to Moderna, its new shot induces aan 8.7-fold increase in neutralizing antibodies against BA.2.86. Additionally, a trio of studies introduced in the past week suggest that BA.2.86 is not as infectious as previous subvariants.

New CMS Model Aims to Address Chronic Diseases

The Centers for Medicare and Medicaid Services (CMS) launched the States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD) Model on Tuesday, which aims to partner with states to address chronic disease, behavioral health, and other medical conditions. Participating states will work with CMS to redesign health care delivery to improve the total by improving the quality and efficacy of care delivery and reducing health disparities. The AHEAD Model hopes to incentivize better health outcomes by providing hospitals with a prospective payment stream via hospital global budgets. The model also intends to boost coordination across payers, providers, and community organizations in participating states. A Notice of Funding Opportunity (NOFO) will be released in late fall 2023.

ICYMI: Most Americans Want Age Cap for President

Some 76% of Americans say there should be a limit for how old someone can be to serve as president, according to a poll from The Economist/YouGov. The poll comes amid growing questions about the age and health of US politicians. For example, 81-year-old Senate Republican Leader Mitch McConnell (R-KY) recently froze up at a press conference, while 90-year-old Sen. Dianne Feinstein (D-CA) did not appear in the Senate for several months due to shingles and other health issues.

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What Happened, What You Missed: May 29-June 2, 2023

Debt Ceiling Deal Takes Back “Some” Unspent COVID Funds

The debt ceiling agreement, passed this week in the House by a 314-117 bipartisan vote, includes the withdrawal of $30 billion in unspent COVID-19 relief funds, which was a top priority for Republican negotiators. However, funding for two COVID-19 programs will remain untouched: an initiative to provide free COVID-19 vaccines to the uninsured, and a project to develop the next generation of COVID-19 vaccines and treatments. According to the Biden administration, some of the unspent money can be used to offset cuts to nondefense spending. The bill would also prevent steep cuts to health care programs in the Labor, Health and Human Services, Education and Related Agencies appropriations bill by keeping nondefense discretionary spending levels nearly flat for Fiscal Year (FY) 2024 and allowing a 1% increase for FY 2025.

KFF: 600K Have Lost Medicaid Coverage since April 1

Over 600,000 Americans have lost Medicaid coverage since the beginning of April, according to a new analysis from the Kaiser Family Foundation (KFF). April 1 marked the earliest date that states could begin to terminate Medicaid enrollment for individuals no longer eligible. According to KFF, the overwhelming majority of people who lost coverage in most states were dropped because of technicalities, not because state Medicaid offices determined they no longer meet Medicaid income limits. Some of the technicalities that result in disenrollment include a failure to complete the enrollment process. The large jump in disenrollments is stoking fears that the end of continuous Medicaid enrollment could mean a significant number of enrollees will eventually lose coverage. Before April 1, KFF estimated that over a quarter of Americans, or 93 million, had coverage under Medicaid or the Children’s Health Insurance Program (CHIP).

CMS Announces Limited Coverage Plan for Alzheimer’s Drugs

The Centers for Medicare and Medicaid Services (CMS) announced that Medicare will eventually cover a new class of Alzheimer’s drugs in specific cases, but only after the Food and Drug Administration grants traditional approval. According to the announcement, Medicare will cover the drugs when a physician and clinical team participate in the collection of evidence about how these drugs work in the real world, known as a registry. Under current CMS policy, Medicare only covers the drugs if the patient is participating in a clinical trial. Known as Leqembi and Aduhelm, these new Alzheimer’s disease treatments work by targeting amyloid plaques in the brain, which is associated with a slower progression of memory loss. However, these treatments have been marred with controversy for the past few years, both for their high price tag, mixed results on efficacy, and side effects related to brain bleeding and swelling.

Study Finds Similar Patient Outcomes Between MDs and Dos

There are no major differences between medical doctors (MDs) and doctors of osteopathy (DOs) when it comes to patient experience and clinical outcomes, according to a study recently published in the Annals of Internal Medicine. Of the nearly 330,000 Medicare admissions analyzed in the study, patient mortality rates for MDs and ODs were nearly identical at around 9.5%, while hospital readmission rates for both stood at just under 16%. Additionally, the length of stay for both MDs and ODs was 4.5 days. While DOs and MDs must both follow a lengthy education process, DOs focus on a more holistic or whole-person approach to care delivery, while MDs focus on diagnosing and treating medical conditions.

ICYMI: National Zoo Welcomes First Baby Gorilla in 5 Years

Lucky visitors to the Smithsonian National Zoological Park this summer might get a chance to see the zoo’s first baby gorilla in five years. The infant, who was born late last week, is a critically endangered lowland gorilla. The Great Ape House space in the zoo provides its gorilla residents access to private space, so visitors may not be able to always see the youngest member of the zoo’s lowland gorilla family.

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