Good morning and welcome from Washington, DC where Members of Congress return to work this week to face a few weeks of varying agendas depending on whether they sit in the Senate or the House. We hope our readers enjoyed a restful week and are back energized and ready to go! Your author was able to avoid any travel this past week but unfortunately experienced his first taste of Disney princess fatigue, as I took my young daughter to see the movie Wish. As the movie has a nice premise of free will and establishing one’s own destiny while not falling victim to a charismatic and selfish leader, I was reminded at times, however, it is good to have a collective group think – and we can only aspire that Congress exhibit this ethos to work together this month to avoid a government shutdown come January 19th. Now that the holiday meals have settled, it is time to get to work! Welcome to the Week Ahead!
The Administration
The Biden administration is moving forward to work with the Senate on its supplemental funding strategy which includes funding for Ukraine, Taiwan, and Israel. The administration sees this as imperative to remaining a trusted leader on the world stage with America’s allies and must work this week to make it happen. Timing is of the essence as only a few weeks remain until the end of the legislative calendar for 2023. The deal will basically hinge on border security measure and asylum policies to address migrant issues at our shared border with Mexico.
It was announced this weekend that President Biden will not be attending the upcoming United Nations Climate Summit known as COP28. The President attended the summit over past two years, but the ongoing war between Israel and Hamas has taken much of the President’s time, as he continues to pursue a ceasefire and the release of hostages. John Kerry, President Biden’s special envoy for climate change will attend the summit in his place.
The Senate
Majority Leader Chuck Schumer issued a Dear Colleague letter outlining the Senate’s ambitious agenda for the remainder of the calendar year. The Senate will aim to tackle a variety of challenging policy areas to include leading with President Biden’s supplemental funding request as early as next week. Several Senate offices have stated that a deal must be worked out this week to successfully place the request on the Senate floor during the week of December 4th. Again, any funding request would most likely be paired with border policy changes. Senate Democrats realize that some policy changes are required to get a deal completed in time. In addition to the funding request, the Senate will work with the House on the first set of appropriations bills to keep the government funded past the January 19th deadline. The Senate will also look to pass the NDAA, confirm further judicial nominations, and work to overcome the legislative blockade of Senator Tuberville on military promotions. With all that is happening on the national stage this month, what passes with regards to health care remains to be seen.
The House
As the House shifts focus to holiday parties and fundraisers, there is still plenty of drama remaining in the lower chamber. With the potential ousting of Rep. George Santos, it will be interesting to see who else retires and how the battle for the House heats up. Since Speaker Johnson cut a deal on the budget, it is holiday season around Washington D.C.!!! Christmas and holiday parties begin this week with a slew of fundraising before the final quarter of this year’s fundraising cycle. Congress has punted the budget to next year, and the town will feel the pressure start to cook once they get back from break.
The House will need to work with the Senate to come to a consensus before recess on the President’s supplemental request. This will be quite tricky as the House has already passed Israeli aide with a pay-for. The House may adjourn by December 8th, pending an agreement with the Senate on this request.
With Congress coming back from the Thanksgiving break, we expect a light week in Washington with few hearings and a focus on legislation largely related to issues other than health care. That said, the House Energy and Commerce Committee will hold two separate health-related topics. First, on Wednesday, the E&C Health Subcommittee will hold a hearing titled “Understanding How AI is Changing Health Care,” which is expected to be a broad hearing covering the potential and concerns surrounding AI in health care delivery. On Thursday, the E&C Subcommittee on Oversight and Investigations hearing will hold a hearing titled “Unmasking Challenges CDC Faces in Rebuilding Public Trust Amid Respiratory Illness Season,” where the Subcommittee will hear from Mandy Cohen, M.D., Director, Centers for Disease Control and Prevention and is expected to pursue questioning regarding the origins of COVID-19 and communications during the pandemic.
Also, with the passage of the continuing resolution to fund the government into next year, Congress also extended several health programs and provided protections from potential cuts into January as well. By taking action to prevent pending cuts under the Medicaid Disproportionate Share Hospital (DSH) program, extending the Work Geographic Practice Cost Index floor, and providing an extension of the Teaching Health Center Graduate Medical Education (THC GME), Community Health Centers (CHCs), and National Health Service Corps (NHSC) programs to January 19, Congress effectively punted on addressing larger health-related legislation until at least January—if not later in 2024.
In addition to pushing off the likelihood of any action on legislation targeted at pharmacy benefit managers, mental health or opioids, the extensions of these programs into January also means that Congress is unlikely to take any action to address a scheduled cut of 3.4% in Medicare payments to physicians that is set to take effect on January 1 as well. Readers may recall that in late 2022, Congress passed legislation to provide relief from projected physician payment cuts in 2023 and 2024. While the Senate Finance Committee included a provision to mitigate the cuts in the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, which it cleared earlier this month, the House seems to have little appetite to provide additional relief to physicians in Medicare and the 3.4% cut is likely to take effect in January.
Create a great week!
