Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


Infrastructure Update

The Senate worked over the weekend to consider the $550 billion bipartisan infrastructure package, voting 68-29 to end debate on the bill. The process was delayed over disagreements about allowing additional votes on amendments, with Republicans forcing the chamber to use all 60 hours of debate before a final vote on passage of the bill. Without an agreement about votes on additional amendments to the bill, opponents could use up to an additional 30 hours of debate – setting up a final vote on passage of the bill for Tuesday morning. The Congressional Budget Office (CBO) estimates that the bill will add $256 billion to the deficit over the next decade, while raising $50 billion in revenue during that time. The Senate was scheduled to begin its recess on August 9, but Majority Leader Chuck Schumer (D-N.Y.) has pledged to keep the chamber in session until they wrap up both the bipartisan infrastructure bill as well as the fiscal year (FY) 2022 budget resolution. Consideration of the budget resolution, which is expected to be released Monday, requires 50 hours of debate and allows for the possibility of an unlimited number of amendments being offered.

Senate Appropriators Begin Work on FY22 Spending Bills

The Senate Appropriations Committee advanced its fiscal year (FY) 2022 Agriculture-Food and Drug Administration (FDA), Energy and Water, and Military Construction- VA spending bills last week. Each measure was approved by a 25-5 vote. The FDA would receive $3.4 billion, a $200 million increase. The Department of Veterans Affairs would receive $112.9 billion, including $97.5 billion for VA medical programs, a $7.5 billion increase. Mental health programs at the VA would receive $13.2 billion, a $2.9 billion increase. The committee adopted an amendment from Sen. Jeff Merkley (D-Ore.) that would allow physicians in the VA to respond to questions from veterans about medical cannabis.

The House of Representatives passed nine of the 12 annual appropriations bills before adjourning for August recess. Lawmakers have until the end of the fiscal year on September 30 to pass individual appropriations bills or an omnibus funding measure or to reach an agreement on a continuing resolution (CR) to avoid a federal government shutdown. Both Senate Appropriations Chairman Patrick Leahy (D-Vt.) and Minority Leader Mitch McConnell (R-Ky.) agree that Democrats and Republicans must first negotiate top-line spending figures for each of the 12 spending bills before legislation is considered on the Senate floor. Republicans are pushing to increase defense and nondefense discretionary spending by an even amount, while the White House’s budget proposed a 16.5% increase for nondefense spending and a 1.7% increase for defense.

HELP Advances Suicide Prevention, Maternal Health Bills

The Senate Health, Education, Labor, and Pensions (HELP) Committee advanced four bipartisan pieces of legislation last week aimed at improving suicide prevention, protecting pregnant workers, and supporting individuals with disabilities. The Pregnant Workers Fairness Act (S. 1486), which would strengthen protections for pregnant workers, was advanced by a vote of 19-2. Identical legislation (H.R. 1065) was advanced with bipartisan support by the House of Representatives in May. The Suicide Training and Awareness Nationally Delivered for Universal Prevention (STANDUP) Act of 2021 (S. 1543) would incentivize states to implement suicide awareness and prevention training in schools. The Suicide Prevention Lifeline Improvement Act (S. 2425) aims to improve the suicide prevention hotline to provide higher quality support for callers. Each was approved by voice vote. The 21st Century Assistive Technology (AT) Act (S. 2401) was also advanced by voice vote. The bill would reauthorize the Assistive Technology Act of 1998.

Finance Leadership Launches Bipartisan Mental Health Effort

The Senate Finance Committee has launched a bipartisan effort to address barriers to mental health care in the U.S. Chairman Ron Wyden (D-Ore.) and Ranking Member Mike Crapo (R-Idaho) invite all panel members to contribute to the development of a bipartisan legislative package that they hope to introduce and markup this year. They specifically seek input on improving the behavioral health workforce, care integration, coordination, and access, mental health parity, and ways to expand telehealth services.

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