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. 

A History of Annual Congressional Sporting Events

Many Americans love sports, and members of Congress are no different.  A few times a year, lawmakers from both parties gather to play games in a variety of sports with the goal of raising money for charities.  Here are some of the games where Representative and Senators have the chance to take a break from the usual grind of Washington and bring out their inner athlete.

Congressional Baseball Game

Founded in 1909 by a Pennsylvania representative who once played baseball professionally, the Congressional Baseball Game is the oldest of the lawmaker-centric sporting events.  In the game, which has been played at Nationals Park since 2008, Democrats and Republicans form different teams and play against one another.  Congressional staffers, lawmakers’ families, and even some presidents attend the game, which raises money for four charities: the Boys and Girls Clubs of Greater Washington, the Washington Nationals Dream Foundation, the Washington Literacy Center, and the US Capitol Police Memorial Fun.

Congressional Football Game

Started in 2004, the Congressional Football Game features members of Congress and former National Football League players facing off against the US Capitol Police.  An Arizona representative led the effort to start the annual tradition as a way to honor the memory of two Capitol police officers who died in a shooting in 1998.  The Congressional Football game raises money for three charities: the US Capitol Police Fund, Our Military Kids, and Advantage 4 Kids.

Congressional Women’s Softball Game

Sen. Susan Collins (R-ME), Sen. Kirsten Gillibrand (D-NY), Rep. Debbie Wasserman Schultz (D-FL) and several other female members of Congress started the Congressional Women’s Softball Game in 2009.  Each year, a team consisting of female lawmakers plays against women of the Washington, DC press corps.  The game primarily raises money for the Young Survival Coalition, which supports women under 40 who are diagnosed with breast cancer. 

Congressional Soccer Match

Founded in 2013, the Congressional Soccer Match consists of separate teams formed by Democratic and Republican lawmakers that play against one another with help from some former professional soccer players.  Nearly all lawmakers who participate in the annual event are members of the Congressional Soccer Caucus.  The US Soccer Foundation hosts the annual match, which raises funds for several charity programs that help children in underserved communities.

Congressional Hockey Challenge

The Congressional Hockey Challenge began in 2009 from a weekly pickup match consisting of congressional staff and lobbyists.  Each year, members of Congress, congressional staff, and administration officials face off against lobbyists, and proceeds from the annual match go towards the Fort Dupont Cannons, USA Warriors Hockey, Capital Beltway Warriors, the Tampa Warriors, and the Professional Women’s Hockey Players Association.

Members of Congress Related to Celebrities

Most members of Congress aren’t household names, but quite a few have people in their family who are, particularly in the world of film and television.  Here are some notable celebrity-lawmaker connections. 

Rep. Fred Upton (R-MI)

The Michigan congressman’s niece is model and actress Kate Upton.  Kate was born in her uncle’s hometown of St. Joseph, MI but later moved with her family to Florida when she was seven years old.  She rose to fame after appearing in the Sports Illustrated Swimsuit Issue in 2011, and since then, she’s appeared in prominent publications like Vogue and Vanity Fair.  Kate is also a successful actress who has appeared in several hit comedy films including Tower Heist and The Layover.  In 2016, Rep. Upton hosted his niece and gave her  a tour of the US Capitolalong with her husband, Houston Astros pitcher Justin Verlander.

Senate Majority Leader Chuck Schumer (D-NY)

Comedienne and actress Amy Schumer and the Senate Majority Leader are first cousins, once removed.  Both Schumers have appeared publicly together to advocate on issues like gun violence, and in 2016, Amy attended a White House press conference with her uncle when then-President Barack Obama announced new actions on gun control.  However, both cousins were largely estranged from one another during Amy’s childhood, and the senator and the comedienne didn’t start to develop a relationship until Amy’s fame started to grow in 2009.

Sen. John Hickenlooper (D-CO)

The freshman Colorado senator’s cousin is filmmaker George Hickenlooper.  His feature-length documentary, 1991’s Heart of Darkness: A Filmmaker’s Apocalypse, explored the chaotic production of the 1979 Vietnam War film Apocalypse Now.  George’s final film was the 2010 comedy-drama movie Casino Jack, which focused on the corruption scandal surrounding lobbyist Jack Abramoff.  The film notably featured actor Kevin Spacey in the titular role, and George’s cousin John even had a brief cameo in the film.  Sadly, George Hickenlooper died in his sleep at the age of 47 on October 29, 2010, just a month after the film’s release.

Speaker Nancy Pelosi (D-CA)

The speaker’s daughter is filmmaker Alexandra Pelosi, who has filmed, produced, and directed 14 films to date.  Pelosi’s first film was the Emmy-nominated 2002 documentary Journeys with George, which chronicled George W. Bush’s first presidential campaign.  Since then, Pelosi has gone on to receive critical acclaim for a host of other documentaries, including Citizen USA: A 50 State Road Trip, which explored the citizenship process for immigrants, and Meet the Donors, which looks at the influence money has  in politics. 

Former Rep. Mike Capuano (D-MA)

A US Representative from Massachusetts who served from 1999 to 2019, Capuano’s famous nephew is actor Chris Evans.  After playing supporting role in films like 2001’s Not Another Teen Movie and 2005’s Fantastic Four, Evans rose to worldwide fame for his portrayal of the titular role in 2011’s Captain America: The First Avenger.  Since then, Evans has appeared as Captain America in several Marvel Cinematic Universe films, and he’s acted in critically acclaimed films like 2013’s Snowpiercer and 2019’s Knives Out.  Notably, Evans told Esquire in 2016 that he’s considered getting into politics someday, and in 2019, he met with several Democratic senators on Capitol Hill for A Starting Point, new political venture aimed at addressing partisanship and distrust.

Sen. Bernie Sanders (I-VT)

Actor, comedian, writer, and filmmaker Larry David and the former presidential candidate are third or fourth cousins.  Neither man was aware of their relation until historian and literary critic Henry Louis Gates Jr. revealed the family connection in a 2017 episode of Finding Your Roots.  David has played Sanders in multiple episodes of Saturday Night Live since 2016.  Both men were born in Brooklyn, New York City and trace their ancestry back to Ashkenazi Jewish immigrants from Poland.

What Will ARPA-H Look Like?

There’s a new federal agency in town.  The Fiscal Year (FY) 2022 omnibus appropriations bill officially created the Advanced Research Projects Agency for Health (ARPA-H), which the Biden administration first proposed last year to drive “transformational innovation” in health research.  However, the omnibus bill is scant on details, and lawmakers have much to decide about the structure of the new agency.

What’s in the spending bill? Beyond appropriating $1 billion in funds to the new agency through September 30, 2024, the FY 2022 omnibus bill allows the ARPA-H director to use those funds to make awards in the form of “grants, contracts, cooperative agreements, and cash prizes.”  Notably, the bill gave the Department of Health and Human Services (HHS) 30 days to decide whether the new agency would be independent or part of an existing institution, like the National Institutes of Health (NIH).

The issue of whether to make ARPA-H an independent agency within HHS or house the new agency within the NIH has been the subject of debate for months.  Public health experts who testified before a congressional panel on February 8 unanimously agreed that ARPA-H would need to foster an independent culture to be successful in delivering biomedical breakthroughs, and most witnesses and lawmakers felt that housing the ARPA-H within NIH would make it impossible to cultivate its own identity and operating structure. 

Since then, more details about ARPA-H have come into focus.  In a March 31 congressional hearing, HHS Secretary Xavier Becerra announced that ARPA-H would be placed within NIH.  However, Becerra did offer key details that suggests the administration wants to help foster an independent culture within the new agency.  For example, he said the ARPA-H director will be under the supervision of the HHS secretary, not the NIH director.  Additionally, Becerra clarified that ARPA-H would not be “physically housed” within NIH.  According to Becerra, the reason for the new agency’s placement within NIH is to allow ARPA-H to focus on research from the get-go while NIH handles all the administrative work like human resources and legal functions.  

However, the makeup and structure of ARPA-H won’t be up to the Biden administration.  That’s the job of Congress where a trio of authorizing bills are under consideration that flesh out the details of ARPA-H. The bills – the Cures 2.0 Act plus the House and Senate versions of the ARPA-H Act – propose similar requirements on the new agency, such as:

  • Presidential appointment of the APRA-H director for one five-year term, with the option to extend for one additional term.
  • Establish goals for delivering biomedical breakthroughs by prioritizing high-risk, high-reward innovations and identifying potential areas of health research advancement that industry stakeholders aren’t currently addressing due to technical or financial reasons.
  • Collaboration with other HHS entities like the Food and Drug Administration (FDA).

There’s one key area where the bills differ – the Cures 2.0 Act calls for APRA-H to be a part of NIH, while both versions of the ARPA-H Act say the new agency should be independent within HHS.  The House Energy and Commerce Subcommittee on Health held a legislative hearing on March 17 to review both the Cures 2.0 Act and the ARPA-H Act, and currently, House leadership supports the ARPA-H Act, which increases the odds the new agency will ultimately be independent from the NIH

As lawmakers continue their work, stakeholders outside of Washington are focusing on a different question: the specific location of ARPA-H.  While Becerra told lawmakers back in March that the new agency wouldn’t physically be a part of the NIH campus in Bethesda, Maryland – neither the FY 2023 omnibus bill nor the three authorizing bills say anything about where ARPA-H should be headquartered.  Currently, cities in California, Massachusetts, North Carolina, and Texas are lobbying to become the location of the new biomedical research agency.

Congress is in recess until the week of April 25, and neither chamber has indicated when it will markup and vote on their respective authorizing bills on APRA-H.  Until the finish line is in sight, conversations over the makeup of ARPA-H – and whether it should be a part of the NIH – are likely to continue

Can Lawmakers Pass Comprehensive Drug Pricing Reform This Year?

The White House is not giving up hope on Congress passing legislation this year to allow Medicare to negotiate on drug prices, according to a White House domestic policy advisor who spoke at  AHIP’s National Conference on Health Policy and Government Health Programs in March.  But if a recent Senate Finance Committee hearing is any indication, the odds of this proposal passing in Congress this year are slim to none.

A Brief History of Recent Drug Pricing Proposals

Allowing Medicare to negotiate with drug manufacturers on prices has been a cornerstone of Democrats’ drug pricing proposals for some time now.  Negotiation was a major health care provision of the Build Back Better Act and President Biden reiterated the need for negotiation in his State of the Union on March 1.

Republicans have never been receptive to negotiation over fears that it would amount to price controls and leave pharmaceutical companies with fewer resources to develop new drugs.  However, in 2019, there was a sense of cautious optimism that a bipartisan compromise on drug pricing policy could be reached. That year, Sens. Ron Wyden (D-OR) and Chuck Grassley (R-IA) introduced a sweeping bipartisan measure that would cap out-of-pocket drug costs under Part D once a beneficiary hits a certain threshold.  But this legislation fell apart after then-Senate Majority Leader Mitch McConnell (R-KY) said he had no interest in bringing the bill up for a vote in the Senate, prompting Wyden to withdraw his support.

The Drug Pricing Debate in 2022

As the 2022 midterm elections approach, many Democrats believe their window of opportunity to pass comprehensive drug pricing reform is rapidly closing.  Despite this, Democrats don’t seem to be in any mood to compromise.  During the March 16 hearing of the Senate Finance Committee, Democrats were unanimous in their support for lowering drug prices through negotiation, which the committee’s Republican members continually opposed. 

Instead, committee Republicans including Ranking Member Mike Crapo (R-ID) voiced support for the Lower Costs, More Cures Act, which would establish an annual out-of-pocket cap of $3,100 for Medicare Part D enrollees – similar to the Grassley-Wyden bill – and allow certain patients to pay in monthly installments.  But Democrats on the Finance Committee didn’t seem interested in half-measures.  For instance, Wyden said out-of-pocket caps would simply “pass higher prices to someone else, like taxpayers.” 

It’s not as if Democrats are completely opposed to the idea of price caps.  During the hearing, Sen. Raphael Warnock (D-GA) touted his bill to cap copayments for insulin at $35 a month – a proposal Biden endorsed in his State of the Union.  However, Republicans seem opposed to this stand-alone measure, even though it’s similar to the Lower Costs, More Cures Act provision that would make permanent the Center for Medicare and Medicaid Innovation model that enables Part D enrollees who take insulin to limit out-of-pocket costs to $35.  During the hearing, Sen. Pat Toomey (R-PA) suggested rising insulin costs over the years have contributed to “tremendous innovation” of insulin products.

What happens next? Warnock said he wants to get his insulin pricing cap bill to the Senate floor by Easter.  The chances of this bill passing don’t look good at the moment and barring a break in the logjam between Democrats and Republicans on negotiation, progress on overall drug pricing reform doesn’t seem likely, either.  Both parties seem entrenched on their preferred legislative solutions to tackle high drug prices to the point that relatively bipartisan proposals like the Grassley-Wyden bill of 2019 wouldn’t stand a chance in passing.

But if Congress can’t do it, maybe the administration can, according to some Democrats.  Seemingly having lost hope in Congress to deliver on major Democratic policy proposals, many Democratic lawmakers are urging President Biden to sidestep Congress and take whatever executive actions necessary to lower the cost of prescription drugs.  On March 17, the Congressional Progressive Caucus issued a list of recommendations for executive action that includes drug pricing, among other issues. 

However, the Biden administration has yet to comment on which specific actions it could take, and any new executive orders on drug pricing could be subject to change – either in the courts or by the next administration.   Therefore, any serious attempt at drug pricing reform this year may still only be through Congress, no matter how slim the odds may be.

Congress’s Long-Standing History of Delaying Medicare Cuts

Medicare cuts are coming.  Automatic spending cuts like Medicare sequestration and PAYGO were initially put in place with the goal of reigning in federal spending, but time after time, Congress has delayed them to shield the popular health care program from payment cuts.  These cuts are nothing new – in fact, they’re part of a long-standing tradition that began with the Sustainable Growth Rate (SGR).

PAYGO and Sequestration: A Brief History

Two laws currently trigger mandatory cuts to Medicare if lawmakers pass legislation that adds to the deficit.  The first, the Statutory Pay-As-You-Go (PAYGO) Act of 2010, requires the president to implement spending cuts to mandatory programs like Medicare and farm support if the Office of Management and Budget (OMB) determines there is a deficit on six- or 11-year PAYGO scorecards. 

The second law is the Budget Control Act (BCA) of 2011, which sets off across-the-board cuts to both mandatory and discretionary spending if spending exceeds explicitly set limits, or “caps.”  These cuts included a maximum 2% reduction in payments to Medicare providers known as Medicare sequestration.

However, Medicare is an incredibly popular program, with over 61 million beneficiaries.  Lawmakers are certainly sensitive to the political consequences of cutting funding to the popular federal health care program, which is why they’ve taken action to avoid automatic cuts as much as possible.  To date, neither the Medicare sequester nor the PAYGO cuts have ever gone into effect.

The SGR’s Precedent for Delaying Medicare Cuts

Congress’s strong tradition of delaying cuts to Medicare goes back to the SGR, which was implemented as part of the Balanced Budget Act of 1997.  The SGR created a formula that was intended to prevent Medicare spending growth for the Physician Fee Schedule (PFS) from exceeding GDP growth.  However, health care spending was continually outpacing GDP growth, making it clear that cuts to the PFS were inevitable.  To avoid the reimbursement cuts for physician services, Congress passed legislation to prevent the cuts from going into effect 17 times between 2003 and 2015.

The need for Congress to keep kicking the can down the road to prevent PFS cuts came to an end in 2015, when lawmakers enacted the Medicare Access and CHIP Reauthorization Act (MACRA).  It replaced the SGR formula with the Merit-Based Incentive Payments System (MIPS), which measures Medicare providers based on performance.  While MIPS hasn’t been without its faults, the new law means Congress no longer has to take action every year to address the SGR. 

It’s worth noting the SGR is not the same as PAYGO and sequestration – while the former only impacted physician payment, the latter affects reimbursement to Medicare providers more broadly. However, both have negative implications for providers and patients if they’re carried out, which is why Congress has regularly prevented such cuts from going into effect. 

Fortunately, Congress no longer has to deal with the SGR on an annual basis because after 15 years, lawmakers finally stepped up to pass legislation to make structural changes to the way physicians are paid.  Does that mean lawmakers will one day step up to make the structural necessary to stop kicking the can down the road every year with Medicare sequestration and PAYGO cuts? 

Congress last took action to address the Medicare sequester and PAYGO when it enacted the Protecting Medicare and American Farmers from Sequester Cuts Act in December 2021.  The law waives a 4% PAYGO cut until 2023, and it imposes a moratorium on the Medicare sequester until April 1, when a 1% cut goes into effect.  In July, the Medicare sequester then increases to 2%. 

While structural changes to address Medicare sequestration and PAYGO are possible, Congress is more polarized now than it was when passed MACRA seven years ago, leaving little room to pass comprehensive legislation to reform the budgeting process.  Additionally, the BCA and the PAYGO Act are far more complex than the legislation that eventually replaced SGR and would require significantly more effort for lawmakers to advance.  Therefore, until there’s widespread agreement among both parties on how to reform Medicare’s payment system, the near-annual ritual of delaying Medicare cuts is likely to continue to for some time.

For the 2022 Midterms, the GOP’s Future Is Female

Republicans are favored to do well in the 2022 midterm elections – after all, the party that occupies the White House historically almost always loses seats in Congress.  But Republicans don’t just want to rely on tried-and-true historical trends to win more seat this fall.  Instead, they’re focused on replicating a strategy that delivered better-than-expected gains for 2020 – supporting female candidates for congressional seats.

The 2018 midterms marked a low point for female Republican lawmakers, especially in the House.  That year, the number of GOP women holding House seats declined from 23 to 13 – which was the same number of Republican women serving in the House in 1989.  In contrast, 2018 saw 36 new Democratic women elected to the House.

To reverse the trend, Republicans adopted a new strategy: support GOP women running at the primary level.  Numerous organizations and political action committees (PACs) like Republican Women for Progress, Elevate PAC, Winning for Women, VIEW PAC, and Elise Stefanik’s E-PAC stepped up to offer their support, based on how the Democrats used Emily’s List to back their female candidates.  Additionally, more GOP women opted to run in 2020, probably in reaction to Democrats’ success in 2018. 

Issues matter, too.  With more and more college-educated men and women increasingly voting for Democratic candidates, many of the Republican women who ran for Congress in 2020 focused less on typical pro-business, main street policies that typically won over moderate voters.  Instead, they focused more on issues related to gun control and abortion that are more popular with the Republican Party’s base.

The new strategy paid off.  The number of GOP lawmakers in the House rose from 23 to 38 in the House after November 2020, beating the previous record high of female Republican representatives of 30.  In contrast, the number of Democratic female lawmakers grew from 89 to 106.  More so, every Republican who flipped a Democratic House district in 2020 was a woman or person of colorThere are now 144 women who are  members of the 117th Congress, compared to 127 in the 116th Congress

Based on the GOP’s success in 2020, the Republican Party is now trying to replicate its strategy of supporting female candidates to regain control of Congress this November.  According to the National Republican Congressional Committee, a record high number of 253 female Republicans have filed to run for House seats, with key recruits in competitive districts like Monica De La Cruz (Texas), Esther Joy King (Illinois), and Jen Kiggans (Virginia).  Additionally, Republicans are also keen on keeping female freshman of the 117th Congress in their seats. 

There are many factors that will affect the midterm elections, like the state of the economy and President Biden’s approval ratings.  However, given historical trends favoring Republicans and the success of Republican women in the 2020 elections, the GOP may have found a winning combination to ensure success in 2022.  And with the Senate split 50-50 and Democrats only having a five-seat majority in the House, it won’t take much for a record high number of female Republican candidates to move the needle and shake up Congress this fall.

When Will the Capitol Reopen to Visitors?

Washington, DC is coming back.  Since the Omicron wave has receded, the Smithsonian is expanding hours at its museums, foot traffic is picking up along K Street, and downtown bars are feeling a little more crowded during happy hour.  But one major exception to DC’s reopening is the US Capitol Complex, which is still largely closed to visitors.  As the rest of the nation continues to transition to a new normal, lawmakers and advocates are wondering when the Capitol will follow suit.

The Evolving Situation for Visitors

Since the Capitol was closed to the public in March 2020, congressional leaders have yet to publicly outline a reopening timeline.  While guests can currently visit members’ offices in the House and Senate office buildings, not just anyone can walk through the door.  All visitors to members’ offices must register in advance and require a member or staff escort upon arrival.  Additionally, both the House and Senate limits the number of visitors per group.

The reopening process has been off to a gradual start in the Senate.  In December 2021, the Senate reinstated tours for visitors, albeit with strict limitations in place.   Individual Senate offices are only allowed two 30-minute tours per week.  All tours must be staff-led, and only tours of up to six visitors each are permitted every half-hour between 9am and 3pm.  Additionally, tours are limited to the Crypt, the Rotunda, and the Brumidi Corridors.

The Senate took another step towards normalcy on March 1, 2022 when it passed by unanimous consent a resolution to reopen the Senate office buildings to the public.  Since then, lobbyists and other visitors have been able to meet in Senate offices on official business.

Calls to Fully Reopen Capitol Complex Grow

As jurisdictions across the country have loosened COVID-19 restrictions over the past few weeks, a growing number of lawmakers say it’s time for the Capitol to fully reopen to the public.  Sen. Gary Peters (D-MI)  is supportive of more broadly restarting Capitol tours, while Rep. Eleanor Holmes Norton (D-DC) called for the Capitol complex to reopen to visitors on March 8 to aid Washington, DC’s tourist economy.  Allowing more visitors on the Hill would align with work habits of congressional staff, who have been increasingly showing up to work in-person after nearly two years of working remotely. 

External stakeholders are weighing in, too.  On March 9, the National Institute for Lobbying and Ethics sent a letter to congressional leaders to start  a dialogue with them on how to reopen the Capitol to the public without appointments.

Why reopen? Congress is an institution that serves the people.  Great strides have been made in advocating virtually, but it’s no replacement for developing relationships through in-person interactions.  By keeping lawmakers and their staff physically separated from the public, advocates are justifiably concerned that they’re limited in how they can communicate their message.

What Reopening Could Look Like

Fortunately for advocates, it appears that congressional leaders are at least thinking about allowing visitors to House offices and tour the Capitol more freely.  According to news reports, the Capitol will kick off its reopening on March 28 with a three-phase process lasting several months. 

  • Starting on March 28, Phase 1 will see the limit on groups of visitors increase from nine to 15, along with the resumption of staff-led tours.  Additionally, school groups will once again be permitted to tour the Capitol, although these tours will be limited to 50 students. 
  • Phase 2 begins on May 30, which will see a “limited reopening” of the Capitol Visitor Center.”
  • Phase 3 will bring a full reopening by Labor Day, although details are still being worked out. 

It should be noted that reopening plans thus far are highly tentative, and the US Capitol Police and the House and Senate sergeants at arms offices are still hashing out the specifics.  A major reason why the reopening is being drawn out over the spring and summer is staffing problems with the Capitol Police, which is currently short hundreds of officers – the department’s training academy was closed during the pandemic, and hundreds of officers resigned following the January 6th riot.

Democrats and Republicans haven’t always been seeing eye to eye in discussions over how to reopen for the past few weeks.   On March 3, House Majority Leader Steny Hoyer (D-MD) outlined  some of his concerns during a somewhat tense colloquy with House Republican Whip Steve Scalise (R-LA).  During the colloquy, Hoyer said the Office of the Attending Physician and the Sergeant at Arms are looking into reopening “from a health and security standpoint.”  Hoyer didn’t offer a specific reopening timeline, simply stating, “as soon as we can do that responsibly, we ought to do that.”  Addressing security, Hoyer expressed a desire to have a “gun-free” and “weapon-free” Capitol once it reopens, and he implied the Republicans weren’t taking ramifications of the January 6th riot seriously enough.

Indeed, the security apparatus at the US Capitol Complex haven’t changed much since the deadly riots over a year ago.  The Fiscal Year (FY) 2022 omnibus appropriations bill contains additional funds to update security measures on the Hill and provide for more Capitol Police officers, but this measure was only signed into law days ago, and it will take time for the additional funds to translate into tangible security improvements at the Capitol.  Without new security measures in place, some Democratic lawmakers are still worried that the Capitol is vulnerable to another attack.

The decision to reopen the Capitol is a major step towards normal for lawmakers, advocates, and the general public.   Nonetheless, congressional leaders and the Capitol Police face a difficult job over the next few months as they try to balance the importance of allowing lawmakers to connect in-person with their constituents while addressing security concerns for all parties involved.

How Is the Pandemic Changing Dress Codes on Capitol Hill?

It’s time to reopen the US Capitol to visitors, say a growing number of lawmakers.  Last month, 26 Republicans senators cosponsored a resolution to reopen the US Capitol and Senate Office buildings to the public, and Sen. Gary Peters (D-MI) said he’s supportive of restarting tours in the Capitol building.  Even external stakeholder are joining the call – the National Institute for Lobbying and Ethics sent a letter to congressional leaders today urging leadership to start a dialogue with them on how to reopen the Capitol to the public without appointments .

But Congress can’t reopen to the American people without staff members to take meetings and give tours.  Like a lot of Americans, congressional staff have spent most of the past two years working remotely while wearing casual, everyday attire.  What does this mean for the dress code once staffers return to in-person work in Washington? 

Before the pandemic, congressional staff wore professional, business attire on days Congress was in session, while casual attire was permitted when Congress was in recess.   

Since May 2021, staff have been gradually returning to in-person work in Congress, although the actual number of people in offices have shifted based on the surges of the pandemic ( for instance, in early January 2022the Office of Attending Physician urged staff to return to “maximal telework” due to a surge of the Omicron variant ).  Since then, DC-based staff have been dressing more casually in congressional offices, although some exceptions remain.  For example, professional attire is still the norm when appearing on the House or Senate floor or in a committee hearing.  Additionally, staff for congressional leadership like Speaker and the Senate Majority Leader also tends to lean professional.

It’s no surprise that most congressional staff reporting to work in-person can get away with more casual attire when they aren’t taking in-person meetings as congressional offices and the Capitol are still effectively closed to visitors.  Therefore, what does this mean for when the US Capitol Complex reopens to the public? 

While the pandemic has shaken up many aspects of office life, dress codes on Capitol Hill aren’t likely to change significantly, at least for when Congress is in session.  Even though office workers throughout the US have been drifting towards casual clothing more and more in the years leading up to the pandemic, attire in the halls (and offices) of Congress have been slow to change.   Even amid the brutally hot summers of DC, congressional staff still make their way to Capitol Hill in suits.  Once visitors return to the Hill, staffers are likely to greet them in the kind of professional attire they would have seen pre-pandemic – albeit with some slightly casual tones.

How to Rock the Virtual Advocacy Meeting in 2022

Two years into the pandemic, and advocates are still primarily connecting with lawmakers in Washington over a telephone line or computer screen.  However, much has been learned over the past two years, and there are plenty of best practices that you can use to make sure your next virtual meeting with a member of Congress is knocked out of the park.

Embrace Videoconferencing

In the pandemic’s first year, conference calls seemed to be the modus operandi for advocates connecting with members of Congress and their staff.  Over the course of 2021, advocates and congressional offices alike increasingly warmed up to the idea of using videoconferencing platforms for meetings – with Zoom being an overwhelming favorite.  Here are some tips and tricks for using Zoom to your advantage.

  • For multiple meetings at the same time, use multiple accounts.  The basic Zoom plan that’s free-of-charge only allows you to schedule one meeting at the same time.  However, scheduling more than one meeting for the same time slot is easy – just use a verified email account to create a new Zoom account. This will allow advocates to run a new meeting that will run concurrent with what’s already on the calendar.  When setting up more than one meeting at the same time, it’s essential to keep in mind two things:  make sure the waiting room is NOT selected, and select the option to allow participants to join at any time.  These two steps will allow participants to meet without the host, which is the person who holds the Zoom account.   
  • Do not schedule meetings with the same Zoom account-back-to-back.  If the ability to allow participants to join early anytime is selected, a participant could join a meeting early only to find that they are inadvertently part of a meeting that’s still running.  Ensuring at least a 30-minute window between meetings on the same Zoom account will prevent any accidental overlap on meeting attendees. 
  • Double-check your links.  Scheduling multiple meetings can be tedious, so make sure all the Zoom links you created are for the intended meeting participates.  This will help avoid cases of participants entering the wrong meeting or starting the meeting at the incorrect time. 

Make Calendar Invitations Your One-Stop-Shop

When your meeting is scheduled, send an invitation via Outlook or another email service to all meeting participants.  This way, both the advocates and congressional offices know who’s attending, which 1) gives the advocates an opportunity to coordinate beforehand and 2) provides a way for advocates and congressional staff to follow-up after the meeting. 

Additionally, be sure to include other information that’s necessary to all participants to have a successful meeting:  This could include:

  • Links to Zoom, WebEx, or other videoconferencing platform.
  • Meeting materials like PowerPoint slides, one-pagers, leave-behinds, and links to relevant external sources.
  • Information about the legislator (connection to organization, past support of the advocacy issue, membership on relevant committee, etc.).

Recruit New Advocates

When setting up virtual meetings, don’t just rely on your normal “crew” that you could count on to meet legislators in-person.  Instead, look for people that may not be able to make travel arrangements to Washington but have plenty to add to the conversation.   With virtual meetings, geography and distance doesn’t pose any limitations, and advocates from anywhere can join your meeting to share a story with a congressional office.

Could Manchin and Sinema Get Primaried for 2024?

Sens. Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ) have torpedoed key Democratic proposals like voting right reform and the Build Back Better Act, which has sparked some lawmakers like Sen. Bernie Sanders (I-VT) to say that he would support primary challengers against both of his Democratic colleagues.  In theory, this would give Democrats an opportunity to replace both Manchin and Sinema with Senators who are more supportive of the party’s legislative agenda.  But what is the likelihood of a Democratic challenger replacing either of them in the Senate?

Joe Manchin

As much as he remains a thorn in the side of many congressional Democrats, Joe Manchin is probably the only Democrat capable of winning a statewide seat in the Mountain State.  That’s because the state leans heavily Republican – in the 2020 presidential election, Donald Trump won West Virginia with nearly 69% of the vote, the second-highest percentage carried by either presidential candidate that year (Wyoming was first, with Trump carrying nearly 70% of the vote). 

Additionally, all winners of statewide races in West Virginia, who are currently holding elected office, are Republicans.  This includes Manchin’s colleague in the Senate, Shelley Moore Capito (R-WV), and all five directly elected executive branch officials in West Virginia’s state government including Republican Gov. Jim Justice.

Even if a Democratic candidate were to successfully defeat Manchin in the 2024 primary, they would almost certainly lose the general election.  In 2018, Manchin defeated his Republican opponent by a margin of only 3%, and it’s highly unlikely a Democrat even one iota further to the left would have fared any better.

It is also worth noting Joe Manchin is quite popular among West Virginia voters.  A recent poll by the American First Policy Institute showed 59% percent of voters approve of Manchin – nearly double of President Joe Biden’s approval rating of 30% in the state.  Manchin is also very familiar to West Virginia voters, having severed six years as governor before being elected to the Senate in 2010.  Even though West Virginia isn’t friendly territory for Democrats, Manchin has proven time and time again he’s the only Democrat capable of winning the state.

Kyrsten Sinema

The senior Arizona senator isn’t as immune to a primary challenger, however.  Arizona is a purple state that has been gradually trending blue.  President Joe Biden won the state in the 2020 general election by a razor-thin 0.4% margin, while then-Democratic candidate Mark Kelly defeated Sen. Martha McSally (R-AZ) by a margin of 2.4%.  In theory, this would give a Democratic senator candidate who’s slightly to the left of Sinema – and more supportive of the party’s legislative agenda – at least a somewhat viable shot at winning a statewide race. 

Like Manchin, Sinema is up for reelection in 2024, and while no Democrats have officially announced plans to primary Sinema, Rep. Ruben Gallego (D-AZ) has publicly expressed interest.  The Phoenix-area congressman has been openly critical of Sinema before, and in January 2022, he met with some of Sinema’s donors in New York City.   

More so, Sinema’s popularity has been dropping among Democratic voters in Arizona.  Sinema started 2021 with a 60% approval rating among Arizona Democrats, but since she voiced her opposition to the Build Back Better Act tax provisions and filibuster changes necessary to bring about voting rights reform, her approval rating among the state’s Democrats has dropped to just under 10% in January 2022.  With low approval ratings, a potential formidable challenger, and a state electorate leaning ever so slightly blue, Sinema could face some serious headaches if she seeks an additional Senate term two years from now.

However, a lot can change between now and 2024.  If the Democrats lose their majority in the Senate in the 2022 midterm elections, Manchin and Sinema’s hold on the party’s agenda won’t be quite as noticeable.  Additionally, priorities can change quickly, and Democrats may not be as occupied with sweeping legislative proposals over the next two years.  But at least in the case of Sinema, opportunities for potential primary challenges remain ripe.