The Week Ahead

Let’s start with 3 questions about timing this week.  See if you can guess the answers! 

• What happened on time?   Selection Sunday for the NCAA Men’s and Women’s Basketball Tourneys – one of our favorite events of the year! 
• What happened early?  Cherry blossoms.  The National Park Service declared peak blooms hit on March 17 – the second earliest peak on record. 
• What happened late? Well, sort of, we still don’t have a clear path to fund the government past March 22.  Better late than never?! 

The Administration 

Health and Human Services Sec. Xavier Becerra will makes a second set of appearances this week on the President’s Budget.  His testimony before the Senate Finance Committee last week touted the Administration’s efforts to lower prescription drug costs and increase the number of people insured under the Affordable Care Act.  Expect more pointed questions in the House Appropriations Committee about funding priorities and the House Ways and Means Committee about Medicare and health savings accounts on March 20. 

What hasn’t yet come up in these hearings is the Administration’s response to the cyberattack on Change Healthcare, a unit of UnitedHealth Group that processes 15 billion health care transactions annually and touches 1 in every 3 patient records.  CMS, the HHS Office of Civil Rights, and the Department of Labor have all sent out notices of assistance within their jurisdiction.  The American Hospital Association has indicated the response to date has been woefully inadequate. 

The Senate 

The mad dash this week is to make sure the government remains funded past March 22 and before both the Senate and House will go back to their states and districts for a 2-week district work period.  While appropriations leaders have been working through the weekend, there’s no paper yet.  

We will be keeping our eyes peeled for any updates on the AI front, as the Gang of Four was predicting releasing their lessons learned from the various AI Insight Forums held over the last few months.  While the leaders will release a set of findings and suggested direction, the work of legislating will be left to the committees. 

The House 

If it feels like déjà vu all over again, you’re not alone.  We have 1 week to go to fund 6 major departments including HHS, Education, Labor, Homeland Security, Defense, State, and Treasury.  Funding for Homeland Security is one of the sticking points.  We had been anticipating the possibility of certain health care policy riders being attached, such as pharmacy benefit manager reform, hospital price transparency, and community health center funding, but it looks like these proposals may have to wait until after the election. 

• Don’t forget – Rep. Ken Buck (R-CO-4) is retiring on March 22 – shrinking the GOP majority to a mere 5 votes (218-213). The margin will likely shrink further when New Yorkers go to the polls on April 30 to select a replacement, likely a Democrat, for the recently retired Rep. Brian Higgins (D-NY-26).  

Besides Sec. Becerra’s appearance before the House Ways and Means Committee, we will be watching closely as the House Energy and Commerce Health Subcommittee rips into FDA’s controversial proposed rule to regulate lab developed tests on March 21. The full Committee may also be marking up a number of health and non-health bills. 

So, here we go – March Madness – DC style.  If you have a free minute, don’t forget that MedPAC and MACPAC sent up their annual March Reports to Congress!  If you remember being able to receive those pubs by mail, let us know….  

Kicking of Women’s History Month, Nikki Haley won the primary in the District of Columbia, making her the first woman to win a Republican primary in US history. The other big news of the weekend was that congressional leadership, along with congressional appropriators, released a bipartisan package of six bills to stave off a government shutdown.  The goal of both chambers is to pass the spending bills by Friday’s partial government funding deadline.

The Administration

President Biden will deliver the State of the Union this Thursday, as the administration hopes to land a winning message with voters.  The President will focus on his accomplishments to include infrastructure and others, while he makes the case for another term. The President will rally around staying the course to continue steady progress as opposed to new leadership. Themes will focus on corporations paying their fair share, protecting democracy, and ending cancer among others.  Despite having the bully pulpit, many polls show President Biden losing to Donald Trump if the election was held today.

The Senate

The Senate will take up the bipartisan appropriations bills once they are passed by the House to avoid a partial government shutdown on March 8.  All signs appear to point to passage, but we can never be too certain in this environment.  The bills included are Agriculture-FDA, Commerce-Justice-Science, Energy-Water Development, Interior-Environment, Military Construction-VA, and Transportation-HUD.  Both sides of the aisle are claiming victory on this package, as funding in many areas largely remains flat.  Funding for the remaining bills will run through March 22 per the earlier passed continuing resolution.

Healthcare

On Wednesday, March 6, the Senate Budget Committee will hold a hearing on how primary care improves health efficiency.  Additionally on Thursday, the Senate HELP Committee will hold full committee hearing on the Older Americans Act.  The OAA is usually met with bipartisan support.

The House 

The House is back in on Tuesday, with 5 bipartisan health policy-related bills on the schedule for the week, covering issues including maternal health, pediatric research, dental health, promoting primary care in Medicaid, and reauthorizing the Firefighter Cancer Registry.

Drawing more attention though will be the House’s consideration of a legislative package that was released Sunday that will finalize funding for government programs and agencies through the remainder of Fiscal Year 2024.  In the closely divided Congress, the package gives both parties victories to champion while there will certainly be detractors among their ranks as well. While Republicans are celebrating certain cuts and law enforcement provisions, Democrats are touting their own success in stopping many cuts and policy riders that Freedom Caucus members had been pushing. Even with some naysayers, the House is expected to pass the legislation by a large margin before sending it to the Senate later this week.

Healthcare

In addition to funding these agencies and programs, the appropriations package includes expiring programs included the Medicaid Disproportionate Share Hospitals (DSH) Program, the Work Geographic Practice Cost Index (GPCI) Floor, and funding for Teaching Health Center Graduate Medical Education (THC GME), Community Health Centers (CHCs), and the National Health Service Corps (NHSC). House Energy & Commerce Ranking Member Frank Pallone (D-NJ) praised the agreement which includes a 10 percent increase for CHCs, a 17% increase for the NHSC, and a 56% increase in THC GME. In addition, after much back and forth, the legislation also provides a 1.68% increase in Medicare physician payments to help mitigate the 3.34% cut in Medicare payments that took effect on January 1.

While the final package also includes measures to reauthorize substance abuse programs under the SUPPORT Act, despite previous optimism, negotiators were unable to reach an agreement on larger health legislation on pharmacy benefit manager reforms, site neutral payment policies, and a reauthorization of the Pandemic and All Hazards Preparedness Act (PAHPA). Conversations continue on these measures with action later this year still very much a possibility.

With a busy week for health policy on the House floor, it will be a little quieter week in most House committees. That said, the House Oversight & Accountability Committee’s Select Subcommittee on the Coronavirus Pandemic will hold what could be an interesting hearing on Wednesday, March 6, titled the “White House Role in Pandemic Preparedness and Response,” where it will hear testimony from Maj. Gen. Paul Friedrichs, M.D. (ret.), the White House’s Director of the Office of Pandemic Preparedness and Response Policy.

As always, please reach out with any questions as we continue to track the developments of this week!

Good morning from Washington, DC where the sun is shining, and the town is all abuzz about the finally unveiled bipartisan border package.  Last night, text was revealed after months of negotiations from bipartisan negotiators.  Like anything with good intention in Washington, it was met with mixed reviews and vocal opposition.  The bill was negotiated by Sens. Lankford (R-Okla.), Sinema (I-Ariz.), and Murphy (D-Conn.). The provisions, discussed below, mark the most aggressive and substantive reforms on immigration and border security in years. House Republicans, who wanted border security tied to any supplemental war funding to Ukraine, Israel, and others, are now retreating from the bill.  As previously discussed, election politics and the hand of the presumptive presidential nominee are impacting support while impeding any initial progress. Speaker Johnson labeled the bill “dead on arrival” in the House.  Nothing like members of Congress calling for reform, achieving the reform in legislation, then blasting it as a non-starter. Just like Madonna said, Congress keeps on pushing us – over the borderline. Welcome to the Week Ahead!

The Administration

President Biden will spend some of this week and next pushing for passage of the Senate negotiated border security bill. The bill provides key supplemental funding for Ukraine and other allies. Republican opposition for the bill is largely mounted in not giving President Biden a win on the issue nine months before the election. Opposition is coming from both sides of the aisle, as the ACLU and Latino organizations are concerned the bill does not have substantive immigration reform.  Senator Alex Padilla (D.Cali.) has already opposed the measure.  

In other news, Secretary of State Blinken will be doing a four-day Middle East tour coming on the announcement of a more severe attack on Iran-backed targets due to previously reported drone strikes killing Americans. The President will also speak congressional Democrats at their policy retreat later this week.

The Senate

The border security deal faces a questionable path this week in the Senate.  A summary can be found here. The bill will cost $118 billion and provides over $48 billion in funding to Ukraine, as well as $10.6 billion to Israel.  As mentioned, the bill has opposition from both parties. Minority Leader McConnell, a staunch advocate for Ukraine funding, will face a huge test within his caucus to get support for the bill.  Leader Schumer stated he never worked so closely with McConnell on any other piece of legislation, adding fuel to the fire for Senate Republicans taking shots at McConnell for the top spot. Schumer promises a procedural vote this week which will be the first test of support for this legislation.  

Health Care 

Artificial intelligence in health care is an area in which policymakers want to better understand the impact of technology on a myriad of areas. Currently, AI is used to benefit physicians such as radiologists in analyzing images, it is also used to track cancer, and helps insurers processing claims. Critics of the use of AI in health claim insurers utilize algorithms which disproportionately impact communities of color and sicker individuals further exasperating health disparities. This week, the Senate Finance Committee is holding a hearing Thursday discussing the promises and pitfalls of AI in healthcare. Stay tuned as we cover this important hearing which will surely be the first of several. Also on Thursday, the Senate HELP Committee will hold a hearing on why the US pays more for prescription drugs than any other country.

The House 

The House reconvenes on Monday, and while there are several bills for consideration, it will be another light week for health policy on the House side of the Capitol. Much of the energy from the House will be focused on leadership’s vocal opposition of the border security bill.  Speaker Johnson has already mentioned introducing a standalone bill with funding for Israel – a measure he is hoping would divide Democrats. 

Health Care

While notable health legislation is not expected on the House floor, the Ways and Means Committee will hold on hearing on “Examining Chronic Drug Shortages in the United States,” on Tuesday. The hearing advisory and witness list have been posted online as well. While it will be relatively quiet in the House committees, House committee activity on health issues is expected to pick up in February and March.

As negotiations pick up on appropriations legislation, the March 8 deadline for several expiring health programs looms. The House Republican Doctors Caucus and physician organizations are continuing their push for relief from the 3.37% cut in Medicare payments that took effect on January 1. While indications point some form of relief being passed by Congress in the coming weeks, nothing has been agreed to and conversations continue.

Create a great week.