CONGRESS

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.  

How Congress May Regulate the Use of Artificial Intelligence in Health Care

Artificial intelligence (AI) is transforming health care, offering ways to improve diagnostics, optimize treatment plans, and enhance patient outcomes. However, its rapid growth raises issues around privacy, safety, bias, and ethics, all of which require regulation. While current frameworks offer some level of oversight, Congress and the Administration have begun exploring new ways to regulate AI, especially in health care. 

Key Areas of Focus for Congressional Regulation 

Data Privacy and Security 

AI systems require massive amounts of health care data to function effectively. Current laws, such as the Health Insurance Portability and Accountability Act (HIPAA), oversee the protection and sharing of medical data. However, HIPAA was not designed with AI in mind. New frameworks may be needed to manage the complexities AI introduces, like the integration of non-traditional data sources and real-time analytics. 

Congress has not passed specific legislation focused on AI data privacy in health care, but there are relevant discussions. Senate Majority Leader Chuck Schumer (D-NY) has taken a leading role in shaping U.S. policy around the use of AI through the formation of bipartisan AI task forces focused on crafting comprehensive legislation to address the rapid advancements in AI, including its implications for health care.  Schumer has expressed concern over the risks associated with AI in health care, particularly regarding patient data privacy, potential algorithmic bias in diagnostic tools, and the need for transparency in AI-driven decision-making. His approach seeks to balance the promise of AI in improving health outcomes with the need for safeguards to protect patients and ensure equitable access to these advancements. 

The House Energy and Commerce Committee, chaired by Rep. Cathy McMorris Rodgers (R-WA), held several hearings focusing on AI in health care. The hearings are part of the Committee’s broader effort to understand and shape the role of emerging technologies in the health sector. The discussions centered on the potential benefits AI could bring to patient care, including improved diagnostic accuracy, faster drug development, and enhanced health care access, particularly in rural and underserved areas.  The hearings also delved into the risks and challenges associated with integrating AI into health care systems. Key concerns discussed included the need for stringent data privacy protections, preventing algorithmic bias that could lead to health care disparities, and ensuring AI tools are transparent and explainable to both patients and providers. 

Safety and Accountability 

Ensuring AI-driven medical technologies are safe is critical. The Food and Drug Administration (FDA) regulates medical devices, including certain AI systems. However, AI presents unique challenges due to its evolving nature, where algorithms may change after initial approval. Current regulations do not always account for this, and Congress may need to create new frameworks to ensure continuous monitoring. 

One such framework may be legislation such as the Artificial Intelligence for the Armed Forces Act which would encourage the use of AI while ensuring safety standards.  While this bill focuses more on defense than health care, Congress could use similar principles to shape legislation addressing health care-specific AI, requiring continuous monitoring and real-time updates to safety regulations. 

An additional approach could be The Advancing American AI Act, which passed the Senate in 2021.  This bill calls for creating government standards for AI across sectors, including health care. Standardization could lead to the development of a more uniform way to evaluate the safety of AI systems in medical settings. 

Bias and Fairness 

AI in health care can perpetuate biases if it is trained on skewed or incomplete data. This is particularly concerning when AI tools are used to diagnose or make treatment decisions, potentially exacerbating disparities in care for marginalized populations. 

On September 24, 2024, Senator Ed Markey (D-MA) introduced legislation to address bias in the use of AI. The Artificial Intelligence Civil Rights Act would prohibit developers from offering or using algorithms that discriminate based on characteristics like race or gender. Additionally, the FDA has acknowledged the issue of bias in AI, proposing guidelines that developers must follow to ensure their algorithms are trained on diverse datasets. Congress may push for legislation that mandates transparency in developing AI health care tools to minimize biases. 

Ethical Standards and Human Oversight 

AI optimizes many aspects of health care, but ethical concerns remain, especially when AI is involved in patient care decisions. AI is already assisting health care professionals in diagnosing diseases, planning treatments, predicting outcomes, and managing population health.  Congress may consider regulations requiring human oversight in critical health care decisions to prevent AI from being the sole decision-maker. Additionally, the need for ethical guidelines to prevent AI from prioritizing efficiency over patient well-being is essential. 

While there is no AI-specific health care legislation addressing ethics, the Biden Administration’s AI Bill of Rights emphasizes the need for meaningful human oversight of AI decisions and proposes guidelines to ensure AI technologies are used ethically. This could lead to future regulations that enforce human oversight in health care AI applications. 

 

Current Legislative Efforts 

Though Congress has yet to pass comprehensive AI health care-specific legislation, several bills touch on important aspects of AI regulation. One key bill is the National AI Initiative Act of 2020 which would establish a national AI strategy.  While not enacted, the bill lays the groundwork for further sector-specific regulations, including health care. The AI in Government Act of 2020 also would seek to improve AI use across federal agencies and could influence how AI is implemented in federally funded health care programs. 

Conclusion 

AI holds tremendous promise for improving health care but also brings new risks requiring legislation and regulatory oversight. While Congress has yet to enact specific legislation targeting AI in health care, discussions are underway. The focus on data privacy, safety, bias, and ethical standards will likely guide future action. By balancing innovation with patient protection, Congress can shape a health care system where AI enhances care while safeguarding rights and well-being. 

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